Addressing myths of anti-vaccine champions
SITUATIONAL INSIGHTS
A delay in acceptance or refusal of vaccines despite availability of vaccination services was noted in the communities, especially Mahadalit hamlets of Bhojpur and Nawada. The community was not forthcoming rather was averse. Health awareness was low while myths weighed high due to illiteracy. Besides, trust was missing – because they had been ignored / deceived with false promises several times in the past. To address the challenging situation, recurring counselling sessions and house visits were made to convince the vulnerable populations. Effective strategies were implemented including involvement of local influencers, peer-to-peer mobilization, door-to-door counselling, awareness drives around vaccine safety as well as health and social protection camps which helped in boosting the vaccine uptake
Subhanti Devi, 28, was new to the concept of routine immunization. Hailing from Ratanpur Mushar Toli, Garhani Block, Bhojpur, one day she was approached by ASHA – Urmila Devi, to get her four-year-old vaccinated. Remotely situated far from the mainstream life, her hamlet was not frequently visited. The hamlet comprises of vulnerable population consisting of stigmatized untouchables, where most of the people could barely meet their minimum day to day needs, remaining landless and excluded. Shubanti and her husband Sonu Mushari were no exception, they are unemployed and engage in the hunt for rats across the paddy fields, to feed their family.
On 23rd Feb, during an interaction of Urmila with her, it was found that Subhanti’s son was a zero-dose child. He had not been routine vaccinated prior. Once introduced to the background of Routine Immunization, Subhanti was swift to deny any further interaction.
Urmila Devi quotes, “When I visited Subhanti’s home, her family members were annoyed, avoiding me. I wanted to explain them about the Special Immunization Drive that was to be conducted in their community during March. But the family hesitated and did not respond well. They seemed disinterested. They had predominant fears about vaccine not being safe, arising from several misconceptions. They lacked trust in the efficacy of the vaccines, the vaccine providers as well as the policymakers. To build confidence in them was difficult but I was determined and did not lose hope. I made my approach humble so that they are free to approach me.”
Subhanti, was not open to adapt to changes and constantly feared that the vaccine would be a threat. Urmila adds, “I left no stone unturned to gain Subhanti’s trust. Apart from explaining her about the importance of the vaccine, I related it to recent outbreak of Measles in Bhojpur and how the unvaccinated were exposed to it. This made her rethink about the relevance of immunization. Further, I requested the religious leader of that hamlet to assist in disseminating information and laying emphasis on the safety of vaccines to address refusals. He agreed to become a vaccine ambassador and shared his personal experience on getting vaccinated, thus reassuring Subhanti’s family that the vaccine is completely safe.”
A day before the session site day, a counselling meet was held to encourage the community to attend the session site the next day. Urmila was waiting for Subhanti who did not come.
“When she did not turn up, I visited her home again to convince the family. This time I also told her about additional health benefits including free health check-up and free medicine distribution which is to be provided at the session site. This finally motivated her family and they came with me to the session site and her child was vaccinated” says Urmila with a spark in her eyes.
On the session site day, the community was mobilized and awareness on vaccination was given by Urmila, making the people understand the pros of being vaccinated and the cons of remaining unvaccinated. Most of the people turned up at the site. Subhanti was one of them.
ASHA Urmila Devi expresses her gratitude to the PCI team for providing her support throughout the process and in instilling confidence in the minds of the people in favour of the vaccine. She trusts that ASHAs have become more confident and efficient because of regular ASHA day meetings, guidance provided on survey register validation, due list preparation and other activities of sensitizing the community for vaccine uptake.
She sums up, “The support provided during ASHA meet has leveraged our knowledge in terms of timely updating the survey registers and due lists, mobilisation of beneficiaries at the session site, imparting the four key messages to the new mothers, full immunization and complete immunization and looking after expecting mothers. We also feel free to reach out to block coordinators for any query or work-related issues.”
Author – Laljeet Kumar (Block Coordinator)
Co-author – Swati Savarn (Consultant)
Editor – Ronnie Clive Francis (Manager – Communication KM)