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3
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84914967381
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-
Estimates of EPI coverage vary by method of measurement used—presence of immunization card in the house, or total number of unit doses reported to be administered nationally divided by the population of eligible children. The poorest immunization rates are for measles and tetanus. Measles claims some one and a half million lives a year. It is estimated that only 30% of mothers are immunized against tetanus globally and some three quarters of a million children die from neonatal tetanus a year.
-
-
-
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4
-
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0023019445
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Primary health care in developing countries: overcoming operational, technical and social barriers
-
At issue here is the occurrence of replacement mortality, that is when death of high risk children from one set of diseases is averted by immunizations only to have the children die from other illnesses in what Lincoln Chen (1986) has referred to as a context of chronic ill health. This possibility suggested by Mosley (1985) and Kasongo Project data (1981) which generated considerable debate as well as a series of studies focusing on the utility of immunizations. For a discussion of this literature and data which demonstrate that measles immunizations have long-term utility during childhood see Aaby (1991); Garenne and Aaby (1990); and Holt et al. (1990). Aaby has been vocal in criticizing the replacement death position. He points out that few community studies examine the total impact of health interventions. His data suggest that both children who have experienced measles and live, and children who have received measles vaccine, have lower mortality [[Truncated]]
-
(1986)
Lancet
, vol.8518
, Issue.2
, pp. 1260
-
-
Chen1
-
6
-
-
0019435011
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Influence of measles vaccination on survival patterns of 7–35 month old children in Kasongo Zaire
-
(1981)
Lancet
, vol.1
, pp. 764
-
-
-
9
-
-
0002204684
-
Determinants of measles mortality host or transmission factors?
-
(1991)
Medical Virology
, vol.10
, pp. 83
-
-
Aaby1
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11
-
-
0028106783
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Children's vaccine initiative stumbles
-
Promises of one dose time-release super shots (nasal sprays, pills, etc.) which protect against EPI diseases and more loom on the horizon of the foreseeable future. Considerable research will be needed, however, to discover how many antigens a baby's immune system can handle at one time, such that one immune response does not wipe out another. See, Unitl the efficacy and long-term effect of such technology is evaluated in less developed countries and research costs are paid for making such technology affordable, inhabitants of less developed countries will continue to be exposed to an increasing number of vaccinations. On the financial blocks impeding the progress of vaccine research
-
(1994)
Science
, vol.265
, pp. 1376
-
-
Gibbons1
-
12
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0028136202
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Bumps on the vaccine road
-
See for example
-
(1994)
Science
, vol.265
, pp. 1371
-
-
Cohen1
-
14
-
-
84925932345
-
Anthropological views of community and community development
-
I use the term ‘community’ in this paper as a heuristic device and recognize a tendency within international health and development to reify community as an entity which exists in its own right (Schwartz, 1981). As distinct from static structures defined by the state, communities are a fluid collectivity mobilized and defined in relation to sets of activities which bring together people having shared stakes and interests. My use of the term community does not suggest consensus or homogeneity beyond shared habitus (Bourdieu, 1997). See
-
(1981)
Human Organiz.
, vol.40
, pp. 313
-
-
Schwartz1
-
16
-
-
84914967380
-
-
Measles deaths are commonly associated with pneumonia and diarrhea. The anorexia which occurs during and following measles is a notable cause of malnutrition.
-
-
-
-
17
-
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84914967379
-
-
The extent to which community trust of vaccination programs has been lowered by press coverage of ineffective vaccines and inappropriate storage is not dealt with in this paper and constitutes an area for future research. In need of study is not only the extent to which mistrust leads people to suspect that ‘normal’ side effects are signs of bad medicine, but the extent to which mistrust leads people to seek out vaccinations from the private sector.
