CHAPTER ONE: INTRODUCTION
1.1 Background
Immunization is one of the safest and most effective interventions to prevent disease and early child death. Although, about three quarters of the world‘s child population is reached with the required vaccines, only half of the children in Sub-Saharan Africa get access to basic immunization. In recent years, many countries have employed a growing range of strategies to increase both the provision and utilization of immunization services. These experiences are in consonant with the Global Immunization Vision and Strategy (GIVS) of ―using a combination of approaches to reach everyone targeted for immunization‖.1
A substantial number of children worldwide do not complete immunization schedules because neither health services nor conventional communication mechanisms regularly reach their communities. In some communities, low immunization rates are associated with families living a long distance from health services, having little access or exposure to large-scale or local media, and low doctor- and nurse-patient ratios (e.g. slum-dwellers in the Philippines and South Africa, nomadic populations in Sub-Saharan Africa, and internal migrants in Brazil, Cameroon, and Mozambique). Underserved communities have consistently shown low immunization coverage.6Innovative outreach strategies are needed to particularly target children who are excluded or beyond the reach of immunization services.
Similarly, anti-vaccination information and/or refusal to get children immunized is not new in the world. Historically, populations have rejected immunization due to concerns about vaccine safety as well as political, cultural, and religious reasons.7Today, trust and acceptance of immunization faces two new formidable challenges. Firstly, a global, fast-paced communication environment makes it possible for negative publicity and anti-immunization positions to be disseminated quickly worldwide. Localized opposition (e.g., polio campaigns in India and Nigeria), negative publicity surrounding vaccine safety (e.g., MMR vaccination
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