Patient and provider perspectives on how patient trust within the patient-provider relationship influences maternal vaccine acceptance among pregnant women in Kenya Público
Nganga, Stacy (Spring 2018)
Published
Abstract
ABSTRACT
Background: altered immune systems during pregnancy and the inability to vaccinate newborns until they are at least 6 weeks old puts both mother and child at high risk of infections. Maternal immunization is therefore critical for the safety of pregnant women and newborns everywhere. This study aimed to find out how the patient-provider relationships impacts maternal vaccine uptake, particularly in the context of developing countries where limited literature exists.
Methods: In-country research team conducted semi-structured, in-depth narrative interviews. Both providers and pregnant women were interviewed from four different sites in Kenya: Kisumu, Nairobi, Mombasa and Marsabit. Interviews were conducted in either English or, when needed, in one of the local regional languages and translated to English.
Results: we found that patient trust in health care providers (HCPs) is integral to vaccine acceptance among pregnant women in Kenya. Theirs is a fiduciary relationship whereby the patients’ trusts is primarily rooted in the provider’s social position as a person who is highly educated in matters of health. Furthermore, patient health education and provider attitudes are crucial for reinstating and fostering that trust, especially in cases where trust is impeded by rumors and religious / cultural factors.
Conclusion: Patient trust in providers is a strong facilitator for vaccine acceptance among pregnant women in Kenya. To maintain / increase this trust, providers must foster a positive environment that allows for positive interactions and patient health education. This includes improving provider attitudes towards patients and learning effective risk communication.
Table of Contents
TABLE OF CONTENTS
Chapter 1: Introduction 1
Objectives and Aims 2
Research Problem 3
Chapter 2: Literature Review 5
Maternal Vaccines 6
Need for maternal vaccines 6
Available maternal vaccines 7
Current maternal vaccine coverage 7
Major factors influencing vaccine uptake/ acceptance 8
Patient- Provider Relationship 9
Types of patient- provider relationships 9
Physician- centered models 9
Patient- centered models 11
Mutual Models 12
Effects of the Patient- Provider Relationship on vaccine acceptance 14
Patient trust in providers as a facilitator for acceptance 14
Provider Attitudes/ patient voice as a function of patient trust 15
References 17
Chapter 3: Manuscript 18
Cover Page 19
Abstract 20
Introduction 21
Methods 22
Results 25
Discussion 29
References 33
Tables 34
Chapter 4: Public Health Implications 46
Recommendations 47
Appendices 48
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