From Intense Rejection to Advocacy: How Muslim Clerics Were Engaged in a Polio Eradication Initiative in Northern Nigeria

Sani-Gwarzo, Nasir; Aliyu, Gambo; Ya'u, Inuwa; Gadanya, Muktar A; Mohammad, Muktar; Zubair, Mahmud; El-Kamary, Samer S.

doi:10.1371/journal.pmed.1001687

Cited by 41 publications

(30 citation statements)

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“…These factors are very likely to be the source of misconception and potential barriers to behaviours change. Based on our findings, and other reported literature [ 33 ], it would be safe to say that the transfer of knowledge from trusted sources like community leaders and religious scholars could significantly reduce the burden of polio from the affected countries. We suggest that the whole campaign should be divided into 2 domains; one should be responsible for the education and the counselling of the people, while the other domain can focus on vaccination and reaching out remote areas which are still not accessed.…”

Section: Discussionsupporting

confidence: 70%

Knowledge, attitudes and perceptions towards polio immunization among residents of two highly affected regions of Pakistan

et al. 2015

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BackgroundDespite the efforts of national and international organizations, polio has not been eradicated from Pakistan. The prevalence of polio in Pakistan is exceptional in global context. Quetta and Peshawar divisions are amongst the most affected regions hit by polio in Pakistan. This study was carried out to assess the knowledge, attitudes and perceptions towards polio immunization among residents of Quetta and Peshawar divisions in Pakistan.MethodsA descriptive, cross-sectional study involving 768 participants was conducted from August to December, 2014 in Quetta and Peshawar divisions in Pakistan. Multistage sampling technique was used to draw a sample of residents from each division. A pre-tested, self-administered questionnaire was used to collect the data from eligible participants. Descriptive and logistic regression analyses were used to express the results.ResultsA total of 38.8 % participants exhibited good knowledge about polio. Mean knowledge score of the participants was 7.35 ± 2.54 (based on 15 knowledge questions). Older age (p < 0.001), low qualification (p < 0.05), rural locality (p < 0.05) and Quetta division (p < 0.001) were significantly associated with poor knowledge of polio. A large proportion of participants displayed negative attitudes towards polio immunization (84.8 %), with a mean score of 19.19 ± 2.39 (based on 8 attitude statements). Lack of education (p < 0.001) and rural residence (p < 0.001) were significantly associated with the negative attitudes of participants towards polio immunization. False religious beliefs (39.06 %), lack of knowledge (33.7 %), fear of infertility by polio vaccines (32.16 %) and security issues (29.42 %) were reported by the participants as the main barriers towards polio immunization.ConclusionThe findings of this study showed poor knowledge and negative attitudes of participants towards polio immunizations. Religious beliefs and lack of knowledge about polio immunization were reported as the major barriers towards polio immunization.

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Section: Discussionsupporting

confidence: 70%

Knowledge, attitudes and perceptions towards polio immunization among residents of two highly affected regions of Pakistan

et al. 2015

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“…The engagement of traditional and religious leaders as advocates for immunisation, especially targeting improving acceptance and uptake of polio in resistant communities, was used more visibly in Bauchi than in Cross River State. This may be because many cases of vaccination rejection in Bauchi, especially for polio vaccine, were for religious reasons and linked to rumours started by some religious leaders ( 32 ). Such intervention may be well accepted in this context and may contribute to reducing vaccine hesitancy ( 33 ).…”

Section: Discussionmentioning

confidence: 99%

Communication strategies to promote the uptake of childhood vaccination in Nigeria: a systematic map

