Deconstructing social resistance to pulse polio campaign in two North Indian districts.
OBJECTIVE
To gain an insight into the phenomenon of social resistance and rumors against pulse polio campaign.


METHODS
Qualitative, community-based investigation, mapping perceptions of various stakeholders through in-depth interviews (IDIs), focus group discussions (FGDs), non-formal interactions and observations.


METHODS
Moradabad and JP Nagar districts of Uttar Pradesh.


METHODS
IDIs (providers 33, mothers 33, community leaders 10); FGDs (providers 4, mothers 8) and non-formal interactions (156) with community leaders, parents, businessmen, journalists (Hindi and Urdu media), mobilizers, vaccinators and supervisors.


RESULTS
A distinct machination of social resistance and rumors against oral polio vaccine during supplementary immunization activities (SIA) was observed in some minority dominated areas. The pattern can be understood through a model that emerged through qualitative evidence. Inspite of all this, most parents in minority areas supported the SIAs. Only a few clusters from extremely marginalized sections continued to evade SIAs, with an endemic pattern. Through social osmosis, these rumors reached majority community as well and some parents were affected. However, in such cases, the resistance was sporadic and transient.


CONCLUSIONS
While the programs focus was on microbiological issues, the obstacles to polio eradication lie in the endemicity of social (and/or cultural) resistance in some pockets, leading to clustering of perpetually unimmunized children - inspite of good coverage of SIAs at macro level. This may sustain low levels of wild poliovirus transmission, and there can be exceptions to the robustness of the pulse approach. A micro level involvement of volunteers from marginalized pockets of minorities might be able to minimize or eliminate this resistance.
Chaturvedi
Sanjay
S
INCLEN Trust International, INCLEN Executive Office, New Delhi.
Dasgupta
Rajib
R
Adhish
Vivek
V
Ganguly
Kalyan K
KK
Rai
Sanjay
S
Sushant
Leena
L
Srabasti
S
S
Arora
Narendra K
NK
D001294:Attitude to Health; D002648:Child; D003153:Community Health Services; D055812:Community-Based Participatory Research; D005260:Female; D014943:Global Health; D006801:Humans; D007194:India; D009035:Mothers; D011051:Poliomyelitis / Q000208:ethnology / Q000517:prevention & control* / Q000523:psychology*; D011055:Poliovirus Vaccine, Oral / Q000008:administration & dosage*; D035502:Trust / Q000523:psychology; D014611:Vaccination / Q000523:psychology*
D011055:Poliovirus Vaccine, Oral