Tapping midwives' views about the neonatal hepatitis B vaccine: how welcome is a move towards a health promoting orientation?

Issues Addressed: Although current health care policies in theory are moving more towards inclusion of prevention and health promotion approaches alongside curative care, it is questioned whether these policies are being embraced by health care professionals in their practice. One area where providers might take an active health promoting role is in influencing parents' decisions to have their children vaccinated against serious diseases. This pilot exploratory study was undertaken to gain some understanding of attitudes and perceptions among midwives towards administering and promoting the neonatal dose of the hepatitis B vaccine.

Method: In-depth interviews were conducted with six key informant midwives recruited through a snowball sampling technique. The interviews were guided by open-ended questions providing a flexible framework for qualitative data collection and analysis.

Results: These midwives regarded immunisation primarily as a procedure embedded within many other clinical requirements. They expressed strong deference to consumer sovereignty in immunisation choices. A few held some reservations about safety and necessity with the latter perception underscored by little mention of hepatitis B as a serious and common disease and they expressed little consequent acceptance of the need to take a strong role in prevention and health promotion.

Conclusions: This pilot project provides grounds for further exploring how midwives prioritise and conceptualise their health promoting role with regard to infectious disease prevention.