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.

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

Background: 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. Materials and Methods: 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. Results: 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. Conclusions: 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.

NIGERIA; HEALTH facilities; HEPATITIS B vaccines; HEALTH facility administration; NEONATAL infections; HEPATITIS B virus

Annals of African Medicine, 2025, Vol 24, Issue 1, p113

1596-3519

Academic Journal

10.4103/aam.aam_28_24