-
-
-
-
18
-
-
0003309238
-
Vaccinations in South Asia: false expectations and commanding metaphors
-
J. Coreil, D. Mull, Westwood Press, Connecticut, On the spread of conspiracy stories as a new form of folklore worthy of serious attention see Campion-Vincent. The baby parts story: a new Latin American legend
-
(1990)
Anthropology and Primary Health Care
-
-
Nichter1
-
19
-
-
0007213274
-
The Baby-Parts Story: A New Latin American Legend
-
(1990)
Western Folklore
, vol.49
, pp. 9
-
-
-
21
-
-
0024601196
-
Anti-fertility vaccines
-
Fears that vaccinations might be related to family planning efforts emerged during ethnographic interviews, but did not surface as responses to survey questions about vaccination demand. Notably, this perception was articulated by men and not women and did not appear to be widespread. My impression is that the fear is presently latent, but capable of capturing the popular imagination given the right set of conditions. One can only wonder what impact an injectable contraceptive might have on the EPI program given the memory of ‘emergency’ family planning excesses in India during the 1970s and present ethnic and religious tensions. On this note, it is worth mentioning that Talwar and associates (Talwar and Raghupathy, 1989) have been experimenting with an injectable contraceptive in India. Although this research has been reported in the press, and protested by women's health activists (AIDS Weekly, 1992), it is not widely known about. Rumors [[Truncated]]
-
(1989)
Vaccine
, vol.7
, pp. 97
-
-
Talwar1
Raghupathy2
-
22
-
-
84914955619
-
Cultural perception of neonatal tetanus and program implications, Bolivia
-
Santa Fe, New Mexico, 1989, AIDS Weekly, Activists protest proposed AIDS and contraceptive vaccines
-
(1992)
Applied Anthropology Meetings
, pp. 8
-
-
Bastien1
-
23
-
-
0003911187
-
-
Members of this peri-urban community rarely utilized primary health care services and depended on private practitioners for their health care needs. They viewed vaccination surveillance with suspicion. While the government, in principle, supplied vaccines free of charge to private practitioners, the supply was erratic, many private practitioners did not request vaccines routinely, and there was poor follow up on the part of practitioners with respect to reminding mothers about vaccination schedules. Practitioners complained that mothers frequented more than one doctor, making it difficult for them to know what vaccinations a child had received. On the growing importance of private practitioners as providers of immunizations in India, see, Foundation for Research in Community Health, Bombay, India, They report that 42% of children surveyed in Jalgoan District, Maharastra, received their immunizations exclusively [[Truncated]]
-
(1989)
Cost of Health Care: A Household Survey in an Indian District
-
-
Duggal1
Amin2
-
24
-
-
0004220908
-
-
The ‘other’ would be included in a global ‘community’ defined in relation to mutual desires as well as perceptions of risk and protection. Similarities may be drawn between missionary activities directed at clothing the natives for their own good (and good health) and attempts to penetrate the surface and vaccinate. Germane to this assessment are the deliberations of Comaroff and Comaroff (1992, Chap. 10) on the relationship of domestification and colonialism in Africa. See, Westview, Boulder, CO
-
(1992)
Ethnography and the Historical Imagination
-
-
Comaroff1
Comaroff2
-
25
-
-
85025290236
-
The changed mother or what the smallpox goddess did when there was no more smallpox
-
An example of how deities are perceived to show their power through new disease patterns after biomedicine has controlled diseases traditionally associated with their power is provided by Egnor (1984). Egnor considers the fate of the smallpox goddess, once smallpox was controlled in Tamil Nadu, India. On the open ended way in which deities show their power in India see Nuckolls (1992)
-
(1984)
Contribut. Asian Stud.
, vol.18
, pp. 24
-
-
Egnor1
-
26
-
-
85044901288
-
Divergent ontologies of suffering in South Asia
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(1992)
Ethnology
, vol.31
, pp. 57
-
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Nuckolls1
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27
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38749144206
-
Of ticks, kings, spirits and the promise of vaccines
-
Kyasanur forest disease was linked to the wrath of local deities (bhuta) as the result of both forest clearance and the failure to perform yearly rituals to these patron spirits. A vaccine to combat this deadly disease was promised in the press, but was not forthcoming, C. Leslie, A. Young, Univ. of California Press, Berkeley, Calif
-
(1992)
Paths to Asian Medical Systems
, pp. 224-556
-
-
Nichter1
-
31
-
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84914967378
-
-
Such data would in any case be accessible from hundreds of thousands of Indians living abroad.
