Is religion the forgotten variable in maternal and child health? Evidence from Zimbabwe

Ha, Wei; Salama, Peter; Gwavuya, Stanley; Kanjala, Chifundo

doi:10.1016/j.socscimed.2014.07.066

Cited by 46 publications

(66 citation statements)

References 17 publications

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“…Embora haja evidências de que a religião possa influenciar a utilização dos serviços de saúde, principalmente por meio da hipótese de seletividade, na qual um grupo religioso poderia ter maior acesso ao capital social, que, por sua vez, aumentaria seu acesso aos serviços de saúde. Neste estudo, nenhuma relação foi observada 41 .…”

Section: Discussionunclassified

Fatores associados à adequação do cuidado pré-natal e à assistência ao parto em São Tomé e Príncipe, 2008-2009

et al. 2015

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Section: Discussionunclassified

Fatores associados à adequação do cuidado pré-natal e à assistência ao parto em São Tomé e Príncipe, 2008-2009

et al. 2015

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“…Reasons for hesitancy among Apostolic Church members in Zimbabwe have generally been assumed to be related to their religious beliefs (Pomerai et al 2012; Ha et al 2014; Tumwine 1999; Hove et al 1999). Hesitancy has also been viewed as a result of racial separation under White Rule when indigenous Africans had none or at the best limited access to hospitals (Andersson 1958; Sundkler 1961).…”

Section: Introductionmentioning

confidence: 99%

Qualitative Assessment of Vaccination Hesitancy Among Members of the Apostolic Church of Zimbabwe: A Case Study

et al. 2017

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Vaccine hesitancy or lack of confidence in vaccines is considered a threat to the success of vaccination programs. The rise and spread of measles outbreaks in southern Africa in 2009–2010 were linked to objections among Apostolic Church members, estimated at about 3.5 million in Zimbabwe as of 2014. To inform planning of interventions for a measles–rubella vaccination campaign, we conducted an assessment of the factors contributing to vaccine hesitancy using data from various stakeholders. Among nine districts in three regions of Zimbabwe, we collected data on religious attitudes toward, and perceptions of, vaccines through focus group discussions with health workers serving Apostolic communities and members of the National Expanded Programme on Immunization; semi-structured interviews with religious leaders; and open-ended questions in structured interviews with Apostolic parents/caregivers. Poor knowledge of vaccines, lack of understanding and appreciation of the effectiveness of vaccinations, religious teachings that emphasize prayers over the use of medicine, lack of privacy in a religiously controlled community, and low levels of education were found to be the main factors contributing to vaccine hesitancy among key community members and leaders. Accepting vaccination in public is a risk of sanctions. Poor knowledge of vaccines is a major factor of hesitancy which is reinforced by religious teachings on the power of prayers as alternatives. Because parents/caregivers perceive vaccines as dangerous for their children and believe they can cause death or disease, members of the Apostolic Church have more confidence in alternative methods such as use of holy water and prayers to treat diseases. Under these circumstances, it is important to debunk the myths about the power of holy water on the one hand and disseminate positive information of the efficacy of vaccines on the other hand in order to reduce hesitancy. Education about vaccines and vaccination in conjunction with government intervention, for example, through the use of social distancing policies can provide a framework for reducing hesitancy and increasing demand for vaccination.

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“…The rise and spread of measles outbreaks in southern Africa in 2009–2010 (Shibeshi et al 2014) were linked to objections to receipt of vaccination originating from Apostolic gatherings (WHO IST 2012; Ha et al 2014). The Apostolic church is a Pentecostal Christian denomination, which originated in the USA in the early twentieth century (Blumhofer 2002).…”

Section: Introductionmentioning

confidence: 99%

“…The Apostolic church is a Pentecostal Christian denomination, which originated in the USA in the early twentieth century (Blumhofer 2002). Founded in Zimbabwe in the 1950s, the Apostolic church has built up a large number of followers with an estimated 3.5 million in Zimbabwe in 2014 (Ha et al 2014) as well as a presence in Botswana, the Democratic Republic of Congo, South Africa and Zambia (WHO IST 2012). Apostolic communities in Zimbabwe have been found to be poorer, less educated, more likely to reside in rural areas and having a higher ratio of economically inactive household members (those aged less than 15 years and those above 64 years) to economically active members (those aged 15–64 years) than other Christian groups (Ha et al 2014).…”

