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_aAmoranto, Maria Antoinette A.
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_aHesitant response to childhood vaccination in selected cities in the province of Laguna :
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_bstrategic policy for vaccination program management /
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_cMaria Antoinette A. Amoranto.
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_c202046
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_c28 cm.
_axviii, 194 pages
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_aThesis (Ph.D.)-- Pamantasan ng Lungsod ng Maynila, 2020.;A dissertation paper presented to the School of Government in partial fulfillment of the requirements for the degree Doctor of Public Administration.
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_aABSTRACT: Although the global confidence towards vaccines is relatively high (Larson et al., 2016), scientific and medical experts see the urgency to alleviate the growing level of vaccination hesitancy meaning deliberate refusal or delay of vaccination despite of its availability (Georgiou, 2019), a phenomenon that is blamed for the declining vaccine uptakes that may resort to disease outbreaks and greater economic loss (Lo & Hotez, 2017). Previous researchers found vaccine hesitancy to be context-specific that varies in time and place (Dub et al., 2012) and solving this problem remains unsuccessful (Pluviano et al., 2017). Recognizing the impact of vaccination hesitancy as a national issue and potential threat to world health, the researcher was motivated to take a scholarly initiative with the end in view of proposing a policy strategy for vaccination program management. This study was deemed significant to health providers because they would understand how parents perceive childhood vaccination program in the country and how their hesitancy affects their decision to have children vaccinated. This descriptive-correlational research delved into the level of awareness, attitude and hesitancy in vaccination among parents in the cities in Binan, Santa Rosa and San Pedro, Laguna. This is to provide a deeper analysis of their awareness, attitude and hesitancy in childhood vaccination program in order to propose a policy strategy for vaccination program management. Specifically, it determined the respondents' profile in terms of age, gender, civil status, highest educational attainment and monthly family income. It also looked at the respondents' level of awareness on childhood vaccination program along Bacille Calmette-Guerin (BCG); diphtheria, pertussis and tetanus (DPT); oral polio vaccine (OPV); measles, mumps and rubella (MMR); Hepatitic Vaccine; and Dengvaxia. Furthermore, the attitude of respondents towards the abovementioned childhood vaccination programs was measured as well as the significant difference in the attitude of parents when classified according to their profile variables and their level of hesitancy of respondents in terms of the abovementioned vaccination programs. Moreover, a significant difference in the respondents' level of hesitancy when classified according to their profile variables was determined together with the significant relationship between the profile of the respondents and their level of hesitancy and the significant relationship between the respondents' level of awareness on vaccination and their level of hesitancy. Additionally, the study looked into the factors that contributed to the level of hesitancy with respect to the childhood vaccination program along perception of adverse effects from vaccination, appraisal of the illness, general attitudes, vaccine recommendations, practicalities, and information about the vaccine, trust in the healthcare profession, emotions and trust in the government. It also measured the significant relationship between the respondents' level of hesitancy and the factors that contribute to their level of hesitancy. The data of the study after the survey to 1,063 respondents who were randomly selected from the cities of Binan, Santa Rosa and San Pedro, Laguna were treated using the Statistical Package for the Social Sciences (SPSS) software to generate statistical results. Percentage and frequency distribution were used to describe the profile of the respondents along age, gender, civil status, highest educational attainment, and monthly family income. Meanwhile, weighted mean was used to describe the respondents' a) level of awareness on childhood vaccination program b) attitude on childhood vaccination program c) hesitancy in childhood vaccination program and d) extent of factors that contribute to their hesitancy. Moreover, t-test was used to determine the difference in the respondents' attitude and hesitancy in childhood vaccination program when grouped according to their gender. Furthermore, Analysis of Variance (ANOVA) was used to determine the difference in the respondents' attitude and hesitancy in childhood vaccination program when grouped according to their age, civil status, highest educational attainment and monthly family income. Additionally, Chi-square was used to determine the relationship between the respondents' profile and their level of hesitancy in childhood vaccination program. Finally, Pearson r Moment Correlation Coefficient was used to determine the relationship between the respondents' level