Perceptions of immunisation adherence by caregivers in the Western Cape province, South Africa: a qualitative study

Abstract

Background: Although the Expanded Programme on Immunisation in South Africa has received considerable funding for universal access, immunisation rates remain low. It is important to understand the perceptions of caregivers to develop interventions that can improve immunisation adherence. Objectives: To examine the perceptions of caregivers in relation to immunisation adherence in the selected Western Cape districts, and to examine the important barriers and facilitators that affect the immunisation process in urban primary healthcare. Method: A qualitative research method was employed to gain a clear understanding of the phenomenon. The semi-structured interview technique was employed using an interview guide focused on the perceptions of caregivers regarding immunisation adherence. The participants were selected through purposive and convenience sampling. The qualitative thematic analysis technique was employed to identify themes based on the framework proposed by Braune and Clark, as discussed in the data analysis and management section of this article. Results: Six themes emerged that affect immunisation compliance: barriers to accessibility, communication, efficiency of the healthcare system, knowledge and attitudes of caregivers, socioeconomic factors, and the role of cultural and religious beliefs. Conclusion: The conclusion of the study was that caregivers showed high levels of commitment to childhood immunisation, but were hindered in their efforts by systemic, socioeconomic and cultural factors. Contribution: The contribution of the study is that it offers evidence that can be used to develop strategies to improve immunisation compliance.