Background: The rising incidence of novel viral diseases has made immunisation an indispensable tool in safeguarding the health of whole populations . A robust pharmacovigilance system will assure the public of vaccine safety in countries like Ghana with relatively low reportage of adverse events following immunization (AEFIs).
Objectives: We documented the experiences of health workers in Ghana to ascertain the existing capacity for data collection and information reporting flows for health events associated with vaccination.
Methods: We conducted a cross-sectional quantitative survey among healthcare workers in Ghana from December 2020 to February 2021 in 25 selected districts using a detailed structured questionnaire. Health facilities were community-based health planning services (CHPS) compounds, health centers, district and regional hospitals and a teaching hospital. Both vaccinators and prescribers were interviewed. We documented their experiences on the ground with regards to knowledge, perceptions and practice of reporting AEFIs to gain insight into challenges in the reporting process.
Results: 851 participants were interviewed, 51.7% males, 59.9% between 30 to 39 years and 34.1% nurses.49.2% said their institutions had established processes for AEFI reporting. The majority (98%) had not heard about online reporting of AEFIs. Only 25% had encountered an AEFI within the past year out of which only 55% reported the AEFI. The pharmacovigilance Centre did not give feedback to 61.1% of those who reported AEFIs. Healthcare workers who had worked for at least six years received more AEFI training (56.4%) with nurses receiving the least (31.0%). The CHPS compounds had the highest percentage of AEFI training (42.9 %) while private facilities had 17.6%. Most healthcare workers (about 60%) had fair to poor knowledge of AEFIs. The main factors affecting AEFI reporting among health care workers were heavy workload and a lack of time (54.1%), as well as unavailability of reporting forms (57.5%). Logistic regression analysis revealed gender as a negative factor, and age and profession as positive factors that influence AEFI knowledge and reporting. Also, training (p < 0.0001), and profession (p=0.006) significantly influenced knowledge level of AEFIs.
Conclusions: There is great opportunity to strengthen the pharmacovigilance system in Ghana in the face of emerging epidemic and pandemic diseases. Regular targeted training of health workers would improve AEFI reporting rates. Every health facility should have processes and guidelines on identifying and reporting AEFIs. There should be prompt feedback from the national pharmacovigilance centre to health workers to motivate them to report.
