Social Science

PSYCHOLOGICAL AND OPERATIONAL BARRIERS

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ABSTRACT
Background: Adverse Events Following Immunization (AEFI) surveillance is a key mechanism for monitoring the
safety of vaccines. Little is known about the barriers affecting its functionality among healthcare workers in
Nor

thern Nigeria. This study aims to identify the barriers health workers experience and provide understanding of
the surveillance system.
Methods: A cross-sectional study was conducted among three hundred and eighty-seven (387) healthcare workers
in Kano State, Nigeria. All healthcare facilities in the metropolitan zone were included. Self-administered
questionnaires were used for data collection. Collected data were statistically analyzed using Stata version 15
software at a significance level of p0.05.
Results: Out of the 387 respondents, 299 (77.3%) reported they had experienced an AEFI. Among those who had
encountered an AEFI, over half (258, 86.3%) indicated they had reported it. The results obtained in this study
showed a significant association between gender, job position, and training with reporting (p0.05) of AEFI.
Barriers to reporting AEFI were managing the patient is better than reporting (121, 40.47%), not knowing about the
AEFI reporting system (115, 38.46%), guilt about having caused harm (108, 36.12%) and planned to do it later, but
forgot (103, 34.45%). However, barriers that showed significant association with reporting AEFI were “those who
do not think AEFI is necessary to be reported” (p=0.00), “not knowing about the AEFI reporting system” (p=0.04)
and “managing the patient is better than reporting” (p=0.04).
Conclusion: Not knowing about the AEFI reporting system, not thinking AEFI is necessary to be reported, and
managing the patient is better than reporting were the only barriers significantly associated with reporting of AEFIs.
These barriers can lead to the underreporting of the adverse effects of vaccines thereby resulting in poor vaccine
safety surveillance.
Keywords: adverse events following immunization (AEFI), health care workers (HCWS), monitoring, Nigeria,
public health, routine immunization (RI), surveillance.