Portrait of a lengthy vaccination trajectory in Burkina Faso: from cultural acceptance of vaccines to actual immunization

Abstract

BackgroundThe global recognition of vaccination is strongly related to the fact that it has proved in the past able to dramatically reduce the incidence of certain diseases. Nevertheless, reactions regarding the practice of vaccination still vary among communities, affecting the worldwide vaccination coverage. Numerous studies, conducted from varying perspectives, have focused on explaining this active refusal or resistance to vaccination. Although in some cases low immunization coverage has been well explained by active refusal or resistance to vaccination, little is known about the reasons for low coverage where those reactions are absent or play a minor role, especially outside an epidemic context. This study attempts to explain this situation, which is found in the health district of Nouna in Burkina Faso.MethodsAn in-depth ethnographic study was undertaken in the health district of Nouna in an effort to understand, from an anthropological point of view, the logic behind the parental decision-making process regarding the vaccination or non-vaccination of children, in a context where rejection of, and reservations concerning vaccination are not major obstacles.ResultsThree elements emerged from the analysis: the empirical conceptions of childhood diseases, the perceived efficacy of vaccine and the knowledge of appropriate age for vaccination uptake; the gap between the decision-making process and the actual achievement of vaccination; and the vaccination procedure leading to vaccination uptake in the particular context of the health district of Nouna.ConclusionThe procedures parents must follow in order to obtain vaccination for their children appear complex and constraining, and on certain points discord with the traditional systems of meaning and idioms of distress related to pregnancy, the prevention of childhood diseases and with the cultural matrix shaping decision-making and behaviour. Attention needs to be directed at certain promotional, logistical and structural elements, and at the procedure that must currently be followed to obtain vaccination for a child during routine vaccination sessions, which are currently limiting the active demand for vaccination.Abstract in FrenchSee the full article online for a translation of this abstract in French.

Childhood Vaccine Acceptance and Refusal among Warao Amerindian Caregivers in Venezuela; A Qualitative Approach

“…The perception that unwanted symptoms due to vaccination are diseases warranting adequate treatment has, to our knowledge, not been previously described in indigenous South American populations. Dugas et al also described a major role of the empirical concept of childhood disease in low vaccination coverage rates among ethnic groups in Burkina Faso, Africa [16]. In concordance with their study, symptoms/diseases that were most often mentioned by Warao mothers resembled the frequently named side effects of vaccination, with most importance assigned to fever and diarrhea.…”

“…Other studies, including from South American indigenous populations, have documented that practice of traditional medicine, religious beliefs or a lack of faith in Western medicine may negatively affect decisions around health care and vaccination acceptance [16, 28–31]. Although the majority of Warao caregivers visited traditional healers (68%) and were Christians (71%), a major role of these factors in vaccine decision-making was not identified.…”

Immunization coverage and its determinants among children aged 12 - 23 months in a peri-urban area of Kenya

“…Despite the rating of immunization services in the area as being good or very good, reasons given by participants for not taking children for immunization include; unawareness that the child was due for another vaccine, loss of immunization card, child was ill, migration of parents upcountry, service charge and shortage of vaccines at the health facilities. Previous studies have shown an association between full immunization coverage and the said factors [10, 13]. …”

The fallacy of coverage: uncovering disparities to improve immunization rates through evidence. Results from the Canadian International Immunization Initiative Phase 2 - Operational Research Grants

“…The first theme is the challenge of timeliness or age-appropriate immunization . This is evident in the studies presented in this supplement from India [7], Pakistan [4,8], and Burkina Faso [9,10]. By assessing coverage through the analytical lens of age-appropriateness of coverage, these studies bring into question the progress of immunization coverage.…”

“…Mitchell et al [8] provide evidence on how poor access and mother's education (in urban areas only) were the key equity factors obstructing measles vaccination uptake in the Lasbela district of Pakistan. In the Nouna district of Burkina Faso, Sanou et al [12] provide evidence for how the education of both parents along with the economic conditions of households affected immunization coverage.…”