Maternal immunization in Malawi: A mixed methods study of community perceptions, programmatic considerations, and...

Area of Science:

• Public Health
• Vaccinology
• Global Health

Background:

• Maternal immunization is crucial for infant and maternal protection against infectious diseases.
• Despite its importance, maternal immunization coverage remains low in low- and middle-income countries (LMICs).
• Tetanus toxoid vaccination in Malawi's antenatal care demonstrates successful delivery strategies.

Purpose of the Study:

• To explore community perceptions of maternal immunization in Malawi, using tetanus vaccine as a model.
• To identify factors facilitating the introduction of new maternal vaccines, such as influenza vaccine.
• To understand challenges and opportunities for enhancing maternal immunization programs in LMICs.

Main Methods:

• A mixed-methods study was conducted in Malawi in 2015.
• Included 18 focus group discussions with pregnant/postpartum women and families.
• Involved 76 semi-structured interviews with diverse stakeholders, including health workers and policymakers.

Main Results:

• Community acceptance, existing tetanus vaccine delivery strategies, and positive health worker attitudes support new maternal vaccines.
• Challenges include identifying target populations, monitoring adverse events, and ensuring health system capacity.
• Limited awareness and prioritization of influenza disease pose specific challenges for its introduction.

Conclusions:

• Malawi's experience with maternal tetanus immunization offers valuable insights for other LMICs.
• Successful implementation requires addressing community perceptions, health system readiness, and vaccine-specific challenges.
• Optimizing delivery of existing and new maternal vaccines is critical for improving maternal and infant health outcomes.