Integration of Routine Immunization and COVID-19 Vaccination in Ekiti State Primary Health Care Facilities: A Qualitative Assessment of the Enablers and Barriers

Abstract

Abstract Background The development of the COVID-19 vaccine influenced the discussion on the importance of exploring the interaction between COVID-19 vaccination and routine immunization. Subsequently, the WHO Strategic Advisory Group Experts (SAGE) on immunization plausibly advised countries to leverage the COVID-19 vaccination rollout as a transformative opportunity to establish a resilient immunization system, through the integration of routine immunization, resulting in strengthened primary healthcare services. Objective This study assesses the enablers and barriers to integrating COVID-19 vaccination and routine immunization in Ekiti state, Nigeria. Methods This study adopted a qualitative research approach to obtain information from 40 participants selected purposively across the primary healthcare facilities, LGA, and state levels. A three-tier approach was used in selecting the LGAs. At the same time, In-depth interviews were conducted to elicit relevant information on the assessment of enablers and barriers to integrating COVID-19 vaccination and routine immunization through an interview guide. All audio interview files were transcribed in the English language, coded, and presented using a thematic approach (inductive and deductive approaches) Results A total of 40 healthcare workers across Ekiti state were selected to participate in this study. Our study found the enablers of integrating COVID-19 into routine immunization to include demand generation and social mobilization, health education, health workers training, data validation, financing, and supervision. However, rumors, demand for palliatives, Adverse Events Following Immunization (AEFI), manpower shortage, poor network services, and bad road networks were reported as barriers to integrating COVID-19 vaccination and routine immunization in Ekiti state. Conclusion While the enablers of integrating COVID-19 and routine immunization may outweigh its barriers, it is pertinent to know that the efforts towards integrating COVID–19 vaccination on RI is a call to all stakeholders. The identified barriers in the study must be addressed to ensure a strengthened health system. Therefore, achieving a successful integration and uptake of vaccination/immunization is anchored on driving demand generation, social mobilization, health education, availability of healthcare workers, integrated supervision, and financing.