EXAMINING PROGRESS TOWARDS REDUCING REFUSAL OF THE ORAL POLIO VACCINE IN NIGERIA FROM 2008-2013

Abstract

Refusal of the oral polio vaccine has served as a major obstacle to the global eradication of polio, especially in the final three countries that remain endemic for the disease: Afghanistan, Pakistan and Nigeria. The independent monitoring board of the World Health Organization reported that 25% of all missed children in Nigeria during immunization days were due to noncompliance with vaccination, and that if refusal remained unaddressed, successful eradication of polio will not be accomplished. This thesis utilizes probit regression analysis to test the hypothesis that although OPV coverage in Nigeria has increased from 2008-2013, refusal was not necessarily reduced during that time period. This hypothesis was proved false by the results of the regression models, but not without some caveats. While refusal was reduced in the north west region of Nigeria, many women with the characteristics correlated with a likelihood to refuse OPV (specifically, low levels of education, low wealth status, young age, and religious identification as Islam or traditionalist) were just as likely to have unvaccinated children in 2008 as they were in 2013, suggesting that these groups were still noncompliant. Improving the collection of data on refusal (and targeting existing anti-refusal strategies towards women with the characteristics correlated with refusal) may result in an eventual decrease in the refusal of the OPV by Nigerian mothers.