Knowledge, attitudes, and practices toward seasonal influenza vaccination among healthcare workers and pregnant women in Pakistan: A mixed methods approach

Figures & data

Figure 1. Knowledge of the healthcare workers regarding influenza vaccine.

Figure 2. Attitudes and practices of the enrolled healthcare workers in Pakistan.

Figure 3. Knowledge, attitudes and practices of pregnant women toward influenza vaccine.

Table 1. Sociodemographic characteristics of the enrolled healthcare workers.

Characteristics	n = 420
	N (%)
Province
Sindh	100 (23.8%)
Federal	108 (25.7%)
KPK	105 (25.0%)
Baluchistan	107 (25.5%)
Age, years, (Mean ± SD)	33.7 ± 7.8
Gender
Male	221 (52.6%)
Female	199 (47.4%)
Highest level of education
Primary	20 (4.8%)
Secondary	21 (5.0%)
Vocational education	35 (8.3%)
Graduation	180 (42.9%)
Postgraduate	164 (39.0%)
Occupation
Doctor	209 (49.8%)
Nurse	103 (24.5%)
Midwife	20 (4.8%)
Others	88 (21.0%)
Department/Unit
Medicine/ICU	146 (34.8%)
Pediatrics/NICU	96 (22.9%)
Surgery	22 (5.2%)
Obstetrics/Gynecology	77 (18.3%)
Others	79 (18.8%)
Years of experience
<5 years	175 (41.7%)
5–9 years	117 (27.9%)
>9 years	128 (30.5%)
Vaccinated against COVID-19
Yes	405 (96.4%)
No	15 (3.6%)

Table 2. Sociodemographic predictors of KAP scores among healthcare workers.

Characteristics	Attitude Scores		Practice Scores
	Co-eff(CI)	P-value	Co-eff(CI)	P-value
Province
Sindh	Ref		Ref
Federal	0.10(−2.29,2.49)	.932	2.3(1.72,2.88)	<.001
KPK	−3.92(−6.45,-1.39)	.002	−0.07(−0.64,0.49)	.8
Baluchistan	−13.60(−16.1,-11.08)	<.001	−1.57(−2.11,-1.02)	<.001
Age, years	-		-
Gender
Male			Ref
Female	-		0.43(0.01,0.85)	.045
Occupation
Doctor	Ref		Ref
Nurse	−6.17(−8.34,-4.01)	<.001	−0.56(−1.07,-0.06)	.029
Midwife	−3.1(−7.05,0.84)	.123	−0.59(−1.54,0.36)	.221
Others	−2.84(−5.03,-0.65)	.011	−0.29(−0.81,0.23)	.272
Years of experience
<5 years	Ref		-
5–9 years	−2.25(−4.39,-0.11)	.04	-
>9 years	−0.29(−2.41,1.83)	.787	-
Vaccinated against COVID-19
Yes	-		2.2(1.14,3.27)	<.001
No	-		Ref

Table 3. Sociodemographic characteristics of the enrolled pregnant women.

Characteristics	N = 750
	n(%)
Province
Sindh	425 (56.7%)
Federal	110 (14.7%)
KPK	105 (14.0%)
Baluchistan	110 (14.7%)
Age, years	n = 749
Under 18	16 (2.1%)
18–24	240 (32.0%)
25–29	255 (34.0%)
30–34	174 (23.2%)
35–39	55 (7.3%)
40–49	9 (1.2%)
Highest level of education	n = 742
No formal education	294 (39.6%)
Primary	212 (28.6%)
Secondary	138 (18.6%)
Higher secondary or above	98 (13.2%)
Currently employed*	44 (6.0%)
Gestational age in weeks at the time of enrollment, (mean ± SD), n = 733	26.2 ± 10.3
Total number of pregnancies including current, median(IQR)	3 (2–5)
Total number of children, median(IQR)	2 (0–3)
Vaccinated against COVID-19	209 (27.9%)

*Currently employed: Pakistan, n = 737.

Table 4. Sociodemographic predictors of KAP scores among pregnant women.

Characteristics	Knowledge Scores		Attitude Scores		Practice Scores
	Co-eff(CI)	P-value	Co-eff(CI)	P-value	Co-eff(CI)	P-value
Province
Sindh	Ref		Ref		-
Federal	−0.80(−1.23,-0.35)	<.001	−3.16(−4.78,-1.54)	<.001	-
KPK	−1.74(−2.23,-1.26)	<.001	−1.31(−3.05,0.42)	.138	-
Baluchistan	−1.00(−1.44,-0.57)	<.001	−2.23(−3.84,-0.63)	.007	-
Age, years
Under 18	-		−4.25(−7.95,-0.56)	.024	−0.77(−1.44,-0.09)	.026
18–24	-		−0.2(−1.53,1.13)	.771	0.04(−0.2,0.27)	.757
25–29	-		Ref		Ref
30–34	-		0.3(−1.11,1.72)	.672	−0.11(−0.36,0.15)	.405
35–39	-		−0.7(−2.82,1.42)	.518	0.08(−0.31,0.46)	.701
40–49	-		1.7(−3.13,6.52)	.491	−0.12(−1,0.77)	.796
Highest level of education
No formal or little education	Ref		Ref		-
Primary	−0.18(−0.54,0.18)	.342	0.28(−1.03,1.59)	.678	-
Secondary	0.53(0.11,0.96)	.014	1.82(0.28,3.35)	.021	-
Higher secondary or above	0.69(0.18,1.21)	.008	2.2(0.38,4.01)	.018	-
Employment status
Currently employed	0.73(0.10,1.37)	.023	-		-
Not currently employed	Ref		-		-
Vaccinated against COVID-19
Yes	-		-		0.53(0.31,0.74)	<.001
No	-		-		Ref

Table 5. Sociodemographic characteristics of participants in IDIs and FGDs.

Interview type	Occupation	Gender	Region	Vaccination status (Influenza)
IDI	Assistant medical director	Male	Islamabad	Non-vaccinated
IDI	Stock officer (health department)	Male	District Dadu (Sindh)	Non-vaccinated
IDI	Deputy director	Male	Provincial disease surveillance response unit (Sindh)	Non-vaccinated
IDI	Senior medical officer, provincial focal person for COVID-19 vaccination	Female	Directorate General Sindh health services	Vaccinated
IDI	Senior registrar	Female	Polyclinic (Islamabad)	Non-vaccinated
IDI	Consultant	Female	Health service academy (Islamabad)	Non-vaccinated
IDI	Deputy provincial coordinator (MNCH)	Male	Quetta, Baluchistan	Non-vaccinated
IDI	Deputy, District Health Officer	Male	District Korangi, Karachi, Sindh	Non-vaccinated
IDI	Senior lecturer, Sarhad university	Male	North-west & KPK	Non-vaccinated
IDI	Field fellow	Male	Regional disease surveillance, Karachi, Sindh	Non-vaccinated
IDI	Field fellow	Male	Regional disease surveillance, Karachi, Sindh	Non-vaccinated
FGD	Community physicians	Both	AKU center (Rehri Goth)	Vaccinated
FGD	Pediatric Residents	Both	Aga Khan University Hospital, Karachi	Vaccinated
FGD	Pediatric Nurses	Both	Aga Khan University Hospital, Karachi	Vaccinated

Data availability statement

Data are available upon reasonable request from the corresponding author.We have not uploaded the data on a repository and so there is no URL provided.