Exploring Parental Challenges and the Role of Nurses in Promoting Routine Childhood Vaccination
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Keywords

routine immunization
public health nurses
low-income communities
parental support
Tondo Manila
Philippines

How to Cite

Exploring Parental Challenges and the Role of Nurses in Promoting Routine Childhood Vaccination. (2025). WVSU Research Journal, 14(1), 10-20. https://doi.org/10.59460/wvsurjvol14iss1pp10-20

Abstract

This study examines the challenges of routine immunization in low-income communities of District II, Tondo, Manila, highlighting the role of public health nurses in addressing these barriers. Using a descriptive quantitative correlational design, data were collected from 150 parents through a structured questionnaire, revealing significant challenges in three key areas: logistical and resource constraints (GWM = 3.57), community and societal attitudes (GWM = 3.58), and support and infrastructure (GWM = 3.68). Financial limitations and educational gaps were identified as primary logistical barriers, while vaccine hesitancy was influenced by family and societal norms. Additionally, the absence of health personnel and limited resources further hindered immunization efforts. A strong correlation was found between these challenges and the support provided by nurses, emphasizing their critical role in mitigating immunization barriers. To enhance their effectiveness, the study proposes targeted training programs in data management, community engagement, infrastructure management, financial guidance, and immunization advocacy, ultimately strengthening immunization efforts and improving public health outcomes in low-income communities.

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References

Al-lela, O. Q., Bahari, M. B., Salih, M. R., Al-Abbassi, M. G., Elkalmi, R. M., & Jamshed, S. Q. (2014). Factors underlying inadequate parents' awareness regarding pediatrics immunization: Findings of cross-sectional study in Mosul-Iraq. BMC Pediatrics, 14, 29. https://doi.org/10.1186/1471-2431-14-29

Albers, A. N., Thaker, J., & Newcomer, S. R. (2022). Barriers to and facilitators of early childhood immunization in rural areas of the United States: A systematic review of the literature. Preventive Medicine Reports. https://doi.org/10.1016/j.pmedr.2022.101804

Amit, A. M. L., Pepito, V. C. F., Sumpaico-Tanchanco, L., & Dayrit, M. M. (2022). COVID-19 vaccine brand hesitancy and other challenges to vaccination in the Philippines. PLOS Global Public Health, 2(1). https://doi.org/10.1371/journal.pgph.0000165

Añabieza, M. (2023). Reaching Every Purok Strategy [PowerPoint slides]. UNICEF, Department of Health, Republic of the Philippines.

Arceo, E., Dizon, J. C., Chavez, M., Cordero, P. K., de Leon, M. R., de Luna, J., ... & Tiongco, R. E. (2021). Knowledge, attitude, and practices of mothers from a rural community in Pampanga, Philippines toward childhood immunization: A cross-sectional survey. Vacunas, 22(3), 167-172. https://doi.org/10.1016/j.vacun.2020.12.002

Balgovind, P., & Mohammadnezhad, M. (2022). Factors affecting childhood immunization: Thematic analysis of parents and healthcare workers' perceptions. Human Vaccines & Immunotherapeutics, 18(6)https://doi.org/10.1080/21645515.2022.2137338

Barría, R. M. (2021). Nursing and its essential role in vaccination against COVID-19: New challenge in a pandemic scenario. Investigación y Educación en Enfermería, 39(3). https://orcid.org/0000-0002-3764-5254

Beck, A. M., Piontek, A. J., Wiedenman, E. M., & Gilbert, A. (2022). Perceptions of COVID-19 mitigation strategies between rural and non-rural adults in the US: How public health nurses can fill the gap. Nursing Reports, 12(1), 188–197.

Benner, P. (1982). From novice to expert. The American Journal of Nursing, 82(3), 402–407. https://doi.org/10.2307/3462928

Creswell, J. W. (2018). Research design: Qualitative, quantitative, and mixed methods approaches (5th ed.). Sage Publications.

Damnjanović, K., Graeber, J., Ilić, S., Lam, W. Y., Lep, Ž., Morales, S., Pulkkinen, T., & Vingerhoets, L. (2018). Parental decision-making on childhood vaccination. Frontiers in Psychology, 9, 735.

Decouttere, C., De Boeck, K., & Vandaele, N. (2021). Advancing sustainable development goals through immunization: A literature review. Globalization and Health, 17(1), 95.

Department of Health. (2023). Expanded program on immunization. https://doh.gov.ph/expanded-program-on-immunization

Enyinnaya, J. C., Anderson, A. A., Kelp, N. C., Long, M., & Duncan, C. G. (2024). The Social Ecology of Health Beliefs and Misinformation Framework: Examining the impact of misinformation on vaccine uptake through individual and sociological factors. Vaccine.

Etikan, I., Musa, S. A., & Alkassim, R. S. (2016). Comparison of convenience sampling and purposive sampling. American Journal of Theoretical and Applied Statistics, 5(1), 1–4. https://doi.org/10.11648/j.ajtas.20160501.11

Field, A. (2013). Discovering statistics using IBM SPSS statistics (4th ed.). Sage Publications.

