Barriers to childhood immunization in sub-Saharan Africa: A systematic review

作者：Joseph Benjamin Bangura, Shuiyuan Xiao, Dan Qiu, Feiyun Ouyang, Lei Chen · 发表于：BMC Public Health · 年份：2020 · DOI：10.1186/s12889-020-09169-4 · 被引用次数：341 · 研究领域：Vaccine Coverage and Hesitancy、Immune responses and vaccinations、Bacterial Infections and Vaccines

BACKGROUND: Immunization to prevent infectious diseases is a core strategy to improve childhood health as well as survival. It remains a challenge for some African countries to attain the required childhood immunization coverage. We aim at identifying individual barriers confronting parents/caretakers, providers, and health systems that hinder childhood immunization coverage in Sub-Saharan Africa. METHOD: This systematic review searched PubMed/MEDLINE, Web of Science and EMBASE. We restricted to published articles in English that focused on childhood immunization barriers in sub-Saharan Africa from January 1988 to December 2019. We excluded studies if: focused on barriers to immunization for children in other regions of the world, studied adult immunization barriers; studies not available on the university library, they were editorial, reports, reviews, supplement, and bulletins. Study designs included were cross-sectional, second-hand data analysis; and case control. RESULTS: Of the 2652 items identified, 48 met inclusion criteria. Parents/caretakers were the most common subjects. Nine articles were of moderate and 39 were of high methodological quality. Nine studies analyzed secondary data; 36 used cross-sectional designs and three employed case control method. Thirty studies reported national immunization coverage of key vaccines for children under one, eighteen did not. When reported, national immunization coverage of childhood vaccines is reported to be low. Parents/care...