@article{Démolis:8348,
      recid = {8348},
      author = {Démolis, Rachel and Botão, Carlos and Heyerdahl, Léonard W  and Gessner, Bradford D. and Cavailler, Philippe and Sinai,  Celestino and Magaço, Amílcar and Gargasson, Jean-Bernard  Le and Mengel, Martin and Guillermet, Elise},
      title = {A rapid qualitative assessment of oral cholera vaccine  anticipated acceptability in a context of resistance  towards cholera intervention in Nampula, Mozambique},
      journal = {Vaccine},
      address = {2018-10},
      number = {ARTICLE},
      pages = {9 p.},
      note = {Démolis, Rachel est chercheuse à la HES-SO, HESAV, depuis  2018},
      abstract = {Introduction : While planning an immunization campaign in  settings where public health interventions are subject to  politically motivated resistance, designing context-based  social mobilization strategies is critical to ensure  community acceptability. In preparation for an Oral Cholera  Vaccine campaign implemented in Nampula, Mozambique, in  November 2016, we assessed potential barriers and levers  for vaccine acceptability. Methods : Questionnaires,  in-depth interviews, and focus group discussions, as well  as observations, were conducted before the campaign. The  participants included central and district level government  informants (national immunization program, logistics  officers, public health directors, and others), community  leaders and representatives, and community members. Results  : During previous well chlorination interventions, some  government representatives and health agents were attacked,  because they were believed to be responsible for spreading  cholera instead of purifying the wells. Politically  motivated resistance to cholera interventions resurfaced  when an OCV campaign was considered. Respondents also  reported vaccine hesitancy related to experiences of  problems during school-based vaccine introduction, rumors  related to vaccine safety, and negative experiences  following routine childhood immunization. Despite major  suspicions associated with the OCV campaign, respondents’  perceived vulnerability to cholera and its perceived  severity seem to override potential anticipated OCV vaccine  hesitancy. Discussion : Potential hesitancy towards the OCV  campaign is grounded in global insecurity, social  disequilibrium, and perceived institutional negligence,  which reinforces a representation of estrangement from the  central government, triggering suspicions on its intentions  in implementing the OCV campaign. Recommendations include a  strong involvement of community leaders, which is important  for successful social mobilization; representatives of  different political parties should be equally involved in  social mobilization efforts, before and during campaigns;  and public health officials should promote other planned  interventions to mitigate the lack of trust associated with  perceived institutional negligence. Successful past  initiatives include public intake of purified water or  newly introduced medication by social mobilizers, teachers  or credible leaders.},
      url = {http://arodes.hes-so.ch/record/8348},
      doi = {https://doi.org/10.1016/j.vaccine.2017.10.087},
}