Stakeholders’ Perceptions of the Implementation of the Door-to-Door Vaccination Campaign for the Novel Oral Polio Vaccine (nOPV2) in Uganda, 2022 – 2023: A Qualitative Study

Abstract

<title>Abstract</title> <bold>Background</bold> Mass vaccination campaigns are crucial for public health interventions, especially in the eradication of diseases such as polio. Understanding stakeholders' perceptions and experiences during the implementation of these campaigns is essential for improving strategies and addressing challenges. This study aimed to document experiences, identify challenges, and explore stakeholders' perceptions of the implementation of a door-to-door mass vaccination campaign for the novel oral polio vaccine (nOPV2) in Uganda. <bold>Methods</bold> A qualitative research design was employed using face-to-face in-depth interviews with 46 randomly selected implementers from eight randomly selected districts in Uganda. The stakeholders included national/central supervisors, district, subcounty, and parish-level supervisors directly involved in the campaign implementation. Thematic analysis was employed to analyze the collected data, aligning with the major campaign activities. <bold>Findings</bold> Stakeholders expressed good views with some of the campaign aspects, including effective communication, advocacy and social mobilization, successful vaccine delivery and distribution, efficient district readiness assessments, appropriate cold chain management, coordination, and partner/intersectoral collaborations. However, they highlighted challenges that included poor planning, inadequate training of vaccination teams, community resistance, difficulties in recruitment and teaming of vaccinators, payment delays, and logistical issues. They perceived that the first round of the campaign was poorly planned and implemented, while the second round showed improvement based on lessons learned. <bold>Conclusion</bold> The study highlights successes in implementation from the perspectives of the campaign supervisors that can be a benchmark for the implementation of the door-to-door mass campaigns for nOPV2 in Uganda. It also highlights the need for improvements in future campaigns, focusing on motivating implementers and addressing logistical issues. Recommendations include performance reviews, enhanced planning, routine updates, verification of target populations, microplanning training, and mapping of community resistance. We also recommend that campaign planning and implementation should take the bottom-up approach as opposed to the current top-down approach that begins at the national level of the health system and regular simulations of mass vaccination response plans. These findings provide valuable insights for the implementation of future mass campaigns and contribute to the ongoing efforts to eradicate polio.