Redefining Immunization: Not Just a Shot in the Arm

Figures & data

Table 1. Demographic Characteristics of Traditional Health Practitioners in Senegal (N = 696)

Variable	n	%
Age (years)
M ± SD	59.8 ± 12.2
<40	44	6.3
40–60	334	48.0
>60	314	45.1
Gender
Female	241	34.6
Male	455	65.4
Education
French/English school
No formal education	574	82.5
Primary	86	12.4
Secondary	31	4.5
Koranic school	430	61.8
Religion
Muslim	204	29.3
Animist	7	1.0
Christian and Animist	13	1.9
Muslim and Animist	472	67.8
Ethnic group
Wolof	367	52.7
Pulaar	44	6.3
Serere	249	35.8
Other	36	5.2
Marital status
Single	106	15.2
Married	590	84.8
Occupation
Traditional health practitioner (primary occupation)	468	67.2
Traditional health practitioner + other*	228	32.8

*Traditional health practitioner + other refers to those whose secondary occupation is traditional health practitioner.

Table 2. Knowledge and Perceptions About Vaccination Among Traditional Health Practitioners in Senegal (N = 696)

Variable	n	%
Vaccination knowledge	688	98.9
Children/grandchildren vaccinated	16	2.3
Participation in vaccination campaign	187	26.9
Preferred vaccination methods
Oral	564	81.0
Injection	233	33.5
Nasal	115	16.5
Vaccination period (0–6 months)
Good time	500	71.8
Too early	196	28.2
Opinion on vaccination
Protection	624	89.7
Long practice habits	31	4.5
Restore the value of vaccination	39	5.6
Disadvantages of vaccination
Fever	481	69.1
Abscess	101	14.5
Swelling	50	7.2
Functional impairment	114	16.4
Barriers to vaccination
Taboos	209	30.0
Rumors	536	77.0
Beliefs	404	58.0
Cultural factors	384	55.2
Economic factors/lack of resources	630	90.5
Unsanitary personnel	357	51.3
Untrained personnel	123	17.7
Misinformed personnel	213	30.6

Table 3. Factors to Consider for Improving Immunization Coverage (N = 696)

Variable	n	%
Involvement of traditional health practitioners	678	97.4
Consider culture, beliefs, and taboos	626	89.9
Accessibility of vaccination point	615	88.4

Table 4. Logistic Regression Analyses of Factors Associated With Perception of Ineffective Vaccines Among Traditional Health Practitioners in Dakar, Senegal

Variable	Odds ratio	95% CI	p
Traditional health practitioner (primary occupation)	3.78	1.62, 8.84	.002
Female	0.48	0.24, 0.94	.036
Age	0.99	0.97, 1.03	ns
Taboos
Traditional methods	1.28	0.61, 2.70	ns
Source of disease	0.05	0.01, 0.34	.003
Sterility	0.15	0.07, 0.32	<.0001
Rumors
Sterility	0.31	0.13, 0.73	.008
Beliefs
Noninvolvement ofleaders	10.57	2.94, 37.95	<.0001

Note. The odds ratio and 95% confidence intervals were obtained with logistic regression in multivariate analyses adjusted for age and gender. Statistical significance was set at p < .05. Model I was used for the logistic regression analysis. In the logistic regression model age was treated as covariate while other variables were treated as categorical variables.

Table 5. Immunization Outside of Vaccines: Threats and Promotors of Child Health (N = 696)

Variable	n	%
Causes of illness and death for young children
Malnutrition	353	50.7
Malaria	281	40.4
HIV/AIDS	35	5.0
Tuberculosis	36	5.2
Reasons for malnutrition
Unbalanced diet	551	79.2
Not enough food	574	82.5
Poverty	602	86.5
Social conflict	398	57.2
Disaster	465	66.8
Consequences of malnutrition: Increase in morbidity and mortality for…
Pregnant women	598	85.9
Nursing mothers	550	79.0
Infants	529	76.0
Precipitates spontaneous abortion	555	79.7
Specific conditions caused by malnutrition
Kwashiorkor	88	12.6
Goiter	75	10.8
Bleeding gums	143	20.5
Rickets	201	28.9
Process of childbirth—Site and process of delivery—Impact on child health
Preferred site: Modern	590	84.8
Preferred site: Traditional	75	10.8
Preferred site: Home	133	19.1
Protective effect of traditional (upright)versus modern (supine) delivery on childhealth	661	95.0
Barriers to optimal delivery in a modern delivery site
Inability to observe traditional practices	416	59.8
Lack of resources/poverty	657	94.4