The Global Context of Vaccine Refusal: Insights from a Systematic Comparative Ethnography of the Global Polio Eradication Initiative

Closser, Svea; Rosenthal, Anat; Maes, Kenneth; Justice, Judith; Cox, Kelly; Omidian, Patricia A.; Mohammed, Ismaila Zango; Dukku, Aminu Mohammed; Koon, Adam D.; Nyirazinyoye, Laetitia

doi:10.1111/maq.12229

Cited by 11 publications

(28 citation statements)

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“…This approach was designed to maximize the validity of our findings (Bernard, 2011), with the associated limitation being that they may not be widely generalizable. That said, a broader analysis of vaccine refusals across multiple countries shows that dynamics similar to the ones described here underlie oral polio vaccine (OPV) refusal in a variety of contexts (Closser et al, 2016).…”

Section: Yearmentioning

confidence: 64%

Polio Eradication and Health Systems in Karachi: Vaccine Refusals in Context

Closser

Jooma

Varley

et al. 2015

Global Health Communication

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Community and health worker engagement will be key to polio eradication in Karachi, Pakistan. In this study, the authors conducted participant observation, interviews, and a document review in SITE Town, Karachi, an area that in recent years has harbored poliovirus. SITE's diverse population includes large numbers of internally displaced persons who are disproportionately affected by polio and are more likely than other populations to refuse the polio vaccine. Vaccine acceptance and worker motivation in SITE Town were shaped by the discrepancy in funding and attention for polio eradication campaigns as compared with routine services. Parental vaccine refusals stemmed from a distrust of government and international actors that provided few services but administered polio vaccine door-to-door every month. Addressing this discrepancy could therefore be key to eliminating polio. The authors suggest short-term improvements to routine immunization and sanitation in key polio endemic areas, coupled with a longterm focus on sustainable improvements to routine immunization and broader health services.

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Section: Yearmentioning

confidence: 64%

Polio Eradication and Health Systems in Karachi: Vaccine Refusals in Context

Closser

Jooma

Varley

et al. 2015

Global Health Communication

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“…Finally, social scientists have also sought to explain how particular understandings of vaccine risk are produced in specific societies. For those writing about the Global South, the focus has generally been on how prior experiences of colonial rule in combination with the disconnections between crumbling local health systems; immediately perceived needs; and well-funded, intensive, single vaccine initiatives have fueled fears regarding the real intentions of those promoting vaccination (e.g., see Closser et al 2016). Much of the literature regarding the Global North, however, harks back to Giddens (1990Giddens ( , 1991 and Beck (1992), who describe modern, industrialized societies as risk societies.…”

Section: A Social Science Perspective On Vaccinationmentioning

confidence: 99%

Framing Childhood Vaccination in the United States: Getting Past Polarization in the Public Discourse

Brunson¹,

Sobo²

2017

Human Organization

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C hildhood vaccination is once again a "hot topic" in the United States. Recent outbreaks of pertussis, mumps, and measles have ignited widespread public debates about vaccines including whether or not they are safe; who should get them and when; and who, if anyone, should be exempt from existing vaccination policies. A significant, yet often overlooked, aspect of these debates is that positions are generally represented as polarities: some parents and their supporters are portrayed as maintaining that partial, delayed, or complete non-vaccination is the best option for their children and that it is their right to make that choice ("anti-vaccination"); while others are portrayed as claiming that such choices are at best shortsighted and at worst abusive to both the children involved and the community at large ("pro-vaccination"). Drawing on research from California and Washington State, we argue that this stereotype of polarity is problematic because it obscures the complex and socially situated processes of childhood vaccination, including the forces that shape parents' vaccination decisions and ultimately children's vaccination outcomes. As an alternative, using Rose's (2015) critique of social science's fetishization of central tenden

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“…One of the challenges for socio-anthropologists is to bring a deeply contextualized knowledge into the planning and implementation process, in ways that are actionable but not reductionist, taking account of the complexities involved, both from a methodological and social standpoint [ 19 – 20 ]. Monitoring and evaluation (M&E) frameworks and approaches have borrowed from qualitative methods, and many field staff have been trained in these, using them in routine program planning activities.…”

Section: Introductionmentioning

confidence: 99%

Towards a science of global health delivery: A socio-anthropological framework to improve the effectiveness of neglected tropical disease interventions

Bardosh

2018

PLoS Negl Trop Dis

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BackgroundOver the last decade, implementation research and a science of global health delivery have emerged as important vehicles to improve the effectiveness of interventions. Efforts to control neglected tropical diseases (NTD) operate in challenging circumstances and with marginalized populations, making attention to context-specific details particularly relevant. Socio-anthropological insights have much to offer a science of NTD delivery. In this paper, an accessible and actionable framework for understanding NTD intervention effectiveness, based on socio-anthropological research, is presented and its utility for program planning and monitoring and evaluation is outlined.Methodology/Principal findingsThe framework was developed inductively by comparatively analyzing three rapid ethnographic studies undertaken in Eastern Africa (2010–2013) on three different large-scale NTD interventions: rabies elimination in Tanzania, sleeping sickness control in Uganda and the prevention of parasitic worms in Zambia. The framework includes five “intervention domains” where the effectiveness of these interventions was negotiated and determined at the local level. This involves: 1) the terrain of intervention (including seasonality and geographical variability); 2) community agency (including local knowledge, risk perceptions, behaviors, leadership and social pressure); 3) the strategies and incentives of field staff (skills, motivations, capabilities and support); 4) the socio-materiality of technology (characteristics of intervention tools and the adoption process itself); and 5) the governance of interventions (policy narratives, available expertise, bureaucracy, politics and the utilization of knowledge). The paper illustrates the importance of each of these domains by drawing on the case study research, presenting lessons learnt and practical recommendations for how such insights could improve intervention delivery.Conclusions/SignificanceTo help close the gap between efficacy and effectiveness in NTD programs, it is important that field staff: 1) generate meaningful knowledge about contextual factors; 2) use this knowledge to tailor field strategies; and 3) create routine mechanisms to account for the dynamic process of implementation itself. The framework presented here offers a simple analytical tool to strengthen these knowledge-to-action relationships existing project planning tools, drawing on the insights of socio-anthropology.

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The Global Context of Vaccine Refusal: Insights from a Systematic Comparative Ethnography of the Global Polio Eradication Initiative

Cited by 11 publications

References 0 publications

Polio Eradication and Health Systems in Karachi: Vaccine Refusals in Context

Polio Eradication and Health Systems in Karachi: Vaccine Refusals in Context

Framing Childhood Vaccination in the United States: Getting Past Polarization in the Public Discourse

Towards a science of global health delivery: A socio-anthropological framework to improve the effectiveness of neglected tropical disease interventions

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