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ABSTRACT

OBJECTIVE: To find out opinion and response of the community people towards anti-polio campaigns in the target area.STUDY DESIGN: A cross sectional study.

st thPLACE AND DURATION: The research was conducted in Tehsil Takht e Nasrati of District Karak from 1 September 2012 to 28 February 2013.METHODOLOGY: The sample size for the study was 40 and the respondents for the study were head of households and were having children below 5 years of age. The sample respondents were residing in the study area from decades and were having enough knowledge about the norms, values, customs and beliefs of the study area which was very important for the study.RESULTS: Out of total 40 respondents, 85% answered that the goal of polio vaccination campaigns are to eradicate polio disease and nothing other than this. Similarly 22.5% respondents answered that religious clerics are negatively propagating the anti polio vaccines while the remaining 77.5% answered that religious clerics are not negatively propagating polio vaccines.CONCLUSION: Community people are taking polio vaccination positive. They are extending cooperation to the polio vaccination teams and are keen to eliminate this disease. The misconception about polio vaccination can be removed through educating the masses.KEYWORDS: Polio, Oral Polio Vaccine, Wild Polio Virus, Immunization

ORIGINAL ARTICLE

COMMUNITY RESPONSE TOWARDS POLIO VACCINATION CAMPAIGNSIN TEHSIL TAKHT E NASRATI OF DISTRICT KARAK

1 2 3ZIA ULLAH AKHUNZADA , JAN ALAM , SANA ZEB

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INTRODUCTION

Poliomyelitis is a viral infectious disease transmits mainly via the 1faecal-oral route. It mostly affects children under 5 years of age .

This disease can only be prevented through inoculation. Polio virus when enters nervous system via blood stream, cause Acute Flaccid Paralysis (AFP) and make the person handicap. In the last 3 centuries several epidemics are caused by this virus; European and North American were the victims originally,

2contemporary cases are reported from Asia and Africa . In 1988 the World Health Assembly affirmed the pledge of the World Health Organization (WHO) to the worldwide elimination of

3poliomyelitis by 2000 .The Global Polio Eradication Initiative (GPEI) was designed to attain this objective, led by WHO, the UNICEF, Rotary International, and the United States Centers for

4Disease Control and Prevention . Three doses of OPV produce protection to all three poliovirus kinds in above 95% of

5receivers .Pakistan is among those 3 countries where indigenous wild poliovirus (WPV) transmission has never been interrupted. The

6number of reported WPV cases bounced to 198 in 2011 . It can be argued that geopolitical occurrences in the country, such as

war and insecurity, in addition to the loss of masses confidence in the inoculation in certain parts, have continued to hamper elimination programs. False reports disseminated in Pakistan in 2011 that the US and its allies were operating spying nets and are trying to control the population growth through inoculation

7drives .A number of deadly attacks in Dec 2012 and Feb 2013 spotting polio inoculation personnel in Pakistan have led to panic and uncertainty around inoculation initiatives and seem to have compromised the vaccine coverage in several areas. This continues to upset inoculation uptake and meticulous efforts have been made to involve local people and clerics to support

8the cause .The main issues causing to the failure to disrupt virus transmission and the re-circulation of the virus were possibly cross-border transmission from Afghanistan, lack of proper knowledge and awareness, refusals of polio vaccination, pitiable pledge at the district level for polio alleviation, sub district coverage openings, low routine coverage, operational weaknesses in the quality of services and great numbers of children not vaccinated during National Immunization

9Days/Sub-National Immunization Days . This is a state of grave worry for the people as well as the officials because increasing number of new cases each year is registering. There are countries, which are now acknowledged completely polio free and are planning to stop OPV immunization, yet in Pakistan rather having a sharp reduction in fresh cases every year, the

10number of cases documented annually is rising .This article attempts to provide the general perception of community about polio vaccination campaigns. Pakistan is among those three countries where polio is still endemic and new cases have been reported. The article critically examines the perception of people about this disease and the vaccination campaigns being initiated to eradicate this menace. The article also identifies the gaps in the existing mechanism.

1. Lecturer of Social Work2. Lecturer of Sociology,Kohat University of Science & Technology,Kohat, Khyber Pakhtunkhwa Pakistan.

3. Senior Protection Assistant UNHCR, Islamabad.

Corresponding to:

Zia Ullah AkhunzadaLecturer of Social WorkKohat University of Science & TechnologyKohat, Khyber Pakhtunkhwa Pakistan.E-mail: zia.akhunzada@yahoo.com

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teams while the remaining 6 (15%) answered no to this question. The table further reveals that out of total 40 respondents, 28 (70%) respondents said that polio teams are well qualified and discharging duties efficiently, 7 (17.5%) answered in no while the remaining 5 (12.5%) answered in don't know. Out of total 40 respondents, 9 (22.5%) answered that polio vaccines are harmful and affecting the immune system of children while the remaining 31 (77.5%) answered that polio vaccines are neither harmful nor it affects the immune system of the children. Out of total 40 respondents, 7 (17.5%) respondents answered that polio vaccines are anti Islamic, 30 (75%) answered that polio vaccines are not anti Islamic while the remaining 3 (7.5%) were found unaware. The below table reveals that out of total 40 respondents, 3 (7.5%) were found aware about any Fatawa terming polio vaccines as anti Islamic while the remaining 37 (92.5%) were not aware about any Fatawa terming polio vaccines as anti Islamic. Furthermore, out of total 40 respondents, 30 (75%) said yes that community is keen to eliminate polio disease and considering it as serious problem, 3 (7.5%) respondents answered in no while the remaining 7 (17.5%) answered don't know. Similarly out of total 40 respondents, 9 (22.5%) said that religious clerics are negatively propagating the polio vaccination campaigns while the remaining 31 (77.5%) answered that religious clerics are not negatively propagating the polio vaccination campaigns. Out of total 40 respondents, 33 (82.5%) respondents said that the polio vaccination helped in controlling the disease, 5 (12.5%) answered no while the remaining 2 (5%) were found unaware. Similarly out of total 40 respondents, 36 (90%) respondents answered that lack of knowledge misguides the masses about polio vaccination, 1 (2.5%) answered no while the remaining 3 (7.5%) answered don't know. Out of total 40 respondents, 37 (92.5%) respondents answered that imparting awareness to the masses can help in promoting the cause of polio and can make the polio vaccination campaigns more effective.

