Saudi Cultural Missions Theses & Dissertations
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Item Restricted Knowledge and Acceptability of HPV Vaccination in Countries in the Eastern Mediterranean Region: A Systematic Review(University College London, 2024) Aboalaz, Amirah; Sonnenberg, PamBackground: Human Papillomavirus (HPV) is a significant cause of cervical cancer and may cause other cancers, including anal and penile cancers. Despite the availability of effective vaccines, the level of knowledge and acceptability of HPV vaccination varies widely across different regions. This systematic review focuses on the Eastern Mediterranean Region (EMR) to evaluate the current state of awareness and vaccine acceptability. Methods: A systematic review was conducted following PRISMA guidelines, with a comprehensive search across Embase, Scopus, PubMed, and Web of Science for studies published between January 1, 2008, and March 30, 2024. Inclusion criteria were cross-sectional studies conducted in the EMR that included questions on HPV awareness, vaccine awareness, the link between HPV and cervical cancer, and vaccine acceptability. Studies were assessed for quality using the Joanna Briggs Institute (JBI) critical appraisal checklist. Results: A total of 815 studies were identified and after screening and quality appraisal, a total of 36 studies from 14 countries in the EMR were included. The review revealed low levels of awareness about HPV and its vaccine, with median awareness levels at 35.05% for HPV infection and 31.8% for the HPV vaccine. The median acceptability level for the HPV vaccine was higher, at 54.05%. Knowledge about HPV was found to be correlated with higher vaccine acceptability. Conclusion: The findings highlight the need for targeted public health interventions to improve HPV vaccination knowledge and acceptability in the EMR. Strategies may include robust educational campaigns, integration of HPV education into school curricula, community engagement, and training of healthcare providers. Policy interventions to make the vaccine more accessible and affordable are also crucial. Addressing these challenges through comprehensive and multi-faceted approaches can significantly enhance vaccine uptake and reduce the burden of HPV-related diseases in the region.23 0Item Restricted Vaccine hesitancy, social media, and parents’ attitudes towards childhood vaccination: A comparative study of Australian and Saudi populations.(Western Sydney University, 2024-07-27) Alsulami, Khalid; Archee, Raymond; Gurney, MyraParents’ hesitancy to vaccinate their children presents an increasing health risk globally, though public health campaigns can be effective if they address relevant underlying beliefs within a target population. The purpose of this study was to explore and compare Australian and Saudi parents’ attitudes and beliefs about childhood vaccinations, to better understand factors underlying vaccine hesitancy and the role of mediated communication in forming these views. There were two lines of investigation. A self-report survey was distributed to Australian and Saudi parents from 2020–2022 to directly assess their attitudes and beliefs about vaccination. The survey approach was supplemented with a broad search of Twitter for vaccine-related content across Australia and Saudi Arabia from 2018–2021. Qualitative analysis of this content was used to identify themes and concepts to summarise the various perspectives and mediated communications about vaccination. Results showed that different attitudes and beliefs about vaccination were typically held in each country, with Australians generally more positive about vaccinations than Saudis. Findings suggest higher vaccine hesitancy in Saudi Arabia, with different underlying factors and sources relied upon for information. Australians were more likely to rely on their doctor for advice, while Saudis relied more on self-directed sources such as books and social media. Australians were more concerned about vaccine-preventable illnesses, whereas Saudis were more concerned about negative effects of vaccines themselves and were more likely to delay vaccinating their child. Analysis of Twitter content showed that the platform was used extensively to communicate about childhood vaccination in both countries, and that both governments used Twitter to provide health advice. Australians expressed individualist perspectives, with more focus on personal choice, vaccine science, and questioning the influence of the media. Saudis focused more on collectivist themes such as religion and society itself. Together, the two approaches contribute to our understanding of the factors underlying parents’ vaccine hesitancy in Australia and Saudi Arabia. Implications of these findings were discussed in the context of the literature and suggestions were proffered for future research.37 0Item