-
-
-
-
32
-
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0003479615
-
-
Haraway explores the emergence of the immune system as a semiotic system, “an elaborate icon for principal systems of symbolic and material difference in late capitalism, a map drawn to guide recognition and miscognition of self and other in the dialectics of Western politics” (1991, p. 204). See, I would add that in the Indian context this imagery draws meaning from Brahmanic ideology about encoded body substance and fluid self construction which has influenced several healing traditions and influenced codes of conduct having to do with ritual purity, group identity, and boundaries. On this issue see Marriott (1976), Marriott and Inden (1977), and Daniel (1984)
-
(1991)
Simians, Cyborgs and Women: The Reinvention of Nature
-
-
Haraway1
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37
-
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84914967376
-
-
Haraway [20] points out that the trope of “space invasion” when coupled to the trope of “infection” evokes the important question of directionality: in which direction is the invasion? Is it the colonized who are perceived as the invader, or he who colonizes? Put less abstractly, when one travels across national borders one requires a series of vaccinations. How is this read? Do the vaccinations protect you from the other, or them from you?
-
-
-
-
38
-
-
0025196564
-
Crash of the immunization program: consequences of a totalitarian approach
-
While it may be argued that some international agencies/groups have been overzealous in their efforts to promote vaccination programs without considering opportunity costs, it is somewhat misleading to suggest that there is a conspiracy to coerce foreign governments into accepting vaccination programs. For such an argument see
-
(1990)
Int. J. Hlth Services
, vol.20
, pp. 501
-
-
Banerji1
-
39
-
-
84906635786
-
Politics of immunization programme
-
Incentives have been offered to countries which accept vaccination initiatives and provisions of U.S. aid have been tied to vaccination goals. At the same time, researchers in less developed countries associated with groups such as the International Network of Clinical Epidemiology (funded by the Rockefeller Foundation) have been encouraged to test the local effectiveness and efficiency of technological fixes including vaccines. Such groups are by no means rubber stamps for the positions of international agencies. They are not hapless victims of technocentric domination as recent local criticism of vitamin A programs attests. See
-
(1990)
Economic and Political Weekly
-
-
Banerji1
-
41
-
-
0342324426
-
The value of particularism in the study of the cultural, social and behavioral determinants of mortality
-
Kunitz echoes this concern by drawing attention to the “seductiveness of an apparently democratic science which cures/protects everyone equally” while deflecting attention away from diseases as “signs of social and ecological settings negatively disposed toward human survival”, J. Caldwell, S. Finley et al.
-
(1990)
Health Transition
, vol.2
, pp. 92-109
-
-
Kunitz1
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42
-
-
84914967374
-
-
Other Indian scientists I have spoken to have questioned the importance of establishing herd immunity through vaccinations. Herd immunity to an infectious disease refers to the phenomena wherein a majority of the population is rendered immune thereby protecting those who are susceptible from acquiring the infection by making the transfer of infection less likely to occur across the population. These scientists questioned the ability to reach and sustain levels of vaccination sufficient to insure herd immunity given the size of India's population and social mobility. The extent to which immunity established by vaccinations achieved herd effect (compared to that established by natural disease) was also questioned, given that weak organisms are used in vaccines.
-
-
-
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44
-
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0019529217
-
Praise of paradox: a social policy of empowerment over prevention
-
A distinction may be made here between a disease prevention model which views people in difficulty (at risk) as like children, an advocacy rights model wherein people are treated as citizens who contract the assistance of experts, and an empowerment model based upon decentralized problem solving and community diagnosis. On this distinction see Rappaport (1981) as well as the community participation literature, See also
-
(1981)
Am. J. Commun. Psychol.
, vol.9
, pp. 1
-
-
Rappaport1
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45
-
-
0022924846
-
Why health improves: defining the issues concerning “Comprehensive Primary Health Care”
-
(1986)
Soc. Sci. Med.
, vol.23
, pp. 559
-
-
Rifkin1
Walt2
-
46
-
-
84910612829
-
Socio-cultural determinants of health in rural Gujarat: results from a longitudinal study
-
J. Caldwell, S. Findley et al., Australia National University, Canberra
-
(1990)
Health Transition
, vol.2
, pp. 628-643
-
-
Visaria1
Anandjiwala2
Desai3
-
47
-
-
0024787904
-
Women's education and its influence on attitudes to aspects of child-care in a village community in Kerala
-
(1989)
Soc. Sci. Med.