Section: Introductionmentioning

confidence: 99%

“…Founded in Zimbabwe in the 1950s, the Apostolic church has built up a large number of followers with an estimated 3.5 million in Zimbabwe in 2014 (Ha et al 2014) as well as a presence in Botswana, the Democratic Republic of Congo, South Africa and Zambia (WHO IST 2012). Apostolic communities in Zimbabwe have been found to be poorer, less educated, more likely to reside in rural areas and having a higher ratio of economically inactive household members (those aged less than 15 years and those above 64 years) to economically active members (those aged 15–64 years) than other Christian groups (Ha et al 2014). An affiliation with the Apostolic faith was found to be an independent risk factor in reducing the utilization of both maternal and child health services, as a consequence of health beliefs and lack of resources (Ha et al 2014).…”

Section: Introductionmentioning

confidence: 99%

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How to Increase Vaccination Acceptance Among Apostolic Communities: Quantitative Results from an Assessment in Three Provinces in Zimbabwe

et al. 2017

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A worldwide increasing trend toward vaccine hesitancy has been reported. Measles outbreaks in southern Africa in 2009–2010 were linked to objections originating from Apostolic gatherings. Founded in Zimbabwe in the 1950s, the Apostolic church has built up a large number of followers with an estimated 3.5 million in Zimbabwe in 2014. To inform planning of interventions for the 2015 measles–rubella vaccination campaign, we assessed vaccination status and knowledge, attitudes and practices among purposive samples of Apostolic caregivers in three districts each in Harare City, Manicaland and Matabeleland South in Zimbabwe. We conducted structured interviews among 97 care-givers of children aged 9–59 months and collected vaccination status for 126 children. Main Apostolic affiliations were Johanne Marange (53%), Madida (13%) and Gospel of God (11%) with considerable variation across assessment areas. The assessment also showed considerable variation among Apostolic communities in children ever vaccinated (14–100%) and retention of immunization cards (0–83%) of ever vaccinated. Overall retention of immunization cards (12%) and documented vaccination status by card (fully vaccinated = 6%) were low compared to previously reported measures in the general population. Mothers living in monogamous relationships reported over 90% of all DTP-HepB-Hib-3, measles and up to date immunizations during the first life year documented by immunization card. Results revealed opportunities to educate about immunization during utilization of health services other than vaccinations, desire to receive information about vaccinations from health personnel, and willingness to accept vaccinations when offered outside of regular services. Based on the results of the assessment, specific targeted interventions were implemented during the vaccination campaign, including an increased number of advocacy activities by district authorities. Also, health workers offered ways and timing to vaccinate children that catered to the specific situation of Apostolic care-givers, including flexible service provision after hours and outside of health facilities, meeting locations chosen by caregivers, using mobile phones to set up meeting locations, and documentation of vaccination in health facilities if home-based records posed a risk for caregivers. Coverage survey results indicate that considerable progress has been made since 2010 to increase vaccination acceptability among Apostolic communities in Zimbabwe. Further efforts will be needed to vaccinate all Apostolic children during routine and campaign activities in the country, and the results from our assessment can contribute toward this goal.

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Is religion the forgotten variable in maternal and child health? Evidence from Zimbabwe

Cited by 46 publications

References 17 publications

Fatores associados à adequação do cuidado pré-natal e à assistência ao parto em São Tomé e Príncipe, 2008-2009

Fatores associados à adequação do cuidado pré-natal e à assistência ao parto em São Tomé e Príncipe, 2008-2009

Qualitative Assessment of Vaccination Hesitancy Among Members of the Apostolic Church of Zimbabwe: A Case Study

How to Increase Vaccination Acceptance Among Apostolic Communities: Quantitative Results from an Assessment in Three Provinces in Zimbabwe

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