{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T22:45:38Z","timestamp":1792622738113,"version":"4.5.0"},"reference-count":42,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T00:00:00Z","timestamp":1652054400000},"content-version":"unspecified","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["U19GGH001581"],"award-info":[{"award-number":["U19GGH001581"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,3,31]]},"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To gain in-depth understanding of the caregiver experience when navigating urban immunisation services for their children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>An exploratory qualitative assessment comprising 16 in-depth interviews using an interpretative phenomenology approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Caregivers were purposively recruited from slums (n=8) and other urban communities (n=8) in the capital city of Sierra Leone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Caregivers of children ages 6\u201336 months old who were fully vaccinated (n=8) or undervaccinated (n=8).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Emotional enablers of vaccination were evident in caregivers\u2019 sense of parental obligation to their children while also anticipating reciprocal benefits in children\u2019s ability to take care of their parents later in life. Practical enablers were found in the diversity of immunisation reminders, information access, information trust, getting fathers more involved, positive experiences with health workers and postvaccination information sharing in the community. Underlying barriers to childhood vaccination were due to practical constraints such as overcrowding and long waiting times at the clinic, feeling disrespected by health workers, expecting to give money to health workers for free services and fear of serious vaccine side effects. To improve vaccination outcomes, caregivers desired more convenient and positive clinic experiences and deeper community engagement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Health system interventions, community engagement and vaccination outreach need to be tailored for urban settings. Vaccine communication efforts may resonate more strongly with caregivers when vaccination is framed both around parental responsibilities to do the right thing for the child and the future benefits to the parent.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-058203","type":"journal-article","created":{"date-parts":[[2022,5,17]],"date-time":"2022-05-17T06:44:45Z","timestamp":1652769885000},"page":"e058203","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Qualitative assessment of caregiver experiences when navigating childhood immunisation in urban communities in Sierra Leone"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7206-8042","authenticated-orcid":false,"given":"Mohamed F","family":"Jalloh","sequence":"first","affiliation":[{"name":"Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Palak","family":"Patel","sequence":"additional","affiliation":[{"name":"Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"},{"name":"Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Sutton","sequence":"additional","affiliation":[{"name":"ICAP at Columbia University, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4999-570X","authenticated-orcid":false,"given":"Shibani","family":"Kulkarni","sequence":"additional","affiliation":[{"name":"Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"},{"name":"Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mame","family":"Toure","sequence":"additional","affiliation":[{"name":"ICAP at Columbia University, Freetown, Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerrie","family":"Wiley","sequence":"additional","affiliation":[{"name":"School of Public Health, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Sessay","sequence":"additional","affiliation":[{"name":"Expanded Programme on Immunization and Child Health, Sierra Leone Ministry of Health and Sanitation, Freetown, Western Area, Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Lahuerta","sequence":"additional","affiliation":[{"name":"ICAP at Columbia University, New York, New York, USA"},{"name":"Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,5,9]]},"reference":[{"key":"2025121411451796000_12.5.e058203.1","doi-asserted-by":"crossref","first-page":"5495","DOI":"10.1016\/j.vaccine.2016.09.038","article-title":"Assessing strategies for increasing urban routine immunization coverage of childhood vaccines in low and middle-income countries: a systematic review of peer-reviewed literature","volume":"34","author":"Nelson","year":"2016","journal-title":"Vaccine"},{"key":"2025121411451796000_12.5.e058203.2","unstructured":"John Snow International . 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