The social dynamics of infant immunisation in Africa : perspectives from the Republic of Guinea
Year: 2006
Type: article
Abstract: Infant immunisation is currently a focus of national and global policy attention in relation to \nAfrica as a key means to address ill-health and contribute to the Millennium Development \nGoals. Yet vaccination coverage is stagnant or falling in many African countries. Redressing \nsuch declines, and ensuring the effectiveness and sustainability of proposed expansion of \nimmunisation programmes, requires a sound understanding of the factors shaping vaccine \ndelivery and acceptance in contemporary African health systems. This paper explores these \nissues through an anthropological approach. It considers how vaccine delivery is influenced \nby the wider context of the health care system; how vaccination demand is shaped by \nsocially-differentiated knowledges and political identities, and how interactions with delivery \ninstitutions and their frontline health workers unfold. It focuses on urban and rural sites in \nthe Republic of Guinea, where dominant policy perspectives often see increasing immunisation \ncoverage as a matter of (a) improving demand through educational approaches that \nenhance people’s biomedical understandings of the reasons for vaccination, and quell misguided \n‘anti-vaccination’ rumours, and (b) redressing supply difficulties through improvements \nto vaccine delivery system infrastructure, financing and management. In contrast, our \nethnographic findings suggest that high demand already exists, although underlain by socially- \nembedded forms of knowledge and reasoning that fail to match, and often contradict, \nbiomedical views. Yet people frequently cannot realise effective access to vaccines, less \nbecause of inherent problems in vaccine delivery systems, but because of the ways these are \nembedded in the multiple, pluralised processes through which health services are now provided \nin the Guinean context. As health workers struggle to cope with provision dilemmas, \ninteractions arise which mothers often experience as negative, and which can deter their \nfuture demand. Such an analysis, and its implications for policy, emerge only through \ndetailed ethnography of what vaccination practices actually mean to Guinean parents in the \ncontext of everyday child care and social relations. \nKeywords: immunisation, vaccination, Guinea.
Institution: Institute of Development Studies
Language: English
Subfield: Health
Field: Social Sciences
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W2235384881