, vol.29
, pp. 1299
-
-
Kutty1
-
48
-
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84914967373
-
-
High literacy rates and political will are held accountable for much of Kerala's success. See Franke and Chasin (1989, 1992) for a review of articles which speak to Kerala's more extensive health services and dedicated physicians and health workers who are directly responsible to a militant and informed public subject to left-wing radicalism. Kerala's public are more proactive in demanding better health facilities than are the public in other Indian states, an observation I have made over a 20 year period working in neighboring Karnataka State. I do question, however, the literature which suggests that there is high public demand for public health services. The ratio of doctors to population is higher in Kerala than anywhere else in India and a large majority of the public consult private rather than government physicians for most routine health complaints. What needs to be examined is whether existing immunization rates are linked to mothers' privately and [[Truncated]]
-
-
-
-
50
-
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84914967372
-
-
Kutty determined mothers' attitude toward vaccinations based upon 10 forced choice questions. While the utility of this method is open to question, the results of the study are suggestive [see ref. 29].
-
-
-
-
51
-
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84914967371
-
Immunization: Knowledge, Attitudes and Practices
-
On the basis of a 12 district all-India KAP survey of vaccination behavior, a team of marketing researchers estimated that roughly 20% of all respondents were positively predisposed to vaccinations and 5% negatively disposed. The large majority—75%—were passive in attitude, 50% being indifferent and fatalistic, and 25% aware of benefits, but without conviction (IMRB 1988, p. 90) See, UNICEF, New Delhi
-
(1988)
Final Report to UNICEF
-
-
IMRB (Indian Market Research Bureau)1
-
52
-
-
84906641389
-
Universal immunization programme in India: issues of sustainability
-
For example, see Kulkarni's (1992) assessment of issues affecting vaccination program sustainability in India
-
(1992)
Econ. Polit. Weekly
, vol.17
, pp. 1431
-
-
Kulkarni1
-
54
-
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0021890437
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India's immunization programme
-
For example, Basu (1985), reviewing a wide range of health service research in India, concludes that reasons for failure to vaccinate entails (a) lack of awareness (20–44%), (b) timing inconvenience (9–29%), (c) the child not being well (16%), and (d) missed opportunities related to a reluctance among health workers to vaccinate mildly ill children (unspecified)
-
(1985)
World Health Forum
, vol.6
, pp. 35
-
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Basu1
-
55
-
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84914967370
-
-
At issue is which children's illnesses are perceived as aggravated by vaccinations. While the literature draws attention to fever, cough, and colds, I have encountered reluctance to receive vaccinations in South India associated with skin rashes, earache, and digestive complaints associated with excessive heat in the body.
-
-
-
-
56
-
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0022554598
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The Primary Health Center as a social system: PHC, social status, and the issue of team-work in South Asia
-
(1986)
Soc. Sci. Med.
, vol.23
, pp. 347
-
-
Nichter1
-
58
-
-
84914967369
-
Socio-demographic determinants of non-use of measles immunization services among Javanese mothers
-
For example, health social scientists at Gaja Madha University, Indonesia, have studied vaccination acceptance in terms of both the characteristics of mothers and children. Mothers who worked outside the home and were subject to more time constraints were found to have lower acceptance rates than those who worked only inside the home. Mothers who were active members of social groups were more likely to vaccinate their children than were mothers who did not belong to such groups (Kasniyah, 1993). The differences between acceptance of vaccinations among mothers who share common work-time constraints is not accounted for. Why did some mothers working outside the home seek vaccinations for their children while others did not? Moreover, why did group membership have a positive effect on vaccination acceptance? Was this related to social identity (an affiliation with development mandates or a sense of modernity) or was it the result of increased information on [[Truncated]]
-
(1993)
INCLEN Conf. Report
-
-
Kasniyah1
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59
-
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84914967368
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Factors related to children aged 12–51 months not being immunized against measles in Purworejo, Central Java, Indonesia
-
Cairo, Egypt
-
(1993)
INCLEN Conf. Report
-
-
Zulaela1
-
61
-
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84914967367
-
-
See for example Kasniyah N. Social psychological determinants of Javanese mothers failure to immunize their children against measles. Unpublished Master's thesis. Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, N.S.W., Australia.
