Using Religious Leaders of the Community to Address Myths about Polio Immunization in an Urban Slum Area of Pakistan

Background Pakistan among the two countries in the world where polio cases are still reported. Karachi is the largest city and economic centre of the country with an approximate multi ethnic population of 20 million persons. ... [ view full abstract ]

Background
Pakistan among the two countries in the world where polio cases are still reported. Karachi is the largest city and economic centre of the country with an approximate multi ethnic population of 20 million persons. In the recent past community has been refusing polio immunization because of religious disbeliefs. This paper presents a strategy that was adopted by using religious leaders of Sultanabad urban slum area of Karachi to reduce these religious myths in the community in 2014-15.

Methodology
Sultanabad has an approximate population of 78000 and Pushton are the pre dominant ethnic group. The popular myth that has been prevailing is that it is haram (not allowed) to give polio drops to children. After receiving multiple refusals due to religious reasons a strategy was adopted to talk to imams of the local mosques and other religious leaders of the community. Out of 20 identified 13 agreed to participate and became part of our educational sensitization group. These religious leaders were first educated based on edicts available from UNICEF and EPI. They also had certain misconception such as haram contents being part of the drops or the drops may make both males and females sterile and incapacitate them to reproduce. Once their misconcepts were addressed the religious leaders started educating the community males in Friday sermons.

Results
After three months of this campaign the refusal rate started to come down gradually. In 2014 in different three mohallas 39 families had refused polio drops for 0-5 year old children. Between September and October 2015 the refusal rate in the same mohallas had come down to 7 families.

Conclusion
Religious myths against polio still exist even in an urban centre such as Karachi. Religious leaders can be trained and effectively utilized to educate the community for polio immunization uptake.