Community perception toward intensified pulse polio immunization in postcertification era: A mixed-method study in a high-risk area of Kolkata, West Bengal, India

Background: On March 27, 2014, the Regional Certification Commission of the World Health Organization certified South-East Asian Region, which includes India, as polio free. Since then, as part of Polio Endgame Strategy, high-quality national and sub-national polio rounds are being conducted to maintain herd immunity through each year. With years of no fresh cases of polio, several sections in the community have raised doubts over the continuation of the Intensified Pulse Polio Immunization (IPPI) program in postcertification era. Thus, this study with mixed method approach was aimed at assessing the community perceptions toward IPPI using quantitative approach and stakeholder's perception using qualitative approach in a high-risk area of Kolkata. Methods: This cross-sectional study was conducted over a period of 2 months from March to April 2018 in Southern part of Kolkata which involved surveying 104 randomly selected households followed by key informant interviews with community influencers. Pearson's Chi-square test was performed to determine the association between categorical variables. SPSS v. 16.0 software was used for analysis. Results: Inadequate knowledge (32%) and unfavorable attitude (45%) regarding IPPI were observed among the interviewed respondents. Safety concern (5.7%), spouse/elderly pressure (4.8%), and sterility issues (1.9%) were identified as prominent barriers resulting in hesitancy (16.2%) during IPPI. Statistically significant association of respondent's attitude was observed between gender, religion, and education. Conclusion: Social behavior change communication involving community and community influencers would help to overcome the barriers to IPPI coverage and thus to mitigate the risk of re-emergence of polio in future.