-
-
-
-
62
-
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84914967366
-
-
Needed are positive deviance studies which attend to why some people seek out vaccinations when a majority of their peers do not deem it worth their inconvenience.
-
-
-
-
63
-
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84914967365
-
-
I have placed emphasis on the impact of culture on vaccination demand as distinct from an examination of cultural barriers to vaccination programs. The former draws attention to factors which have a positive as well as a negative influence on vaccination acceptance. Examined are factors which lead people to seek out vaccinations, not merely accept them passively. Cultural barrier research typically identifies factors which interfere with program operations.
-
-
-
-
64
-
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0023250544
-
Estimating health service utilization, immunization coverage, and childhood mortality: a new approach in Uganda
-
Vaccination acceptance rates near health posts are not necessarily high. For example, Malison et al. report that in Uganda health workers were surprised to find that only one third of children aged one to four and one fifth of children under one were fully vaccinated despite easy access to vaccines
-
(1987)
Bull. WHO
, vol.65
, pp. 325
-
-
Malison1
Sekeito2
Henderson3
Hawkins4
Okware5
Jones6
-
65
-
-
84914967364
-
Qualitative survey of utilization of health sciences, participation and health needs in Burkina Faso's rural communities
-
Washington D.C.
-
(1993)
World Bank Report
-
-
Ciardi1
-
68
-
-
0024843768
-
Use of ethnographic research for instrument development in a case-control study of immunization use in Haiti
-
(1989)
Int. J. Epidemiol.
, vol.18
, pp. 901
-
-
Coreil1
Augustin2
-
73
-
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84914967371
-
Immunization: Knowledge, Attitudes and Practices
-
The all-India IMRB KAP survey reported that among those who were aware of “preventable injections” 35% did not know that different injections were associated with different types of diseases. Respondents “expected the preventive injections to protect against a wide range of diseases (diarrhoea, dysentery, vomiting, fever, pneumonia, malaria, cough, and cold)” (1988, p. 66) See, UNICEF, New Delhi
-
(1988)
Final Report to UNICEF
-
-
IMRB (Indian Market Research Bureau)1
-
74
-
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84914967363
-
-
However, when these mothers were probed about measles vaccinations, several reported hearing of them. These data are discussed subsequently.
-
-
-
-
75
-
-
0021921819
-
An epidemiological assessment of immunization programme participation in the Philippines
-
The IMRB, study recorded an impression that if a mother has had no trouble during pregnancy, she did not require a tetanus toxoid (TT) vaccination. in South Kanara, the injection was associated with toxins which enter the body with a wound or build up in the body during pregnancy especially if the wrong foodstuffs are consumed. Swelling of the legs and wounds not healing promptly were associated with these toxins (nanju). Not all women were perceived to suffer these problems
-
(1985)
Int. J. Epidemiol.
, vol.14
, pp. 135
-
-
Friede1
Waternaux2
-
76
-
-
44949162677
-
Cultural attitudes to health and sickness in public health programs: a demand-creation approach using data from West Oceh, Indonesia
-
(1990)
Health Transition
, vol.2
, pp. 522
-
-
Raharyo1
Corner2
-
77
-
-
84914967362
-
-
The prevalence of this perception is unknown and constitutes an area for further research.
-
-
-
-
79
-
-
0024882712
-
Traditional or transitional medical systems? Pharmacotherapy as a case for analysis
-
(1989)
Soc. Sci. Med.
, vol.29
, pp. 301
-
-
Tan1
-
80
-
-
0025974882
-
Diarrhea and dysentery: using social science research to improve the quality of epidemiological studies, interventions and evaluations of impact
-
Before use of local terms may be considered in EPI education programs, the sensitivity and specificity of terms (in an epidemiological sense) needs to be established. See
-
(1991)
Rev. infect. Dis.
