Online Program

Redefining immunization: Not just a shot in the arm

Tuesday, November 5, 2013 : 10:45 a.m. - 11:00 a.m.

Nancy Anderson, MD MPH, Division of Evening and Weekend Studies, The Evergreen State College, Olympia, WA
Erick Gbodossou, MD, PROMETRA, Dakar, Senegal
The study "Immunization Advocacy: Saving Lives of Africa's Children" was carried out in Benin, Nigeria and Senegal with traditional health practitioners, and other community-based leaders. The study focused on community knowledge, attitudes, and perceptions of immunizations as well as other practices that affect infant wellbeing. The research was divided into two different methodologies: a socio-anthropological study of 710 focus group participants, and individual-based interviews of 5461 people. Traditional healers and community leaders were central to questionnaire development. The final questionnaire used an endogenous definition of immunization that included all of the practices that promote child wellness and prevent illness through the support of the immune system, from biomedically-based vaccination to traditional beliefs and practices. This definition allowed the researchers to explore ways in which traditional health-promoting practices are congruent with biomedical belief systems and ways that they differ. The survey results showed a high general fund of knowledge about vaccine availability and appropriate use but most respondents stated that other kinds of practices were required to reinforce the immune status of children. These included traditional dietary, prenatal, and childbirth practices among others. Respondents described obstacles to community acceptance of vaccinations including practical constraints as well as concerns about adverse effects, incompetent vaccination providers, and systematic non-inclusion of community-based leaders. Policy implications of this work include the necessity of quality control with respect to vaccines and health providers. Even more important, the work highlights the importance of traditional healers and community leaders in health service and vaccine campaign planning.

Learning Areas:

Assessment of individual and community needs for health education
Implementation of health education strategies, interventions and programs
Protection of the public in relation to communicable diseases including prevention or control
Public health or related public policy

Learning Objectives:
Describe the definition of immunization developed by the national advisory committee for use in the study questionnaire. Compare this definition to the definition of immunization used in Western Biomedicine. Describe three traditional practices that the "Immunization Advocacy: Saving Lives of Africa’s Children" study respondents perceive as important to the immunization of young children. List five obstacles to vaccine uptake identified by "Immunization Advocacy: Saving Lives of Africa’s Children" study respondents. Discuss three potential policy implications of the "Immunization Advocacy: Saving Lives of Africa’s Children" study results.

Keyword(s): Immunizations, International MCH

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a pediatrician with a degree in public health. I spent five years working in Mozambique on maternal child health issues, including attention to immunizations. I worked with PROMETRA for seven weeks on the data collected on this study. I am particularly interested in the relationship between culture, traditional healing, and western biomedicine in Africa.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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