A qualitative analysis exploring barriers and enablers to distribution, delivery, and access to COVID-19 vaccines in Botswana
Notice bibliographique
Résumé
Introduction: The COVID-19 pandemic highlighted pre-existing weaknesses, revealing deep-rooted issues in infrastructure, access, and resource allocation that have long impeded African countries' ability to effectively meet population health needs. It also became evident during the pandemic that there were discrepancies in how vaccines were distributed, delivered and accessed in these countries. We aimed to identify vaccine distribution, service delivery processes and related barriers in Botswana to contextually explore practices that either enhance or hinder access and equity in vaccine distribution and delivery. Methods: We conducted in-depth interviews, using a semi-structured interview guide, with a purposive sample of 18 key informants, including public health sector officials, non-state actors, policy makers, regulatory bodies and other stakeholders. Interviews were audio-recorded and transcribed verbatim. Thematic analysis was conducted following a deductive approach according to the six-step analysis framework by Braun and Clarke: (i) familiarization with the data; (ii) generation of initial codes; (iii) searching for themes; (iv) reviewing themes; (v) refining and naming themes; and finally, (vi) producing the report. Steps i-iii were conducted by two researchers. Attention was given to aspects of credibility, dependability, and transferability of the findings through key strategies, including team data review, coding, consensus on themes and review of both secondary and grey literature on vaccine roll-out in the country. Results: Seven primary themes emerged from the findings. COVID-19 vaccine distribution and delivery in Botswana followed the existing primary health care system structures for routine vaccine delivery. Traditional mechanisms such as static public health facilities, private facilities, outreach campaigns, and mobile stops, were augmented through different roles played by stakeholders in the private sector, civil society organizations and non-governmental organizations. Religious and cultural norms were reported to affect vaccine uptake centered around smaller population groups that are historically known to be anti-vaccines. There is no deliberate gender and the disabled population programming for vaccine distribution and delivery in Botswana. The private sector improved access to vaccines by supporting supply chain logistics with transportation, especially to hard-to-reach areas. Discussions: Achieving equitable vaccine access involves not only logistical and infrastructural considerations, but also coordination and collaboration across several sectors, enhancing gender diversity and inclusivity in planning, coordination, and decision making and implementation of strategies tailored to the needs of a wide range of vulnerable population groups.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,003 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».