, vol.13
, Issue.4 S
, pp. 265
-
-
Nichter1
-
81
-
-
0007197552
-
Social science lessons from diarrhea research and their application to ARI
-
This requires taxonomic as well as task onomic assessment of term use and sensitivity to intracultural variation. The latter does not necessarily preclude local term use in health education. Specificity of term use may be enhanced in an environment where term ambiguity is high See
-
(1993)
Human Organiz.
, vol.52
, pp. 53
-
-
Nichter1
-
83
-
-
0021921819
-
An epidemiological assessment of immunization programme participation in the Philippines
-
On local terms for pertussis encompassing other forms of ARI of long duration in India, see IMRB (1988), See
-
(1985)
Int. J. Epidemiol.
, vol.14
, pp. 135
-
-
Friede1
Waternaux2
-
84
-
-
0028435209
-
Acute Respiratory Illness: popular health culture and mothers knowledge in the Philippines
-
(1994)
Med. Anthrop.
, vol.15
, pp. 353
-
-
Nichter1
Nichter2
-
85
-
-
84914967361
-
-
In my earlier article I noted a similar case in North Kanara District, Karnataka State, India. Once the community found out that whooping cough (nayi kemmu) could be prevented, the local primary health care worker was scolded for not informing the community. In the Philippine case, school teachers and mothers alike showed great interest in a vaccination for tuspirina.
-
-
-
-
86
-
-
0018075005
-
Child immunization—what are the impediments for reaching desired goals in a transitional society?
-
Prevention and cure are often confused. See
-
(1978)
Soc. Sci. Med.
, vol.12
, pp. 353
-
-
Adekunle1
-
87
-
-
84906613804
-
Toward a “People Near” primitive health within primary health care
-
Honolulu School of Public Health, University of Hawaii, Prevention can mean preventing an illness from occurring (protection) or preventing it from manifesting or becoming worse. See also Ciardi (1993) who cites the work of Jaffre in stating that in Burkina-Faso, prevention is equated with protection
-
(1984)
Proc. First Int. Symp. Publ. Hlth in Asia and the Pacific Basin
-
-
Nichter1
-
88
-
-
84914967364
-
Qualitative Survey of Utilization of Health Sciences, Participation and Health Needs in Burkina Faso's Rural Communities
-
Washington D.C.
-
(1993)
World Bank Report
-
-
Ciardi1
-
89
-
-
84914967359
-
-
In South Kanara, for example, both talismans and vaccinations are perceived to provide the user a protective fence (bund) which limits the entry of malevolent agents. Stronger fences are needed against more powerful agents of destruction, and like fences, talismans need to be periodically repaired—replaced as a result of environmental damage (e.g. exposure to an eclipse or source of impurity). While vaccinations were not presented by primary health workers as requiring renewal, they were perceived by many as having a time limited effect.
-
-
-
-
90
-
-
0010694397
-
A Cholera Epidemic in a Chinese Town
-
Paul Benjamin, Russell Sage Foundation, New York, Hsu describes how cholera vaccinations may be used for magical purposes to reduce anxiety at times of cholera epidemics. For another example of how science is used as magic (in a Malinoskian sense) see
-
(1955)
Health, Culture, and Community
, pp. 135-154
-
-
Hsu1
-
91
-
-
0022930153
-
The cultural impact of the “AIDS Test”: the American experience
-
(1986)
Soc. Sci. Med.
, vol.23
, pp. 455
-
-
McCombie1
-
93
-
-
84914967358
-
-
The Bambara perceived a vaccination to be an amulet which works where Koranic charms and diviners' incantations have failed. Just as amulets need to be renewed, so vaccinations were perceived as time bound. In the case of measles, it was believed that this illness could affect one several times. For this reason the demand for revaccination could lead to problems of overuse.
-
-
-
-
94
-
-
0025199585
-
Cow dung, rock salt, and medical innovation in the Hindu Kush of Pakistan: the cultural transformation of neonatal tetanus and iodine deficiency disease
-
An example of how vaccinations are interpreted within local conceptual frameworks is provided by Mull, Anderson and Mull. Virtually all mothers surveyed in the Hindu Kush region of Pakistan reported that vaccinations could prevent or cure khudakan, an illness associated with neonatal tetanus. Vaccinations were popular despite the fact that the illness was believed to be caused by spirits. One reason the vaccination was accepted was because it was administered to mothers for the health of children. According to indigenous belief, this spirit linked illness is passed on from mother to child. Vaccinations offered protection in a manner which was an extension of existing health belief and practices. See
-
(1990)
Soc. Sci. Med.
