A mixed-methods evaluation of hepatitis B knowledge, attitudes, and practices among migrant women in Thailand.
Adolescent
Adult
Cross-Sectional Studies
Female
Focus Groups
Health Knowledge, Attitudes, Practice
Hepatitis B
/ prevention & control
Hepatitis B virus
Humans
Infectious Disease Transmission, Vertical
/ prevention & control
Middle Aged
Pregnancy
Pregnancy Complications, Infectious
/ prevention & control
Prenatal Care
/ statistics & numerical data
Surveys and Questionnaires
Thailand
Transients and Migrants
/ psychology
Vaccination
/ psychology
Young Adult
Hepatitis B
Mother-to-Child transmission
cross-sectional surveys
focus groups
interviews
observations
pregnancy
qualitative research
vaccination
Journal
BMC pregnancy and childbirth
ISSN: 1471-2393
Titre abrégé: BMC Pregnancy Childbirth
Pays: England
ID NLM: 100967799
Informations de publication
Date de publication:
23 Jul 2021
23 Jul 2021
Historique:
received:
04
12
2020
accepted:
25
05
2021
entrez:
24
7
2021
pubmed:
25
7
2021
medline:
16
11
2021
Statut:
epublish
Résumé
Globally 90 % of transmission of Hepatitis B virus (HBV) is from mother-to child and occurs predominantly in resource limited countries where the prevalence of HBV is high. Transmission could be interrupted by timely vaccinations but coverage remains problematic in these areas. Low knowledge or awareness of HBV may play a part in low vaccination coverage. This study examines the provision of antenatal care counselling with a focus on HBV in two different regions of northern Thailand, Sarapee Hospital (SH), Chiang Mai, and Shoklo Malaria Research Unit (SMRU), Tak Province. A mixed-methods sequential explanatory study design was used to evaluate antenatal services for migrants. Cross-sectional knowledge, attitude and practice (KAP) surveys were conducted immediately after counselling at first ANC contact, at 3-6 months after first ANC contact and at delivery. Surveys provided quantitative data, and qualitative methods included observations, focus group discussions (FGD) and in-depth interviews (IDI); analysed thematically to explore concepts of knowledge and understanding, attitude and practice of pregnant women and providers. Between September-2019 and May-2020, 757 women participated to KAP surveys, and 31 observations of counselling, 16 FGD and 9 IDI were conducted. KAP surveys showed in spite of low knowledge about HBV transmission, infection, or vaccination (correct response: SH 5.7 %, 9/157; SMRU 34.0 %, 204/600), most women (≥ 93 %, either site) understood they were screened for HBV and were willing to vaccinate infants for HBV. In explaining KAP survey results, qualitative analysis suggests counselling should: use the appropriate language; be tailored to the local health literacy level, provide only pertinent information, be repeated over the antenatal period; and attempt to ensure patient privacy (where possible). Programme effectiveness benefits from positive attitudes to screening and vaccinations and a high level of trust in the providers nevertheless participants provided good suggestions for improvements of the service. Limited knowledge of HBV among migrant women can be improved by counselling that emphasizes actionable knowledge such as vaccination schedule. Key improvements to the counselling process include training counsellors to conduct interactive counselling sessions in the woman's language, using appropriate visual aids and timely repetition over the course of the antenatal period.
Sections du résumé
BACKGROUND
BACKGROUND
Globally 90 % of transmission of Hepatitis B virus (HBV) is from mother-to child and occurs predominantly in resource limited countries where the prevalence of HBV is high. Transmission could be interrupted by timely vaccinations but coverage remains problematic in these areas. Low knowledge or awareness of HBV may play a part in low vaccination coverage. This study examines the provision of antenatal care counselling with a focus on HBV in two different regions of northern Thailand, Sarapee Hospital (SH), Chiang Mai, and Shoklo Malaria Research Unit (SMRU), Tak Province.
METHODS
METHODS
A mixed-methods sequential explanatory study design was used to evaluate antenatal services for migrants. Cross-sectional knowledge, attitude and practice (KAP) surveys were conducted immediately after counselling at first ANC contact, at 3-6 months after first ANC contact and at delivery. Surveys provided quantitative data, and qualitative methods included observations, focus group discussions (FGD) and in-depth interviews (IDI); analysed thematically to explore concepts of knowledge and understanding, attitude and practice of pregnant women and providers.
RESULTS
RESULTS
Between September-2019 and May-2020, 757 women participated to KAP surveys, and 31 observations of counselling, 16 FGD and 9 IDI were conducted. KAP surveys showed in spite of low knowledge about HBV transmission, infection, or vaccination (correct response: SH 5.7 %, 9/157; SMRU 34.0 %, 204/600), most women (≥ 93 %, either site) understood they were screened for HBV and were willing to vaccinate infants for HBV. In explaining KAP survey results, qualitative analysis suggests counselling should: use the appropriate language; be tailored to the local health literacy level, provide only pertinent information, be repeated over the antenatal period; and attempt to ensure patient privacy (where possible). Programme effectiveness benefits from positive attitudes to screening and vaccinations and a high level of trust in the providers nevertheless participants provided good suggestions for improvements of the service.
