Abstract
The study examined nurse characteristics associated with Knowledge, Attitudes, and Practices (KAP) regarding malaria vaccination in Bungoma County, Kenya. Malaria remains a major health burden in Kenya, with 3.4 million cases and 12,000 deaths in 2021. Bungoma County, a malaria-endemic area, implemented the RTS S1 malaria vaccine, but dropout rates for subsequent doses are high. The fourth dose dropout, particularly in Bungoma and Siaya, poses a significant challenge to vaccine adherence. A cross-sectional descriptive study comprising mixed research methods; comprising key informant interviews was conducted among nurses in Bungoma County. A stratified random sampling was used to select 63 health facilities providing malaria vaccine. Data collection involved structured questionnaires, observation checklist, and key informant interview guide. Hawthorne effect was minimized by rapport building or familiarizing the participants by spending a whole morning at the facility CWC and assuring sampled participants of anonymity, this made the participants calm and can provide immunization services without fear of being judged. Data was analyzed through descriptive and inferential statistics to determine associations between nurse demographics and KAP scores. The study found good KAP was significantly associated with characteristics such as age, years of experience, education level, and prior malaria vaccine training. Nurses aged over 35, with higher education, and those trained in malaria vaccine administration had a higher likelihood of exhibiting good knowledge and positive attitudes. The study concludes that implementing targeted training programs and mentorship initiatives for less experienced and younger nursing staff is essential for strengthening vaccine implementation effectiveness. Enhanced continuous education programs in Bungoma County would likely improve malaria vaccine practices and outcomes. Additionally, the findings indicate that structured support systems and ongoing professional development are crucial elements in maintaining high standards of vaccine delivery. The study recommends that mandatory comprehensive training programs should be established, incorporating both theoretical knowledge and hands-on practical skills development. These programs should be regularly updated to reflect current best practices and emerging challenges in vaccine delivery. Furthermore, the implementation of structured on-site mentorship programs, combined with continuous supervision, should be prioritized to ensure consistent application of proper vaccination protocols. Regular refresher courses should be offered to maintain and update healthcare workers' knowledge and skills, while a peer support system should be established to facilitate knowledge sharing and professional development.