Dasgupta Rajib, Chaturvedi Sanjay, Adhish S Vivek, Ganguly Kalyan K, Rai Sanjay, Sushant Leena, Arora N K
Center of Social Medicine and Community Health, Jawaharlal Nehru University, Delhi, India.
Indian Pediatr. 2008 May;45(5):357-65.
To understand the perceptions and likely determinants that facilitate or act as barriers in implementing additional strategies for polio eradication: (a) accelerated delivery of mOPV1 (monovalent polio vaccine type 1); (b) use of IPV (inactivated polio vaccine); and (c) provision of incentives.
QUALITATIVE. Rapid appraisal procedures (RAP) were adopted to derive the reality by synthesizing multiple sources of information; search for opinions, motivations, behaviors and attitudes of key stakeholders within their organizational and socio-cultural matrix.
Two districts of Uttar Pradesh - Moradabad and J P Nagar.
Total 244 interactions were conducted; 33 interviews and 4 focussed group discussions (FGD) conducted with providers; 33 mothers (<5 years) and 10 leaders were interviewed; 8 FGD were conducted with mothers of under-fives. Informal interactions (156) were also conducted with village pradhans, religious leaders, parents, businessmen, journalists (Hindi and Urdu media), mobilizers, vaccinators and supervisors.
Providers expressed reservation regarding accelerated rounds of OPV; scientific rationale of accelerated rounds is not clear to parents and leaders. Although technical advantages of introducing IPV exist, issues of logistical difficulties and injection safety emerged strongly. Providers and communities indicated a clear 'no' to the cash incentives but argued for developmental issues. Resistance to the program has declined over time but still the program is perceived as the "government's need, not ours".
The polio eradication program is critically poised, an opportunity to intensify efforts for reducing inequities in health services and improve access of all children to the PHC services. Ongoing dialogue with local communities and strong political commitment would be essential to translate the technological innovations into a sustainable program.
了解在实施根除脊髓灰质炎的额外策略时促进或构成障碍的认知及可能的决定因素：(a) 加速提供mOPV1（单价脊髓灰质炎疫苗1型）；(b) 使用IPV（灭活脊髓灰质炎疫苗）；以及(c) 提供激励措施。
定性研究。采用快速评估程序（RAP），通过综合多种信息来源得出实际情况；在组织和社会文化背景中探寻关键利益相关者的意见、动机、行为和态度。
北方邦的两个地区——莫拉达巴德和J P Nagar。
共进行了244次互动；与提供者进行了33次访谈和4次焦点小组讨论（FGD）；访谈了33位母亲（5岁以下）和10位领导人；与5岁以下儿童的母亲进行了8次焦点小组讨论。还与村长、宗教领袖、家长、商人、记者（印地语和乌尔都语媒体）、动员者、疫苗接种员和监督员进行了156次非正式互动。
提供者对加速轮次的口服脊髓灰质炎疫苗表示保留意见；家长和领导人不清楚加速轮次背后的科学依据。虽然引入灭活脊髓灰质炎疫苗存在技术优势，但后勤困难和注射安全问题凸显。提供者和社区明确表示反对现金激励措施，但主张解决发展问题。随着时间推移，对该计划的抵制有所下降，但该计划仍被视为“政府的需求，而非我们的需求”。
根除脊髓灰质炎计划处于关键阶段，这是加强努力以减少卫生服务不平等并改善所有儿童获得初级卫生保健服务机会的契机。与当地社区持续对话以及坚定的政治承诺对于将技术创新转化为可持续计划至关重要。
