Demand Creation for Polio Vaccine in Persistently Poor-Performing Communities of Northern Nigeria: 2013–2014
| Autor: | George Gerlong, Rui G. Vaz, Peter Nsubuga, Charity Warigon, Samuel Bawa, Charles Korir, Yared G. Yehualashet, Richard Banda, Emmanuel Gali, Pascal Mkanda, Andrew Etsano, Ado J. G. Muhammed, Tesfaya B. Erbeto |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Economic growth Best Polio Eradication Initiative (Pei) Practices in Nigeria with Support from the WHO Population Nigeria underserved communities History 21st Century unmet health needs persistently poor performing LGAs 03 medical and health sciences Polio vaccine 0302 clinical medicine Northern Nigeria Environmental protection Poliomyelitis eradication medicine Humans Immunology and Allergy Community Health Services 030212 general & internal medicine education Convention on the Rights of the Child Health Services Needs and Demand education.field_of_study Local Government 030505 public health Immunization Programs business.industry Public health Vaccination Infant Newborn Infant demand creation medicine.disease Polio Vaccination Poliomyelitis Poliovirus Vaccines Infectious Diseases Child Preschool Population Surveillance persistently poor performing high risk communities Patient Compliance noncompliance 0305 other medical science business |
| Zdroj: | The Journal of Infectious Diseases |
| ISSN: | 1537-6613 0022-1899 |
| DOI: | 10.1093/infdis/jiv511 |
| Popis: | Poliomyelitis has remained endemic in 3 countries in 2 regions of the World Health Organization (WHO), resulting in continued shifting of the target date for global eradication. By the end of 2011, polio remained a global threat despite the availability of oral polio vaccine (OPV), widely acclaimed as one of public health triumphs, given its success in reducing the health burden of the paralyzing disease. Because of the difficulty in eradicating polio, in May 2012 the World Health Assembly declared polio eradication as a programmatic public health emergency of global significance [1, 2]. In Nigeria, some children continued to miss the opportunity to be fully vaccinated because, for various reasons (eg, religious and sociocultural beliefs), parents and caregivers do not allow them to be fully vaccinated. In some instances, vaccination programs miss children because of compromised security and population mobility. These missed opportunities conflict with the Convention on the Rights of the Child and the principles of social justice, which demand that all children should have equal access to effective childhood vaccines, given the potential of vaccines to save lives and to give all children a chance in life [3, 4]. Some factors responsible for the suboptimal vaccination coverage in areas with ongoing poliovirus circulation in Nigeria are suboptimal OPV acceptance due to unmet health needs, low uptake of vaccination in security-compromised and underserved areas, due to threats and inaccessibility to OPV, challenges reaching the underserved communities, and poor program visibility. Indeed, the epidemiology of polio transmission in Nigeria has continuously shown a pattern of isolation in noncompliant, hard-to-reach, and security-compromised areas of 11 states in northern Nigeria where the risk of polio is very high [5–7]. Although children were chronically missed in Nigeria over successive rounds of supplementary immunization activities (SIAs), not much was done on the part of the program to systematically generate sufficient demand for immunization of this group, especially in areas of traditional polio endemicity in the north. Put differently, despite the desire to vaccinate all children and meet the Global Polio Eradication Initiative targets, the effectiveness of recommended strategies for creating a genuine demand for immunization was limited. Demand-side interventions have been shown by the World Health Organization and others to lead to significant gains in child vaccination coverage in low- and middle-income countries [8–11]. To stimulate the population to request for OPV, demand creation interventions were introduced during the September 2013 polio vaccination campaign following successive recommendations by the Independent Monitoring Board and the Expert Review Committee, which oversee polio eradication activities in Nigeria. The demand creation activities included the provision of attractive benefits (hereafter, “pluses”) during immunization activities, the establishment of health camps, implementation of the nomadic Ardo (ie, Fulani community leader) intervention, the Qur'anic schoolteacher package, and increasing media visibility at the state level. We describe the implementation and evaluation of several activities to create demand for polio vaccination in persistently poor performing areas of northern Nigeria. These demand creation activities were designed to specifically target children in these communities by providing attractive packages that best respond to caregivers concerns and provide easy access to vaccines among eligible children. |
| Databáze: | OpenAIRE |
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