of awareness and hesitancy in childhood vaccination program. It was also used to determine the relationship between the respondents' level of hesitancy and the extent of factors that contribute to it. After the exhaustive analysis of the findings made, the study showed that: 1) majority of the respondents belong to middle adulthood, were female, married, high school graduates and occupy the population group categorized as the marginalized or economically disadvantaged members of society; 2) the respondents have a high level of awareness on childhood vaccination program along BCG, DPT, OPV, MMR, Hepatitic Vaccine and Dengvaxia, indicating that they learn appropriate information about these vaccinations in their area; 3) the respondents have a favorable attitude towards childhood vaccination program, indicating that they still have trust and confidence in vaccination; 4) the older generation of respondents has a more positive attitude towards vaccination compared to their younger counterpart while those who are earning 10,000 and below have significantly more positive attitude in childhood compared to those earning 10,001 to 20,000; 5) the respondents have low level of hesitancy in childhood vaccination program, showing their strong confidence in the childhood vaccination program of their area; 6) the older respondents have significantly lower level of hesitancy in childhood vaccination program compared to those aged 20 and below while those who are earning 20,001-30,000 have significantly lower level of hesitancy in childhood vaccination program compared to those earning 10,001-20,000; 7) age, gender, highest educational attainment and monthly family income are significant correlates of respondents' hesitancy in childhood vaccination program, the lower is their level of hesitancy in it 9) of the factors that contribute to the respondents' level of hesitancy in childhood vaccination program, only appraisal of the illness has a moderate extent of contribution. Perception of adverse effects from vaccination, general attitudes, vaccine recommendations, practicalities, social influences, information about the vaccines, trust in the health care profession, emotions and trust in the government all yielded a least extent of contribution to the respondents' level of hesitancy in childhood vaccination; and 10) appraisal of the illness, general attitudes, social influences and emotions are the contributing factors that are significantly correlated to the respondents' level of hesitancy in childhood vaccination. Based on the findings made and conclusions drawn, the researcher proposed the following recommendations: 1) Although the respondents showed a high level of awareness and positive attitude in childhood vaccination program, city health departments should still continue educating their constituents as to the important of vaccinations especially for children. Disseminating flyers and house-to-house vaccination awareness campaign can be conducted in order to ensure that all concerned are aware as to the importance of vaccinations and the facts and myths that they should be aware of to combat ignorance about vaccination; 2) When there is a health outbreak that may involve vaccination, the Department of Health should immediately hold briefings through main stream media (television and radio) in order to inform the public of the possible consequences and the counter measures that can be performed.
520 _aAlternative media (social media) can also be utilized provided that these platforms are officially and constantly monitored for hacking; 3) Stronger working synergy and coordination from the national government to local government units should be ensured in order to implement and monitor measures about vaccination as well as when health outbreaks occur; 4) There is a continuous need to emphasize the importance and efficacy of childhood vaccination as a public health intervention. Public health authorities should continuously combat the growing reluctance and hesitation from parents to vaccinate their children, which is caused by concerns about safety and loss of trust in public authorities; 5) Local council of the cities of Binan, San Pedro, Santa Rosa and Laguna should incorporate long-term health immunization system improvement in their strategic planning. This is to ensure that the system is responsive in terms of the local context as to the population demographics, awareness of constituents to vaccination and rate of vaccination in their area; 6) Philippine congressmen and senators may revisit the Senate Bill No. 1573 or the Pandemic and All-Hazard Preparedness Act filed by the late Miriam Defensor-Santiago in 2013 which was for the creation of a national health strategy during pandemics, as most parts of the world then grappled with the Middle East Respiratory Syndrome (MERS) outbreak. This could give the national and local government units with more control and budget with matters pertaining to health crisis as well as other calamities that can paralyze the economy and other sectors of the Philippine society; 7) Local government units of the cities of Binan, Santa Rosa and San Pedro should allot bigger budget for vaccinations as the current allocation for it may not be sufficient. The massive impact of COVID-19 pandemic on various sectors of society can be the strong basis as to how import
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