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Obstacles to routine immunization in Madagascar: Structural, relational and cultural constraints
Henintsoa Joyce Valentina Ramaroson1,2, Chiarella Mattern1, Elise Huysmans3
1Health & Social Sciences, Epidemiology and Clinical Research Unit, Pasteur Institute of Madagascar (IPM), BP 1274 Ambatofotsikely Avaradoha, 101 Antananarivo, Madagascar.
Vaccine: X
|August 3, 2023
Summary
Low childhood immunization rates in Madagascar are influenced by parental understanding and mistrust, exacerbated by COVID-19. Addressing these factors is crucial for strengthening vaccine programs and improving child health outcomes.
Area of Science:
- Anthropology
- Public Health
- Vaccinology
Background:
- Childhood immunization coverage remains low in Madagascar.
- The COVID-19 pandemic has increased vaccine hesitancy.
- Understanding factors influencing immunization practices and perceptions is critical.
Purpose of the Study:
- To provide an overview of anthropological studies on childhood immunization in Madagascar.
- To analyze factors impacting immunization practices and parental representations of vaccines.
- To assess the influence of the COVID-19 pandemic on vaccine perception.
Main Methods:
- Review of anthropological studies on childhood immunization.
- Analysis of parental perspectives on vaccine roles and benefits.
- Examination of contextual factors influencing vaccine uptake.
Main Results:
- Parents view vaccines primarily as reinforcement against illness.
- Misunderstanding exists regarding combination vaccines.
- Complex relationships noted between immunization, injections, and health passports.
- Contextual factors (newborn frailty, postpartum confinement, lack of knowledge) affect uptake.
- Mistrust and lack of understanding signal a fragile health system.
Conclusions:
- Parental understanding and contextual factors significantly impact childhood immunization in Madagascar.
- The COVID-19 pandemic has amplified existing challenges in vaccine perception.
- Strengthening immunization programs requires addressing systemic fragilities and improving health literacy.
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