CONCLUSIONS
CONCLUSIONS
Limited knowledge of HBV among migrant women can be improved by counselling that emphasizes actionable knowledge such as vaccination schedule. Key improvements to the counselling process include training counsellors to conduct interactive counselling sessions in the woman's language, using appropriate visual aids and timely repetition over the course of the antenatal period.
Identifiants
pubmed: 34301179
doi: 10.1186/s12884-021-03914-2
pii: 10.1186/s12884-021-03914-2
pmc: PMC8305500
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
525Subventions
Organisme : Faculty of Medicine, Chiang Mai University
ID : 118/2562
Informations de copyright
© 2021. The Author(s).
Références
MMWR Morb Mortal Wkly Rep. 2018 Nov 16;67(45):1261-1264
pubmed: 30439873
Am J Trop Med Hyg. 2018 Dec;99(6):1469-1474
pubmed: 30298807
Eur J Public Health. 2016 Aug;26(4):561-9
pubmed: 27095794
Int J Hepatol. 2020 Apr 27;2020:7965146
pubmed: 32411482
Trop Med Int Health. 2006 Oct;11(10):1496-502
pubmed: 17002723
BMC Pregnancy Childbirth. 2018 Dec 22;18(1):504
pubmed: 30577760
Midwifery. 2013 Jul;29(7):745-50
pubmed: 22901497
Expert Opin Drug Metab Toxicol. 2006 Jun;2(3):459-69
pubmed: 16863446
Bull World Health Organ. 2007 Jul;85(7):511-8
pubmed: 17768499
Health Policy Plan. 2011 Jul;26(4):307-15
pubmed: 21047809
Lancet Infect Dis. 2015 Aug;15(8):981-5
pubmed: 26145195
MMWR Morb Mortal Wkly Rep. 2020 Jul 31;69(30):988-992
pubmed: 32730237
Int J Hepatol. 2020 Jan 15;2020:5617603
pubmed: 32015916
PLoS One. 2017 Jun 2;12(6):e0178671
pubmed: 28575040
AIDS Care. 2013;25(6):680-5
pubmed: 23317036
Pan Afr Med J. 2016 Aug 17;24:315
pubmed: 28154670
World J Hepatol. 2016 Dec 8;8(34):1521-1528
pubmed: 28008343
Lancet Infect Dis. 2021 Jan;21(1):6-8
pubmed: 32805202
Pediatrics. 2011 Dec;128(6):e1511-9
pubmed: 22106080
Proc Biol Sci. 1993 Aug 23;253(1337):197-201
pubmed: 8397416
Cureus. 2020 Jan 16;12(1):e6673
pubmed: 31976187
PLoS One. 2017 Feb 23;12(2):e0172007
pubmed: 28231251
Open Forum Infect Dis. 2019 Dec 07;6(12):ofz518
pubmed: 31890723
PLoS One. 2019 Apr 10;14(4):e0208154
pubmed: 30969972
BMC Med Inform Decis Mak. 2010 Nov 03;10:69
pubmed: 21047412
Medicine (Baltimore). 2018 Jun;97(22):e10931
pubmed: 29851831
Ann Hepatol. 2020 Jul - Aug;19(4):388-395
pubmed: 32507734
AIDS Care. 2018 Sep;30(9):1161-1167
pubmed: 29701075
Southeast Asian J Trop Med Public Health. 2011 Jan;42(1):152-60
pubmed: 21323178
Bull World Health Organ. 2011 Jul 1;89(7):528-31
pubmed: 21734767
PLoS One. 2019 Jun 13;14(6):e0218138
pubmed: 31194796
Ghana Med J. 2016 Sep;50(3):157-162
pubmed: 27752190
Int J Qual Health Care. 2007 Dec;19(6):349-57
pubmed: 17872937
Clin Infect Dis. 2015 Jan 15;60(2):275-8
pubmed: 25313254
JBI Database System Rev Implement Rep. 2016 Jan;14(1):210-47
pubmed: 26878928
Georgian Med News. 2019 Oct;(295):109-114
pubmed: 31804210
Hepatol Med Policy. 2018 Dec 19;3:14
pubmed: 30598844
Bull Soc Pathol Exot. 2016 Feb;109(1):13-9
pubmed: 26821371
Lancet. 2001 May 19;357(9268):1565-70
pubmed: 11377643
Reprod Health. 2016 Aug 19;13(1):94
pubmed: 27543078
PLoS One. 2013 Aug 27;8(8):e73264
pubmed: 24013709
BMC Pregnancy Childbirth. 2014 Dec 12;14:409
pubmed: 25495459
BMC Pregnancy Childbirth. 2012 Mar 21;12:16
pubmed: 22436344
Lancet Gastroenterol Hepatol. 2017 Dec;2(12):900-909
pubmed: 29132759
Can J Gastroenterol. 2012 Sep;26(9):597-602
pubmed: 22993729