Routine Immunization - Knowledge, Attitude and Perceptions of Community Members and Health Workers
- 1. INTERNSHIP RESEARCH PRESENTATION Presentation by - Dr. Pranjal Mengar M2022PHSE017 MPH-SE TISS (2022-2024) Monday, 16th October’23 Internship Co-ordinators - Dr. Harshad Thakur & Dr. Narendra kakade
- 2. RESEARCH TITLE & BACKGROUND 'Child Immunization - Attitudes and Perceptions of Health workers and Community members in Migrated Rural Community of Sangrai, Bharasar, Kutch.' Child immunization is a worldwide cornerstone of public health efforts, playing a pivotal role in preventing infectious diseases, reducing child mortality, and improving overall community health. Mission Indradhanush is a crucial government initiative in India aimed at bolstering child immunization rates in rural areas. Despite the availability of vaccines and extensive vaccination programs, there are persistent disparities in immunization coverage, particularly in rural and migrant communities.
- 3. A study by Smith et al. (2020) highlighted that migration status, coupled with economic disparities, can lead to lower immunization rates among children in the United States. Migrant populations are at a higher risk of missing out on essential healthcare services, including immunization, due to various barriers, including language differences, lack of awareness, and distrust of healthcare providers (Desai et al., 2017). In a study conducted in a migrant community in India by Patel et al. (2017), it was found that misconceptions and myths regarding vaccines were prevalent among caregivers. These misconceptions, often rooted in cultural and religious beliefs, acted as barriers to vaccination. LITERATURE REVIEW
- 4. AIM & RATIONALE In Sangrai (Bharasar), a migrated rural community of majority Sama-Muslims, adequate child vaccination facilities are provided, but people often need to opt out of getting their child vaccinated. The perceptions of Health workers and Community members towards child vaccination can impact child immunization and, subsequently, children's health and well-being. The primary aim of research is to explore the attitudes and perceptions of health workers and community members in migrated rural community of Sangrai (Bharasar, Bhuj) towards Child Immunization. DATA FROM PHC - Complete Vaccination 63%, Partial vaccination 18%, No Vaccination 19% (2023)
- 5. RESEARCH OBJECTIVES To explore the attitudes and perceptions of health workers towards child immunization in rural migrated communities. To explore the attitudes and perceptions of community members regarding child immunization in rural migrated communities. To understand barriers and facilitators for immunization uptake on the path of Health workers & Community members in these communities.
- 6. METHODOLOGY STUDY DESIGN STUDY LOCATION COLLECTED SAMPLE TOOL SAMPLING PROCEDURE ANALYSIS UNIVERSE/FRAME DATA COLLECTION METHOD Cross-sectional Qualitative Study Sangrai, Bharasar, Bhuj Health Workers of Bharasar Sub Centre and Community Members of the Sangrai community, Bharasar Village, Bhuj 7 Health Workers & 12 Community Members Purposive Sampling - Criterion Sampling Semi-structured in-depth interviews with Health Workers, and Focused Group Discussion (FGD) with Community Members Primary data through face-to-face personal Interviews and FGD. Thematic Analysis
- 7. ANALYSIS
- 8. PERCEPTIONS Knowledge of Health Workers Knowledge and Awareness of Community Members Beliefs and Myths Trust and Confidence "Child Immunization is like a Foundation Stone which is necessary to protect children from diseases and can save children from serious diseases." (42 Female, HW) "I don't know what is in the vaccine. You (Health workers) say that vaccinate your child so they don’t catch fever." (60 Male, CM) " There is no need to worry if we are not vaccinating our child. We think that we have not taken any vaccines since our birth. I am 60 years old now, what happened to me ? Nothing. Vaccine is only given in the acute diseases like Corona but if there is no disease then why to go for vaccination ?" (60 Male, CM) "Many people say that if our child will take a vaccine then their genitalia will not develop and they will become impotent. Many people complains that after vaccination their child's either leg or shoulder is not working." (52 Male, CM) "Dr. Sir had come to the community and explained well, it would be good if he came again. We trust him and his medicines." (23 Female, CM)
- 9. ATTITUDES Health Workers Community Members "If we tell them repetitively, then they will remember. Those parents who are from marginalized section they should be explained more." (31 Female, HW) "Government product is good and especially vaccines, the results of that is seen during Corona that we all fight from the disease due to vaccine." (38 Male, HW) "We tell people that you may believe in the cultural and religious beliefs of Measles but it also has a vaccine for that which prevents its occurrence. So we show them the right way by integrating cultural and religious beliefs with modern medicine." (36 Male, HW) "I think that we should not go for vaccination. We don't care whether we take vaccines or not. What benefit did we got after taking vaccines? If i am not having a fever and then too if I take medicine, will it work? No." (60 Male, HW)
- 10. FACILITATORS & BARRIERS Health Workers Health Workers Community Members Community Members "Through TeCHO software, we transfer to another location when they are migrated." (43 Female, HW) " Due to lack of education, the negative effect of social media is seen on them. " (42 Female, HW) “ Many times it becomes difficult for me also because I know Gujarati but Banni Kutchi language is spoken in Kutch in which some words are totally changed. So to understand the local language is a difficult task for me. ” (33 Male, HW) “ They said that you change the vial and then provide vaccination to our children. Then we started giving vaccines to the children of other community from the same vial so that they can trust the vaccine….They thought that the vaccines are getting trialed on their community, and this fake news was spread through social media.” (31 Female, HW)
- 11. CONCLUSION AND DISCUSSIONS Health Workers Health workers have positive perceptions and attitudes towards child immunization. The barriers on their path outnumber the facilitators, and they hinder child immunization in the community. They opine providing education, and SBCC can change the negative attitude and perception of the community regarding child immunization. Community Members Negative attitudes toward child immunization are built upon past experiences and fake news from social networks. False perceptions are having roots in cultural and religious beliefs of community members regarding the child vaccination. Fear of vaccines and of people other then community members hinders the process of child immunization in the community.
- 12. RECOMMENDATIONS To address the negative attitude of community members, IEC should be scaled up and include audio- visual components and street play (natak) to educate the community members for the child immunization. Provide incentives for immunization. This could include financial incentives, such as cash payments, or non-financial incentives, such as prizes. Incentives can be especially effective for reaching families who are hesitant to vaccinate their children. Increase literacy among the community members and their children by providing non-financial incentives for admission of children into school and their regular attendance in school.
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- 14. THANK YOU Tata Institute of Social Science (Mumbai) MPH-SE TISS (2022-2024)