Date of Award
Master of Public Health (MPH)
Dr. Lee Rivers Mobley, PhD
Dr. Matthew Hayat, PhD
Background: Poliomyelitis is a viral disease that causes temporary or permanent paralysis among children less than five years of age; however, the virus can infect adults, too. There is no cure for poliomyelitis. The only possible way to save the children under the age of five from the disease is to get them vaccinated against the poliovirus. The Global Polio Eradication Initiative (GPEI) aimed to eradicate the poliovirus by the year 2000. Unexpectedly, even today there are still three polio-endemic countries in the world: Afghanistan, Pakistan, and Nigeria. The main hypothesis of the current paper was that mothers with higher levels of education and wealth index are more likely to get their children vaccinated against poliovirus, as compared to the ones with less education and lower wealth index. Also, it is hypothesized that Muslim communities are more reluctant to polio vaccines as compared to non-Muslim communities.
Methods: First, the 2008 Nigeria Demographic and Health Surveys (NDHS) data for Nigeria was analyzed to explore a binary outcome (whether or not the child had polio vaccination). The outcome was explained by categorical variables related to the mother's SES and religion. Next, Seven reasons given by mothers who did not vaccinate their children and who lived in either rural or urban settings was analyzed. The reasons included: Lack of information, fear of side effects, fear that child will get disease, vaccines do not work, post too far and child was absent
Results: Results of the study indicated a statistically significant and direct association between the Nigerian mothers’ level of education and the odds of getting their child vaccinated. It was also suggested that the odds of getting the polio vaccines were higher between the Nigerian Catholic and other Christian communities as compared to the Muslim communities. Lack of information was the number one reason for not getting the child vaccinated between mothers in rural settings (24%) while fear of side effects and span of vaccination posts stood second and third. Among mothers in urban settings fear of side effects was the main reason (16%) while lack of information and religious reasons were the number two and number three reasons.
Conclusion: The study findings suggested that mothers’ SES could affect the likelihood of getting their children vaccinated, suggesting that the governments of polio endemic countries should consider women’s education and empowerment as part of their health promotion policies and strategies. In addition, study findings were consistent with other related literature in pointing out the need for raising awareness regarding the goals of GPEI and adopting community-based strategies to combat the existing sensitivity against the polio eradication campaigns. Further research needs to be conducted to assess the vaccination related behaviors and attitudes related to mothers’ SES with a special focus on Muslim communities where higher reluctance were experienced against polio vaccines as compared to the non-Muslim communities. Nevertheless, the odds of getting their children vaccinated were lesser among the Traditionalists as compared to Muslims. Less has been written about the vaccination disparities among this religious minority in Nigeria. Future research is recommended to explore the factors that influence polio immunization refusals among the mentioned group.
Safi, Sarah, "Barriers and Potential in the Final Stage of Global Polio Eradication Initiative, NDHS 2008." Thesis, Georgia State University, 2015.