Renne Elisha
University of Michigan, Ann Arbor, MI, USA.
Soc Sci Med. 2006 Oct;63(7):1857-69. doi: 10.1016/j.socscimed.2006.04.025. Epub 2006 Jun 12.
Through the efforts of the global campaign to eradicate poliomyelitis, polio cases have declined worldwide, from 35,251 cases in 1988, to 1449 cases as of 28 October 2005. However, confirmed cases of wild polio virus continue to be reported from Northern Nigeria. This paper examines the reasons for the difficulties in eradicating polio in Northern Nigeria from the perspective of residents of one town, Zaria, in northern Kaduna State. Research methods included participant observation, open-ended interviews and the collection of polio-related documents. While some people believed that the vaccine was contaminated by anti-fertility substances, others questioned the focus on polio when measles and malaria were considered more harmful. Some also distrusted claims about the safety of Western biomedicine. These concerns relate to questions about the appropriateness of vertical health interventions, where levels of routine immunization are low. While the Polio Eradication Initiative was considered to be cost-effective by Western donors, from the perspective of some people in Zaria it was seen as undermining primary health care, suggesting that a collaborative, community-based framework for primary health care, which includes routine immunization, would be a more acceptable approach.
通过全球根除脊髓灰质炎运动的努力，全球脊髓灰质炎病例已有所减少，从1988年的35251例降至截至2005年10月28日的1449例。然而，尼日利亚北部仍不断有野生脊髓灰质炎病毒确诊病例报告。本文从卡杜纳州北部扎里亚镇居民的角度，探讨了尼日利亚北部根除脊髓灰质炎存在困难的原因。研究方法包括参与观察、开放式访谈以及收集与脊髓灰质炎相关的文件。一些人认为疫苗被抗生育物质污染，另一些人则质疑在麻疹和疟疾被认为危害更大的情况下却将重点放在脊髓灰质炎上。一些人还不信任关于西方生物医学安全性的说法。这些担忧涉及到常规免疫水平较低时垂直卫生干预措施是否恰当的问题。虽然西方捐助者认为根除脊髓灰质炎倡议具有成本效益，但从扎里亚一些人的角度来看，它被视为破坏了初级卫生保健，这表明包括常规免疫在内的基于社区的初级卫生保健协作框架将是一种更可接受的方法。
