DRC: Religious beliefs, tradition, distrust of gov’t service barrier to polio eradication –UNICEF

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Staff writer

Between 8-12% of children under-5 years old are left unvaccinated against the poliovirus after each of DR Congo’s polio vaccination campaigns, occurring almost monthly. There could be many reasons for unimmunized children in DR Congo – vaccination teams may not have arrived at their designated households – either due to poor performance or logistical constraints; when teams do arrive, parents may refuse the vaccine; or they may inform frontline workers that children are not at home when they arrive.

Among children that are missed each month, up to 40% are missed due to their parents’ refusal to accept the oral polio vaccine. According to UNICEF, in DR Congo, deeply entrenched religious and traditional beliefs as well as a strong distrust of government health services undermine polio eradication efforts, particularly in Katanga.

“We don’t trust the vaccine; we have faith in God who heals us. We trust in God,” says Maman Adèle told UNICEF researchers in Katanga. A profound belief in divine intervention against polio, among many other religious and cultural beliefs, contributes to DR Congo’s high proportion of children who are unvaccinated due to parents’ refusal of the oral polio vaccine. A deeply entrenched social and cultural system that rejects ‘western medicine’ compounds the eradication effort in some of the highest risk areas.

In the first quarter of 2012, approximately 46% of missed children were not vaccinated due to refusal, and 35% were due to child absence.

In some cases, reporting of child absence has been found to conceal vaccine avoidance behaviour, rooted in religious beliefs or distrust of government health services. In Kinshasa, parents who don’t want to give their children OPV are fairly outspoken in openly refusing it. But in other provinces, where children seem to be missed largely because they were absent at the time teams’ visited, and caregivers claim that they will accept vaccination during the next round, this willingness has been found to conceal a fear of reprisals from authorities for openly refusing OPV.

missed by the October campaign in the five provinces that reported polio cases in 2011: Kinshasa, Bas Congo, Bandundu, Katanga, and Kasai Occidental. Results are not representative, but are indicative of trends in these areas. The goal of the study was to explore which social factors contribute to missed children – such as the credibility and quality of information parents receive about polio, risk perceptions to polio, and motivations for vaccination.

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