Maternal Satisfaction With Children's Vaccination and Its Contributing Factors in Ethiopia: A Systematic Review and Meta-Analysis

"Clients who are dissatisfied with a service...are less likely to return or use immunization services, resulting in...children receiving less than acceptable vaccination in underdeveloped and developing nations..."

Various initiatives are underway to improve maternal satisfaction with the vaccination of children in Ethiopia, where, according to a 2024 umbrella review, only 57.72% of children aged 12-23 months received full immunisation coverage. Governments, international organisations, and non-governmental organizations are actively working to improve healthcare infrastructure, expand service accessibility, improve communication, and foster community engagement. This systematic review and meta-analysis assesses the pooled prevalence of maternal satisfaction with the child vaccination service and its predictors in Ethiopia.

The rationale for the study is that assessing clients' satisfaction with the immunisation service is functionally significant because satisfied clients are more likely to adhere to intervention and return to the childhood immunisation facility. Satisfied mothers may not only be more likely to continue using healthcare services and be proactive in ensuring their children receive full immunisation, but they may also spread positive vibes about their experiences at a facility to others, thereby facilitating vaccine uptake among their social networks.

The researchers searched Scopus, Embase, Web of Science, Google Scholar, PubMed, African Journals Online, and Semantic Scholar to access the included articles. They then: used a weighted inverse-variance random effect model to estimate the prevalence of maternal satisfaction with vaccination of children; adjusted variations in pooled prevalence estimates by subgroup analysis according to the specific region where the study was conducted; used funnel plot and Egger's regression test to check publication bias; and used STATA version 14 statistical software for meta-analysis.

Five hundred and five original article records were found through the online search, of which eight studies conducted between 2018 and 2022 were included in the review. The combined prevalence of maternal satisfaction with vaccination of children was found to be 73% (95% confidence interval (CI): 72-75; I2 = 0.00%, p value < 0.001).

The study found the following determinant factors associated with satisfaction of mothers with their children's vaccination, but none was statistically significant: short waiting time, age of the mothers between 20-24 years, receipt of current vaccine information, good knowledge of vaccination, favourable attitude toward childhood vaccination, and receipt of greetings from the healthcare provider. These factors are explored in the discussion section of the paper.

Based on the subgroup analysis, results revealed that the prevalence of maternal satisfaction with vaccination of children was 63% in Southern Nations, Nationalities, and People's Region (SNNPR), 74% in Amhara, and 79% in Oromia. Per the researchers, the Oromia and Amhara regions in Ethiopia share similarities in terms of culture, traditions, and socioeconomic conditions. Cultural beliefs and social norms related to vaccination may be relatively consistent between the two regions, resulting in similar levels of maternal satisfaction. On the contrary, the SNNPR region may face challenges related to the limited availability and accessibility of vaccines, contributing to lower satisfaction levels.

Thus, this meta-analysis of mothers' satisfaction with vaccination services for their children in Ethiopia found a low level of satisfaction. Addressing these challenges requires a multifaceted approach involving efforts to address vaccine hesitancy through evidence–based communication strategies, public health education, community engagement, improved access to vaccines, and strengthened healthcare systems. For instance, the researchers recommend using various communication channels, including the media, community health workers, and local community leaders, to distribute accurate and culturally sensitive information. It is also important, they argue, to develop robust monitoring and evaluation systems that assess the quality, coverage, and satisfaction of vaccination services.

In conclusion: "Governments, healthcare providers, researchers, and communities need to work together to ensure the success of vaccination programs and improve maternal satisfaction."