PPI has been designed to eradicate polio. If this can be achieved it will also set pace for the eradication of other diseases such as measles. Such a major initiative requires cooperation from all sectors, particularly members of the general population. Thus their perception and acceptance of PPI becomes very vital for its success.
This study revealed that all the participants had heard about polio and PPI. Regarding awareness of the disease, the majority of participants knew that children are most susceptible to polio, that paralysis is an important sequel and that the disease is preventable. These findings were similar to a study done by Singh et al where 70.3% of the participants knew that polio leads to paralysis of legs and 86.2% knew that polio is preventable by vaccination.7
However, a study done by Chincholikar et al showed that in spite of a good literacy status only 60% of the respondents knew about polio.(8
) Similar findings were reported by Misra et al where only 56% knew about polio and only 63% knew that it is preventable.(6
) The differences between studies may be because the latter two studies were undertaken in a rural and slum area respectively while the former study and ours were done in urban areas. This could indicate that level of knowledge about polio differs depending upon the area of residence.
In spite of a good knowledge regarding most aspects of the disease, more than quarter of participants in our study had the misconception that polio is curable and 89% did not know the right mode of disease transmission. Even in the study done by Singh et al 30.7% of respondents thought polio to be a curable disease.(7
The primary source of information about PPI in this study was mainly from the television. In several other studies too television was found to be the commonest source of information for participants.(7
) This indicates that television is a key resource to use when wishing to disseminate information of public health importance.
The role of health workers as providers of primary information about PPI was very limited (7.2%) in our study. This was in contrast to results of studies done in West Bengal and Agra where health workers were the main source of information in about 70% participants.(12
Health workers are supposedly the most effective means to improve the success of the programme. This is because they are chosen from the community and are known to influence the knowledge of local people by interpersonal approach during door-to-door campaign as also observed in a study done by Manjunath et al.(14
Sixty five to 75% participants in our study knew the target population, number of rounds of PPI and the season during which PPI is held. This was similar to observation of Bhasin et al where 75% respondents knew the target group correctly.(15
) Whereas in a study done among Delhi slum population, 82% of respondents knew the correct target group for PPI which was more than our study results.(6
) This could be because the main source of information on PPI among participants in their study was health workers (67.2%). As discussed earlier inter-personal communication is the most efficient means of information dissemination. In another study done in Delhi only 18.1% of respondents knew the PPI days correctly.(7
In our study, almost 24% participants had a misconception that OPV can prevent other diseases as well. This belief could lead to poor uptake of immunizations for diseases.
A further misconception was identified in 2.2 % participants in our study, as they believed that repeated vaccination under PPI results in over dosage. This was comparable to the finding of Dobe et al where 2.2 to 6.3% respondents in various districts did not vaccinate their children due to the fear of over dosage.(12
Forty percent of the participants in our study did not know that polio drops can be given to children with mild illnesses. This could also be a factor causing under coverage of PPI in certain areas. Again only 40% participants knew that child should not be given anything hot for at least 30 minutes following vaccination. This was similar to the findings of Misra et al where 43% participants knew this fact.(6
) Faulty practices such as eating hot food soon after vaccination could result in child not being sufficiently protected by the vaccination as the potency of live vaccine is reduced by this activity.
Educational status was found to be significantly associated with level of awareness about the PPI programme in our study; this is similar to the findings of Chincholikar et al and Rasania et al where also significant association was seen.(8
Participants’ perceptions regarding reasons for non immunization among the general population included the misconception that it is harmful to children followed by ignorance and lack of faith in PPI. Inconvenience (38.8%), misconception that it is harmful (25.2%) and ignorance (9.7%) were the commonest reasons stated by Manjunath et al.(14
) In a study done in Chandigarh too, the commonest reason was inconvenience (46.7%) followed by lack of faith in PPI (20%).(9
) In a study done in Delhi and Calcutta, the main reason for non immunization was ignorance.(6
) A survey done by Jugal Kishore identified a fear of infertility among those vaccinated to be another cause of non immunization.(16
) From the various reasons for non immunization it appears that people have not fully understood the importance of PPI. This needs to be addressed by aggressive campaigning and dissemination of information during future PPI rounds in order to minimize chances of non immunization. Few participants preferring PPI at home over booths in spite of booths being placed conveniently within city limits indicate that they have misunderstood the true purpose of house to house immunization initiative of government.
It was encouraging to learn that all the children from the households of study participants were vaccinated during the previous immunization round and that most were immunised on the booth day itself. Only 12.5% children received vaccination at home. This is less in comparison to studies done in West Bengal and Assam, where about 25% beneficiaries were vaccinated at home.(12
These findings reveal that in spite of a high literacy rate and relatively good knowledge about the disease and the programme, misconceptions still exist in the minds of the people. These issues need to be addressed to improve the success of this programme.