, vol.30
, pp. 675
-
-
Mull1
Anderson2
Mull3
-
95
-
-
84973669959
-
The veil of objectivity prophecy divination and social inquiry
-
On the similarities between diagnosis and divination and the need for a broader appreciation of magic see Jules-Rosette (1978), and O'Keefe (1982)
-
(1978)
American Anthropologist
, vol.80
, pp. 549
-
-
Jules-Rosette1
-
97
-
-
0028435209
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Acute Respiratory Illness popular health culture and mothers knowledge in the Philippines
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Chap. 11
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(1989)
Medical Anthropology
, vol.15
, pp. 353
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Nichter1
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98
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The myth of the people's ignorance
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Das Hammarskjold Foundation, Uppsala, On local interpretation of biomedical resources and indigenous criteria of efficacy see
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(1984)
Development Dialogue
, pp. 42-62
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Fuglesang1
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100
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The association between talismans and vaccinations has been exploited in a Sri Lankan health education program. An analogical approach to vaccination education was piloted by a member of the Health Education Bureau of the Ministry of Health (Mr B. A. Ranaverra). Each type of vaccination offered to children under five was compared to one of five symbolic weapons displayed on a popular amulet. At a recent meeting with my former colleague in 1992, I was informed that this education approach proved to be successful. An image of an amulet had been used on a national vaccination poster.
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Determinants of measles mortality host or transmission factors?
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See
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(1991)
Med. Virol.
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, pp. 83
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Aaby1
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105
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Vaccinated children get milder measles infection: a community study from Guinea-Bissau
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Aaby et al. note that 95% of mothers of children who experienced measles after being vaccinated went on to vaccinate their next child, a rate significantly higher than the general population
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(1986)
J. infect. Dis.
, vol.154
, pp. 858
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Aaby1
Bukh2
Leerhoy3
Lisse4
Mordhorst5
Pedersen6
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106
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Some informants spoke of different types of kora distinguishable by the size of spots. Ame kora is a term used to refer to the rash some infants experience soon after birth. This rash is deemed a good sign that excess heat and poison are leaving the body.
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Asked why kora troubled some people and not others during an epidemic, I was told that many people experienced kora, but did not know it. The illness only manifested if the person was weak or their body became hot. Twenty years ago when I first conducted fieldwork in this area of India, fevers which occurred during summer season were not treated for three days to make sure the illness was not kora. Nowadays there is a propensity to treat any fever as soon as it is noticed.
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Medicines are taken to assist the rash come out and to reduce other symptoms. Such medicines are known as shamana medicines which assist the body, but do not interfere with (or control) the illness process.
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0028435209
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Acute Respiratory Illness popular health culture and mothers knowledge in the Philippines
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The concept of latent illness is not limited to pox diseases in South Kanara. For example, see a discussion of krani and tamare (illness associated with states of malnutrition) in, Research is needed on how perceptions of latency impact on health care behavior over time as well as in relation to an understanding of lay perceptions of vulnerability. Critics of vaccination programs in the West have also focused attention on the possibility that “artificial immunity” might “drive the disease deeper into the body where it might later manifest in more dangerous and disabling ways” (James 1988, p. 33)
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(1989)
Medical Anthropology
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, pp. 353
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Nichter1
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111
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A few mothers spoke of a child getting fat after measles as the illness was thought to purge the body of impurities which would impede the digestive process.
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In the local language of illness, the names of pox illnesses are not directly referred to for fear of calling them into presence. To convey the idea that experiencing kora would prevent other pox illnesses, the Tulu prase malla borugi (big not falling) was used.