Gilmore, B., Gerlach, N., Lopes, C. A., Bhattacharyya, S., de Claro, V., Ndejjo, R., ... & Tchetchia, A. (2022). Community engagement to support COVID-19 vaccine uptake: A living systematic review protocol. BMJ Open, 12(9). https://doi.org/10.1136/bmjopen-2022-063057

Hao, F., & Shao, W. (2022). Understanding the influence of political orientation, social network, and economic recovery on COVID-19 vaccine uptake among Americans. Vaccine, 40(14), 2191–2201. https://doi.org/10.1016/j.vaccine.2022.02.066

Hobani, F., & Alhalal, E. (2022). Factors related to parents’ adherence to childhood immunization. BMC Public Health, 22(1), 819.

Hopkins, K. L., Underwood, T., Iddrisu, I., Woldemeskel, H., Bon, H. B., Brouwers, S., ... & Lihemo, G. (2023). Community-based approaches to increase COVID-19 vaccine uptake and demand: Lessons learned from four UNICEF-supported interventions. Vaccines, 11(7). https://doi.org/10.3390/vaccines11071180

Lee, J., & Huang, Y. (2022). COVID-19 vaccine hesitancy: The role of socioeconomic factors and spatial effects. Vaccines, 10(3), 352. https://doi.org/10.3390/vaccines10030352

MacKenzie, N. E., Tutelman, P. R., Chambers, C. T., Parker, J. A., MacDonald, N. E., McMurtry, C. M., ... & Boerner, K. E. (2021). Understanding parents' use of a knowledge translation tool to manage children's vaccination pain. Pain Reports, 6(1). https://doi.org/10.1097/PR9.0000000000000907

McKee, C., & Bohannon, K. (2016). Exploring the reasons behind parental refusal of vaccines. The Journal of Pediatric Pharmacology and Therapeutics, 21(2), 104–109. https://doi.org/10.5863/1551-6776-21.2.104

Migriño, J., Jr., Gayados, B., Birol, K. R. J., De Jesus, L., Lopez, C. W., Mercado, W. C., ... & Tulagan, G. (2020). Factors affecting vaccine hesitancy among families with children 2 years old and younger in two urban communities in Manila, Philippines. Western Pacific Surveillance and Response Journal, 11(2), 20–26. https://doi.org/10.5365/wpsar.2019.10.2.006

Nuwarda, R. F., Ramzan, I., Weekes, L., & Kayser, V. (2022). Vaccine hesitancy: Contemporary issues and historical background. Vaccines, 10(10), 1595. https://doi.org/10.3390/vaccines10101595

Oku, A., Oyo-Ita, A., Glenton, C., Fretheim, A., Ames, H., Muloliwa, A., ... & Lewin, S. (2017). Perceptions and experiences of childhood vaccination communication strategies among caregivers and health workers in Nigeria: A qualitative study. PLOS ONE, 12(11), e0186733. https://doi.org/10.1371/journal.pone.0186733

Quero, R. A. D., Puno, P. A. A., Qua, A. M. P., Quiroz, R. J. T., Quenery, T. J. L., Polido, P. J. B., ... & Pua, J. C. (2019). A cross-sectional study on the knowledge, attitude and practices (KAP) of mothers and caregivers on immunization in Quezon City. UER, 101. https://doi.org/10.1186/1471-2458-12-578

Seidman, G., & Atun, R. (2017). Does task shifting yield cost savings and improve efficiency for health systems? A systematic review of evidence from low-income and middle-income countries. Human Resources for Health, 15, 1–13. https://doi.org/10.1186/s12960-017-0200-9

Singh, S., Sahu, D., Agrawal, A., & Vashi, M. D. (2019). Barriers and opportunities for improving childhood immunization coverage in slums: A qualitative study. Preventive Medicine Reports, 14, 100858. https://doi.org/10.1016/j.pmedr.2019.100858

UNICEF Philippines. (2022, October 21). Philippines in top 5 countries globally for zero-dose children. https://www.unicef.org/philippines/press-releases/philippines-top-5-country-world-zero-dose-children

UNICEF Philippines. (2023). Country Office Annual Report 2023. https://www.unicef.org/reports/country-regional-divisional-annual-reports-2023/Philippines

Usman, S., Bologna, L., & Stamidis, K. V. (2019). The CORE Group Partners Project in North East Nigeria: Community engagement strategies to combat skepticism and build trust for vaccine acceptance. The American Journal of Tropical Medicine and Hygiene, 101(4 Suppl), 68. https://doi.org/10.4269/ajtmh.19-0143

While, A. (2021). Evidence-based strategies to promote vaccine acceptance. British Journal of Community Nursing, 26(7), 338–343. https://doi.org/10.12968/bjcn.2021.26.7.338

Wolf, E. R., O’Neil, J., Pecsok, J., Etz, R. S., Opel, D. J., Wasserman, R., & Krist, A. H. (2020). Insights from caregivers and clinicians on missed pediatric wellness appointments. The Annals of Family Medicine, 18(1), 30–34.

World Health Organization. (2022). Regional committee for the Western Pacific seventy-second session. https://apps.who.int/gb/who_covid19/

World Health Organization. (2023). Ten threats to global health in 2019. https://www.who.int/news-room/spotlight/ten-threats-to-global-health-in-2019

World Health Organization & United Nations Children's Fund. (2022, July). The State of the World’s Children 2022: Immunization – A chance to reach every child. UNICEF. https://www.unicef.org/press-releases/WUENIC2022release

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