Health Facility Capacity and Health-care Worker Knowledge, Attitudes, and Practices of Hepatitis B Vaccine Birth-dose and Maternal Tetanus-Diphtheria Vaccine Administration in Nigeria: A Baseline Assessment

• Published in: Annals of African medicine
• Main Authors: Uba, Belinda V, Mohammed, Yahaya, Nwokoro, Ugochukwu Uzoechina, Fadahunsi, Rhoda, Adewole, Adefisoye, Ugbenyo, Gideon, Simple, Edwin, Wisdom, Margeret Osas, Waziri, Ndadilnasiya E, Michael, Charles A, Okeke, Lilian Akudo, Kanu, Florence, Ikwe, Hadley, Sandhu, Hardeep S, Asekun, Adeyelu, Tohme, Rania A, Freeland, Catherine, Minta, Anna, Bashir, Sulaiman Saidu, Isa, Abdullahi, Vasumu, James J, Bahuli, Abubakar U, Ugwu, George O, Obi, Emmanuel I, Ismail, Binta Aduke, Okposen, Bassey Bassey, Bolu, Omotayo O, Shuaib, Faisal
• Format: Journal Article
• Language: English; French
• Published: India 23.10.2024
• ISSN: 1596-3519; 0975-5764; 0975-5764
• DOI: 10.4103/aam.aam_28_24

Hepatitis B virus (HBV) and neonatal tetanus infections remain endemic in Nigeria despite the availability of safe, effective vaccines. We aimed to determine health facilities' capacity for hepatitis B vaccine birth dose (HepB-BD) and maternal tetanus-diphtheria (Td) vaccination and to assess knowledge, attitudes, and practices of HepB-BD and maternal Td vaccine administration among health facility staff in Nigeria. This was a cross-sectional study assessing public primary and secondary health facilities in Adamawa and Enugu States. A multistage sampling approach was used to select 40 facilities and 79 health-care workers (HCWs) from each state. A structured facility assessment tool and standardized questionnaire evaluated facility characteristics and HCW knowledge, attitudes, and practices related to HepB-BD and maternal Td vaccination. Frequencies and proportions were reported as descriptive statistics. The survey of 80 facilities revealed that 73.8% implemented HepB-BD and maternal Td vaccination policies. HepB-BD was administered within 24 h of birth at 61.3% of facilities and at all times at 57.5%. However, administration seldom occurred in labor and delivery (35%) or maternity wards (16.3%). Nearly half of the facilities (46.3%) had HCWs believing there were contraindications to HepB-BD vaccination. Among 158 HCWs, 26.5% believed tetanus could be transmitted through unprotected sex, prevented by vaccination at birth (46.1%), or by avoiding sharing food and utensils. 65% of HCWs knew HBV infection had the worst outcome for newborns. The limited implementation of national policies on HepB-BD and maternal Td vaccination, coupled with knowledge gaps among HCWs, pose significant challenges to timely vaccination, necessitating interventions to address these gaps.