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Of three cases of adult onset kora seen by a local doctor, only one was measles. One of the other two cases was chickenpox. Chickenpox, an illness which affects older children in less developed countries (around years 10–12), is uncommon in South India for some unknown reason. When adults visit North India they often contract this disease. A popular ayurvedic practitioner linked the “outbreak of kora” with amlapitta, a condition characterized by excess heat and poor digestion. This was associated with increased use of chemical fertilizer and insecticide. Juxtaposed to the public health idea that failure to maximize biotechnology (vaccinations) resulted in measles was his idea that biotechnology (chemicals) fostered the epidemic.
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A few mothers believed that kora was protected against by “DPT.” One mother noted that she gave her child only two doses of DPT as she was afraid that three doses would suppress kora to the point that it would remain latent in the body causing intermittent skin rashes (kajji). Two doses, she believed, would lessen the severity of the illness, plus the child would get the illness only once. She also believed that DPT protected against “all sudden sicknesses.”
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Two distinct perceptions of the effect of vaccinations were framed around the concepts of sthambhana and upasamana—denoting total protection and protection which minimizes a problem's severity.
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The impression that measles vaccinations renders the illness less severe was also encountered in Java. Remaining to be studied is whether acceptance/demand of measles vaccination is greater among those who think it (a) prevents measles or (b) reduces its severity. Consideration also needs to be given to whether “reduction of severity” is perceived as interfering with the illness process.
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Health for the people or cash for the clever?
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(1986)
Br. Med. J.
, vol.293
, pp. 324
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Lankester1
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119
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What do we mean by health
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J. Caldwell, S. Fendle et al., Australia National University, Canberra
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(1990)
Health Transition
, vol.2
, pp. 27-46
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Das1
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120
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Trust of the motives of those advocating and administering vaccinations has been addressed in this paper. Trust of the skills of those administering vaccinations has been addressed in Nichter (1990) [10].
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I am not saying that selective neglect in the form of non-acceptance or late and incomplete use of vaccinations does not occur. My point is that health concerns based on cultural reasoning and communication underdevelopment lead some people who maximize other preventive health measures to use vaccinations cautiously.
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This perception emerged during exploratory interviews directed toward factors which motivate people to get vaccinations. Information generated by this question frame may differ from that produced by interviews which focus on why child caretakers had not sought out vaccinations for their children in a timely manner. The latter frame is more commonly reported in the literature and may cause informants to be defensive.
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History is rife with examples of how such thinking has served the cause of racism, especially when epidemics have emerged. It is diseases of foreign origin which are perceived to be especially dangerous.
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Health for the people or cash for the clever?
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This quote is taken from Nabarro, Nabarro goes on to suggest that of the six antigens regularly offered through EPI, “only measles—and perhaps polio—can be considered to have major public health importance in most societies.” See
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(1986)
Br. Med. J.
, vol.293
, pp. 324
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Lankester1
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126
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Vaccinations of children in the U.S. is largely achieved by state coercion—children not being allowed to enter school until they are fully vaccinated. The degree to which state coercion translates into citizen demand and perception of need may be ascertained by a more careful look at vaccination statistics. Approximately half of U.S. children are not fully vaccinated before the age of three, the stage of life when they most need the protection. Community surveys in Arizona suggest the public has poor knowledge of what diseases specific vaccinations protect against. While the press plays up clinic accessibility and cost as reducing vaccination rates, demand factors are relatively unexplored.
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Anthropology and psychology toward an epidemiology of representations
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(1985)
Man
, vol.29
, pp. 73
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Sperber1
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129
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Mothers, injections and poliomyelitis
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I am not suggesting that social marketing has no important role to play in promoting health resources and concepts. Market segmentation, product positioning and placement, attention to imagery, and the creation of a sense of what is normative and valued behavior are important lessons to be learned from marketing. What is questioned is an approach which ‘short changes’ local populations by selling instead of educating. Vaccinations are not Coca-Cola and the goals of business and public health are not identical. There is a difference between citizens and consumers. Social marketing typically attends to one target at a time and measures success by increases in product use or message retention. The impact of marketing campaigns on coexisting health practices and conceptualizations of health and illness is overlooked. Apparent marketing success may deflect attention away from unintended negative outcomes. For example, Wyatt (1992) discusses how [[Truncated]]
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(1992)
Soc. Sci. Med.
, vol.35
, pp. 795
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Wyatt1
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