METHODOLOGY

The study area was restricted to Tehsil Takht e Nasrati of Karak st thDistrict and was conducted from 01 September 2012 to 28

February 2013. The study was conducted with an objective to find out opinion and response of the community people towards anti-polio campaigns. Interview schedule was designed in view of study objective for obtaining primary data from the respondents using likert scale. The research was conducted by selecting 40 respondents from the research area. Purposive sampling technique of non-probability was used for selecting the sample respondent. The sample respondents were head of the households in the target area. The research included only married males who were having children less than five years of age. Un-married males and those who were not having any less than five years old child were excluded from the study. Married women were also excluded due to socio-cultural barriers. Field work for the study was carried out by two professional Social Workers who were having Master degree in the subject of Social Work and the required expertise and knowledge about the subject matter. They went door to door for the collection of data. Before interviewing the respondents, the respondents were briefed about objectives, nature and scope of the study. Informed consent was taken from the respondents before interviewing them.

RESULTS

Table - I shows that out of total 40 respondents, majority of the respondents i.e. 34 (85%) were found familiar with the goals of polio vaccination campaigns and said that the sole goal of polio vaccination campaigns is to eradicate this disease while the remaining 6 (15%) answered negatively. Out of total 40 respondents, 34 (85%) respondents answered that they are extending full cooperation and support to the polio vaccination

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DISCUSSION

Coverage of polio inoculation in Pakistan is extremely low. Such low coverage obviously answers the problem as why polio is still widespread and new cases are emerging. Over the years,

11,12countries account 80–100% coverage . Elimination of Polio needs 100% coverage by complete doses but a huge segment of population is incompletely inoculated making them

10susceptible .Community response towards polio vaccination in our study was positive and people are keen to eliminate this disease. Goal of polio vaccination according to them is to eradicate this disease and not to control population growth. They reject that polio vaccination are administering to children in order to reduce their fertility. Polio vaccines affecting a person's capability to bear children is false and is just a rumor. Children have gotten polio drops when they were young and they've

13grown up normally, got wedded and had normal offsprings .People are considering polio as a serious problem in Pakistan

14and are keen to eradicate this disease from the country . Polio vaccines are neither harmful nor it affects the immune system of the children. The vaccine has been recommended by Advisory Committee on Immunization Practices of the Center for Disease Control and Prevention, American Academy of

15Pediatrics and the American Academy of Family Physicians . Since the Global Polio Eradication Initiative was launched in 1988, the amount of polio cases has decreased by an over 99%. During the same time, the number of polio affected countries dropped from 125 to only 3. Zero case has been reported in the Western hemisphere in 2 decades and Europe was confirmed as

16polio free in 2002 . Health workers are efficiently performing their duties and working round the clock to eradicate this disease despite

17security hazards . They are impartial, neutral and don't hold up any political interests. Their only attention is children; no matter

16who they are or where they are .Islam places on community prosperity and safety, especially for children, as the best guarantee of a better future for the Muslim community. Islam strongly advocates for children's rights and recognizes the right to life as supreme. From this perspective, to ensure the protection of life and health through the prevention of communicable diseases, including vaccine-preventable diseases, is a key value. Islam therefore strongly condemns whoever tries to prevent a child from accessing this basic right,

18including parents and community leaders .Top 22 Islamic scholars from around the globe have also signed an acknowledgement of the polio elimination initiatives, which firmly say that Islam doesn't in any way, form or mode prevent intake of the oral polio vaccine and that the oral polio vaccine being administered to the children is acknowledged by them and is completely harmless. They issued a call for all Muslims to cooperate with the immunization of Muslim children against polio. Maulana Sami ul Haq, head of an Islamic seminary issued a Fatwa urging parents to immunize their children against polio

19and other diseases .Disinformation about polio vaccination is widely hindering the efforts of eradicating this disease. Such indoctrination

orchestrates refusals on part of parents to vaccinate their 20children . People are being guided wrongly regarding polio

vaccination. The EPI personnel also reported dearth of awareness among people as the major barrier. Due to the insignificant role of media, people still trust in myths about

21vaccination . Extra media coverage needs to be given to vaccination to enhance awareness. A study in India has revealed radio as the most common source of information during NIDs. As TV and radio is the most common source of information therefore, in order to amend the attitude of the communities about

22vaccination .

CONCLUSION

Community people are taking polio vaccination positive. They are extending cooperation to the polio vaccination teams and are keen to eliminate this disease. The misconception about polio vaccination can be removed through educating the masses.

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