Browsing by Author "Cameron, Neil"

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    The acceptability of three vaccine injections given to infants during a single clinic visit in South Africa
    (BioMed Central, 2016) Tabana, Hanani; Dudley, Lilian D.; Knight, Stephen; Cameron, Neil; Mahomed, Hassan; Goliath, Charlyn; Eggers, Rudolf; Wiysonge, Charles S.
    BACKGROUND: The Expanded Programme on Immunisation (EPI) has increased the number of antigens and injections administered at one visit. There are concerns that more injections at a single immunisation visit could decrease vaccination coverage. We assessed the acceptability and acceptance of three vaccine injections at a single immunisation visit by caregivers and vaccinators in South Africa. METHODS: A mixed methods exploratory study of caregivers and vaccinators at clinics in two provinces of South Africa was conducted. Quantitative and qualitative data were collected using questionnaires as well as observations of the administration of three-injection vaccination sessions. RESULTS: The sample comprised 229 caregivers and 98 vaccinators. Caregivers were satisfied with the vaccinators’ care (97 %) and their infants receiving immunisation injections (93 %). However, many caregivers, (86 %) also felt that three or more injections were excessive at one visit. Caregivers had limited knowledge of actual vaccines provided, and reasons for three injections. Although vaccinators recognised the importance of informing caregivers about vaccination, they only did this sometimes. Overall, acceptance of three injections was high, with 97 % of caregivers expressing willingness to bring their infant for three injections again in future visits despite concerns about the pain and discomfort that the infant experienced. Many (55 %) vaccinators expressed concern about giving three injections in one immunisation visit. However, in 122 (95 %) observed three-injection vaccination sessions, the vaccinators administered all required vaccinations for that visit. The remaining seven vaccinations were not completed because of vaccine stock-outs. CONCLUSIONS: We found high acceptance by caregivers and vaccinators of three injections. Caregivers’ poor understanding of reasons for three injections resulted from limited information sharing by vaccinators for caregivers. Acceptability of three injections may be improved through enhanced vaccinator-caregiver communication, and improved management of infants’ pain. Vaccinator training should include evidence-informed ways of communicating with caregivers and reducing injection pain. Strategies to improve acceptance and acceptability of three injections should be rigorously evaluated as part of EPI’s expansion in resource-limited countries.
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    External stakeholders and health promoting schools: complexity and practice in South Africa
    (Emerald, 2014) Preiser, Rika; Struthers, Patricia; Mohamed, Suraya; Cameron, Neil; Lawrence, Estelle
    Purpose: This paper examines the role of two higher education institutions in the Western Cape, South Africa, and how their initiatives and collaboration brought about a particular Health Promoting Schools (HPS) program in a resource poor setting. The aim of this paper is to reflect on the importance of the role that external systemic actors and stakeholders can play in the process of designing and implementing HPS programs in resource poor settings. Design/methodology/approach: In this paper a complex systems approach is employed to describe two different participatory methods of engagement with HPS by higher education institutions. On the one hand, engagement took place in terms of a formal and funded project, directed at the organizational level of the school, with capacity building as its aim. On the other hand, engagement was initiated informally (as part of a service learning project) via collaboration with the formal project, directed at the individual level of learners in the school. Findings: In recognizing the complex nature of planning and implementing HPS programs, the paper demonstrates that HPS approaches could benefit from engaging with resources outside the ambit of institutional health and educational policies and structures. Originality/value: By acknowledging the systemic nature of implementing HPS strategies, novel collaborations emerge as a result. The paper highlights the important role that external stakeholders such as higher education institutions play in creating and sustaining tailor-made HPS programs for schools based in resource poor settings.