ISLAMABAD: Researchers at the Harvard School of Public Health have suggested to the Pakistan government to build trust with communities in areas where oral polio vaccine (OPV) coverage is lower by offering health-related facilities demanded by the community in addition to polio campaigns.

Preliminary findings of a poll carried out in collaboration with Unicef, and released on Tuesday, “clean water” was among the top requests made by nearly 60 per cent parents in the Federally Administered Tribal Area (Fata) when they were asked about the most critical concerns they would like their local government to address.

“Polio programmes may consider this as a platform for more broadly supporting children’s health and opening doors to delivering broader health services in these challenging environments,” according to findings of the survey carried out from Nov 8 to Dec 23 last year.

Basic facilities for Fata pledged

Poll results indicate that there are some misperceptions about polio and OPV that could erode demand in the future, if not addressed. Results show that 37pc parents in Fata and 19pc in lower-conflict areas of the country were not aware that OPV must be taken every time it is offered to maximise protection against the disease.

Although a few parents had explicitly negative views of the vaccinators who came to them, poll results in Pakistan reveal important limits on parental trust in this key aspect of vaccination efforts, particularly in higher-conflict areas.

Limits in trust also extended to the vaccine itself, particularly in Fata where polling results show that nearly half of the parents (48pc) said they had heard rumours about the vaccine, including the rumour that the vaccine causes sterility in boys or girls. However, 33pc of the parents believed there was at least some truth in rumours they heard.

Missed children in the higher-conflict areas included those with parents who have never heard of polio. In Fata, 11pc of parents have no knowledge about polio. Three per cent of parents said that vaccinators came during the last campaign, but their child did not receive polio drops or they did not know if their child received vaccine.

Notably, according to the polls, very few parents suggested that the reason that their child did not get the vaccine was because of concerns about vaccination. Additional reasons parents provided included the idea that, when vaccinators came, the child was not home or the child was sick or sleeping.

Overall, in Fata, 70pc of parents confirmed their children received polio vaccine in the most recent campaign. The polls show coverage to be significantly lower in Fata since inaccessibility and security play a critical role for lower coverage suggested by the finding that 15pc of parents in Fata said vaccinators did not come or they do not know if vaccinators came during the last vaccination campaign.

The polls in Pakistan included 3,396 caregivers in the high-risk union councils of each districts and sub-districts of Bajaur, Khyber Agency, Kurram Agency, Mohmand Agency, Orakzai Agency in Fata; Charsadda, Mardan, Peshawar, Lakki Marwat and Nowshera; Quetta, Pishin, Qila Abdullah; and Gadap in Karachi.

Security concerns prevented interviewers from conducting interviews in North and South Waziristan. Further, they necessitated that only male interviewers were able to conduct interviews in the rest of Fata and thus only male respondents were included in the sample.

Separate analyses comparing the reasons of men and women in other provinces suggest there are a few differences between male and female opinions and experiences with regard to polio vaccination, thus suggesting that comparisons across geographies are still meaningful.

Published in Dawn, August 1st, 2014