Mapping the maternal vaccination journey and influencing factors for Māori women in Aotearoa New Zealand: a qualitative study
Natalie Gauld
1 * , Samuel Martin (Ngā Puhi) 2 , Owen Sinclair (Te Rarawa) 3 , Felicity Dumble 4 , Helen Petousis-Harris 5 , Cameron C. Grant 6
1 Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, and School of Pharmacy, The University of Auckland, Auckland, New Zealand.
2 Huntly West Pharmacy, Huntly, Waikato, New Zealand.
3 Paediatrics, Waitematā District Health Board, Auckland, New Zealand.
4 Public Health, Waikato District Health Board, Waikato, New Zealand.
5 Department of General Practice, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
6 Department of Paediatrics: Child and Youth Health, The University of Auckland, and Starship Children’s Health, Auckland, New Zealand.
Journal of Primary Health Care 14(4) 352-362 https://doi.org/10.1071/HC21166
Published: 30 September 2022
© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of The Royal New Zealand College of General Practitioners. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
Introduction: Uptake of maternal vaccinations (MVs) is suboptimal in Aotearoa New Zealand, particularly for Māori.
Aim: To describe Māori women’s journeys regarding maternal pertussis and influenza vaccinations and explore influences on uptake.
Methods: Semi-structured interviews were conducted in Waikato, Aotearoa New Zealand, with pregnant or recently pregnant Māori women, and separately with Māori healthcare professionals (HCPs) to understand women’s decisions regarding MVs and enablers and barriers to uptake.
Results: Nine women and nine HCPs were interviewed. Verbal communications from midwives, general practice and pharmacy strongly influenced women’s journeys. Women’s decisions appeared largely straight-forward, with influences including awareness, knowledge, underlying beliefs and previous MVs. Enablers for MV uptake included HCPs’ discussions, pro-vaccination beliefs, and accessibility. Barriers for MV uptake included poverty (and transport), lack of awareness, insufficient knowledge of benefits, late presentation to the midwife and other commitments or challenges in the women’s lives affecting prioritisation of the vaccine. Misconceptions, seasonality, and lower HCP emphasis impaired influenza vaccination uptake.
Discussion: With multiple barriers to accessing MVs, HCPs who see pregnant women are the primary resource to improve awareness, knowledge, and access through kōrero (discussions) with the woman and, where possible, being able to administer the vaccinations. These HCPs need to be well-informed, aware of likely concerns women may have and how to address them, encourage these discussions and preferably be trusted.
Keywords: access to medicines, health equity, healthcare professionals, Indigenous population, influenza vaccination, Māori, maternal vaccination, midwifery, pertussis vaccination, vaccine hesitancy.
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