Oku

Oyo‐Ita

Glenton

et al. 2016

Global Health Action

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BackgroundEffective communication is a critical component in ensuring that children are fully vaccinated. Although numerous communication interventions have been proposed and implemented in various parts of Nigeria, the range of communication strategies used has not yet been mapped systematically. This study forms part of the ‘Communicate to vaccinate’ (COMMVAC) project, an initiative aimed at building research evidence for improving communication with parents and communities about childhood vaccinations in low- and middle-income countries.ObjectiveThis study aims to: 1) identify the communication strategies used in two states in Nigeria; 2) map these strategies against the existing COMMVAC taxonomy, a global taxonomy of vaccination communication interventions; 3) create a specific Nigerian country map of interventions organised by purpose and target; and 4) analyse gaps between the COMMVAC taxonomy and the Nigerian map.DesignWe conducted the study in two Nigerian states: Bauchi State in Northern Nigeria and Cross River State in Southern Nigeria. We identified vaccination communication interventions through interviews carried out among purposively selected stakeholders in the health services and relevant agencies involved in vaccination information delivery; through observations and through relevant documents. We used the COMMVAC taxonomy to organise the interventions we identified based on the intended purpose of the communication and the group to which the intervention was targeted.ResultsThe Nigerian map revealed that most of the communication strategies identified aimed to inform and educate and remind or recall. Few aimed to teach skills, enhance community ownership, and enable communication. We did not identify any intervention that aimed to provide support or facilitate decision-making. Many interventions had more than one purpose. The main targets for most interventions were caregivers and community members, with few interventions directed at health workers. Most interventions identified were used in the context of campaigns rather than routine immunisation programmes.ConclusionsThe identification and development of the Nigerian vaccination communication interventions map could assist programme managers to identify gaps in vaccination communication. The map may be a useful tool as part of efforts to address vaccine hesitancy and improve vaccination coverage in Nigeria and similar settings.

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“…Perhaps of greater concern, is the fragility of community trust. The recent memory of the loss of trust in polio programs and high cost in time lost and money to regain this community trust was still fresh in the minds of government officials [ 27 ]. Therefore, officials have considered it a moderate to high risk in Sokoto to switch gel tube size and introduce multiple application of chlorhexidine digluconate 7.1% gel.…”

Section: Discussionmentioning

confidence: 99%

A Report of At-Scale Distribution of Chlorhexidine Digluconate 7.1% Gel for Newborn Cord Care to 36,404 Newborns in Sokoto State, Nigeria: Initial Lessons Learned

et al. 2015

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BackgroundWith an annual estimated 276,000 neonatal deaths, Nigeria has the second highest of any country in the world. Global progress in accelerating neonatal deaths is hinged to scaled-up interventions in Nigeria. We used routine data of chlorhexidine digluconate 7.1% gel utilized by 36,404 newborns delivered by 36,370 mothers, to study lessons associated with at-scale distribution in Sokoto State, North West Nigeria.Methods and FindingsUnder state government leadership, a community-based distribution system overseen by 244 ward development committees and over 3,440 community-based health volunteers and community drug keepers, was activated to deliver two locally stored medicines to women when labor commenced. Newborns and their mothers were tracked through 28 days and 42 days respectively, including verbal autopsy results. 36,404 or 26.3% of expected newborns received the gel from April 2013 to December 2013 throughout all 244 wards in the State. 99.97% of newborns survived past 28 days. There were 124 pre-verified neonatal deaths reported. Upon verification using verbal autopsy procedures, 76 deaths were stillborn and 48 were previously live births. Among the previous 48 live births, the main causes of death were sepsis (40%), asphyxia (29%) and prematurity (8%). Underuse of logistics management information by government in procurement decisions and not accounting for differences in LGA population sizes during commodity distribution, severely limited program scalability.ConclusionsEnhancements in the predictable availability and supply of chlorhexidine digluconate 7.1% gel to communities through better, evidence-based logistics management by the state public sector will most likely dramatically increase program scalability. Infections as a cause of mortality in babies delivered in home settings may be much higher than previously conceived. In tandem with high prevalence of stillborn deaths, delivery, interventions designed to increase mothers’ timely and regular use of quality antenatal care, and increased facility-based based delivery, need urgent attention. We call for accelerated investments in community health volunteer programs and the requisite community measurement systems to better track coverage. We also advocate for the development, refinement and use of routine community-based verbal autopsies to track newborn and maternal survival.

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From Intense Rejection to Advocacy: How Muslim Clerics Were Engaged in a Polio Eradication Initiative in Northern Nigeria

Abstract: Gambo Aliyu and colleagues describe an approach to eradicating polio in Northern Nigeria by engaging Muslim clerics in influencing community perceptions. Please see later in the article for the Editors' Summary

Cited by 41 publications

References 13 publications

Knowledge, attitudes and perceptions towards polio immunization among residents of two highly affected regions of Pakistan

Knowledge, attitudes and perceptions towards polio immunization among residents of two highly affected regions of Pakistan

Communication strategies to promote the uptake of childhood vaccination in Nigeria: a systematic map

A Report of At-Scale Distribution of Chlorhexidine Digluconate 7.1% Gel for Newborn Cord Care to 36,404 Newborns in Sokoto State, Nigeria: Initial Lessons Learned

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