Naomi Tomlinson, Sabi Redwood
Childhood vaccination is one of the most important public health interventions, preventing two to three million deaths worldwide every year. Successful immunisation depends on the attitudes of mothers towards vaccination. The Somali community in Birmingham in the UK represents a significant proportion of a growing black African population which has the lowest levels of preschool immunisation. There is no evidence about perceptions of preschool immunisation among Somalis in Birmingham. We explored the health beliefs of Somali women resident in the UK in order to assist healthcare providersto deliver services in a manner sensitive to Somali culture. Semi-structured interviews were conducted at third-sector organisations providing services to Somali women in Birmingham. Participants were born in Somalia, but were resident in the UK and had at least one child under 5 years old. Purposive and snowball sampling were employed. Data were analysed using inductive thematic analysis. Data were collected from 23 participants from two centres. Attitudes towards preschool immunisations were positive. However, there was significant suspicion about the MMR vaccine, predominantly due to anxiety about a link with autism. Beliefs were affected by social and cultural interpretations of Islam and practices associated with them, mothers’ personal experiences of preschool vaccinations, and perceptions of their child’s susceptibility to infection. This study highlights the centrality of women’s understanding and perception of risk and how these shape decision making. Risk perceptions were mediated by women’s social networks, their knowledge and understanding about the relative risk of infection versus vaccination, and their own experience. There was a strong emotional component to the decision-making process, characterised by mistrust and fear. Appropriate information addressing anxieties and suspicions, as well as a closer relationship between the local Somali community and healthcare professionals, will be crucial for future vaccination services to ensure adequate uptake.