Restricted Challenges Facing COVID-19 Vaccines Cold Chain Systems in Low-income Countries and Their Effects on COVID-19 Vaccine Inequity in Africa and Globally(Saudi Digital Library, 2022-10-03) Alfaraj, Ghaidaa; Roberts, StephenRealizing that the COVID-19 pandemic is a tremendous public health burden due to dramatically increased morbidity and mortality rates, countries undertook measures to limit the transmission of the virus. Eventually, experts and scientists met the urgency of this matter with unprecedented extensive efforts to develop safe and effective vaccines for COVID-19. Unfortunately, the COVID-19 vaccines were developed quickly, and little attention was drawn to their deployment. Therefore, it is justified to expect supply chain challenges in low-income countries, especially those related to the vaccination cold chain. This literature review dissertation aims to explore the challenges facing the COVID-19 vaccines’ cold chain systems in low-income countries and discuss what impacts these challenges have on vaccine inequity in the African region and on larger global efforts to end the pandemic. The methodology of this dissertation is a literature review that employs a qualitative research approach to address the research questions. It is conducted by referring to the six-phase framework for doing a thematic analysis by Braun and Clarke. All publication types were retrieved electronically by searching relevant databases. A total of 14 papers were included in this review. Thematic analysis resulted in four themes, including the challenges facing cold chain systems in low-income countries which are: inadequate cold chain establishment, special vaccine requirements, lack of human resources, and poor infrastructures. Findings show that low-income countries struggle to provide and maintain cold chain systems for COVID-19 vaccines, leading to difficulty deploying them where they are needed, which confirms the contribution of the COVID-19 vaccines cold chain systems’ deficiencies in low-income countries to vaccine inequity in Africa and globally. These consequences and delays in COVID-19 vaccines’ deployment cause vaccine inequity in low-income countries, further exacerbating the pandemic’s dire global effects and challenging global health’s progress towards achieving global health equity.19 0Item Restricted Three Essays on the Impacts of Immigrants on Natives(University of Connecticut, 2023-08) Almuhaisen, Abdulmohsen; Furtado, Delia; Agüero, Jorge; Amuedo-Dorantes, Catalina; Cesur, ResulThis dissertation explores the impacts of refugee and immigrant inflows on natives in the context of developing (Jordan) and developed (United States) countries. The first chapter investigates whether the sudden influx of Syrian refugees into Jordan starting in 2011 induced a reduction in healthcare utilization among native Jordanians, perhaps especially in terms of routine care. Exploiting variation in the share of refugees across time and space and using an instrumented difference-in-differences identification strategy, this chapter examines the impact of Syrian refugees on childhood immunization rates of native Jordanians. I find that the influx delayed natives’ receipt of childhood vaccines, suggesting some congestion in the healthcare sector. However, I find no effect on the likelihood of eventually receiving the vaccines, pointing to the short-term nature of the impacts of such events. The second chapter investigates another potential impact of the same influx –namely the impact on school enrollment among youth Jordanians. Using a similar identification strategy, I show that the influx reduced school enrollment, primarily among males and youths with less educated parents. Next, I show that the effect would have been larger in the absence of post-influx investments in educational infrastructure in the most impacted areas. Finally, I show an increase in employment among Jordanian youths, pointing to a potential labor market mechanism for the estimated effect. The third chapter examines the relationship between immigration enforcement and the institutionalization rates of the elderly. Exploiting the staggered implementation of the Secure Communities (SC) immigration enforcement program across U.S. counties from 2008 through 2014, we show that SC increased the likelihood that Americans aged 65 and above live in an institution. Supportive of supply shocks in the household services market as a central mechanism, we find that the elderly who are most likely to purchase domestic worker services are also the most likely to move into nursing homes following the implementation of SC. Additionally, we find suggestive evidence of significant reductions in the work hours of housekeepers, personal care aides, and home health workers hinting at the critical role of negative supply shocks in occupations that facilitate aging in community.23 0