Feasibility and ethical issues: experiences and concerns of healthcare workers regarding a new RSV prophylaxis...

Area of Science:

• Public Health
• Pediatrics
• Immunology

Background:

• Respiratory Syncytial Virus (RSV) significantly impacts young Inuit children, leading to hospitalizations.
• Palivizumab prophylaxis is standard for high-risk infants, but eligibility was expanded in Quebec to include healthy full-term newborns in Nunavik.
• This expansion aimed to address high RSV hospitalization rates in this specific population.

Purpose of the Study:

• To evaluate the impact of the expanded palivizumab prophylaxis program on Nunavik's health services.
• To identify challenges, concerns, and needs of healthcare workers (HCWs) during the program's initial implementation (2016-2017).

Main Methods:

• An ethnographic approach was employed to gather data.
• Semi-structured interviews were conducted with 20 healthcare workers involved in the program's rollout.
• Interviews focused on HCWs' experiences and suggestions for program enhancement.

Main Results:

• Key challenges included increased workload and concerns regarding the necessity and efficacy of palivizumab for healthy full-term newborns.
• Communication gaps among stakeholders and ethical considerations related to the Inuit population were also reported.
• The program proved to be resource-intensive, highlighting feasibility and acceptability issues.

Conclusions:

• The study identified significant implementation challenges and concerns among healthcare workers.
• Further evidence-based data on palivizumab's effectiveness in healthy full-term infants is required.
• Involvement and consultation with the Inuit population are crucial for future program development and success.