Exploring barriers to the expanded programme on immunisation service utilisation in pastoralist communities of Afar, Afar Regional State, Ethiopia

Background: Vaccination is a crucial public health intervention for reducing child mortality and morbidity, but Ethiopia and Africa have not met the Global Vaccine Action Plan’s target. Aim: The study aimed at exploring barriers to the expanded programme on immunisation service utilisation in pastoralist communities of Afar Regional State, Ethiopia. Setting: The research study was conducted in the Afar region of Ethiopia. Methods: A qualitative research approach was utilised, combining exploratory and descriptive designs with an appreciative inquiry method. The study focused on parents or guardians of children aged 12 months – 23 months who missed vaccines, along with Expanded Program on Immunisation (EPI) health workers, totalling 77 participants (60 parents and 17 healthcare providers). Data were collected through one-on-one interviews and focus group discussions, with the sample size determined by data saturation, employing non-probability purposive sampling. Results: Four main themes from the interview data include barriers to community immunization programs, such as geographical challenges, family mobility, vaccine hesitancy due to concerns about side effects, and general reluctance or ignorance regarding vaccination. Conclusion: The study identified barriers to community immunisation programmes, including geographical challenges, family mobility, vaccine hesitancy due to concerns about side effects and general reluctance or ignorance regarding vaccination. Contribution: This study provides context-specific insights into nursing care supervision, informing practice and policy for primary health care professionals in patient management and serving as a foundation for future research.