Prioritising culturally appropriate interventions to increase antenatal immunisation in Aotearoa New Zealand: a Delphi study.

Introduction

Antenatal immunisation rates for influenza and pertussis in Aotearoa New Zealand (NZ) are low and inequitable. Culturally appropriate interventions are urgently needed.

Aim

This study aims to identify and prioritise culturally appropriate, equitable interventions to improve antenatal immunisation rates in NZ.

Methods

A three-round Delphi study was conducted. In the first round, interventions to increase antenatal immunisation rates were identified in qualitative interviews with 40 healthcare professionals. In the second and third rounds, 21 panellists (healthcare professionals and health policy and practice experts) rated 10 interventions for their feasibility, equity and impact on a five-point Likert scale. Median and interquartile ranges (IQRs) were calculated. For each parameter, consensus was defined as an interquartile range ≤1. In the third round, panellists selected their 'top three' prioritised interventions for NZ.

Results

Panellists rated all interventions arising from the first round highly for feasibility, equity and impact. Consensus for all parameters was achieved at the strongest level for 5 of the 10 interventions in the second round. At the completion of the third round, consensus had been achieved for all parameters for 8 of the 10 interventions. The introduction of outreach immunisation services for hapū māmā appeared most frequently in participants' 'top three' (selected by 55% of panellists).

Discussion

The 10 interventions identified by participants in the first round were rated highly for their feasibility, equity and impact by panellists in the second and third rounds of this Delphi study. These interventions should be considered by those developing interventions to increase antenatal immunisation rates in NZ.