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Bridging Tradition and Modern Medicine: Health Beliefs and Practices of Meranaw Faith Healers Toward Vaccination Against Preventable Communicable Diseases

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Background: The study explores the health beliefs and practices of Meranaw faith healers in Marawi City, Lanao del Sur, regarding vaccination against preventable communicable diseases. The cultural and religious values of the Meranaw community significantly influence the acceptance and integration of modern medical practices, including vaccination. Objectives: To understand how cultural and religious values affect the acceptance of vaccination among Meranaw faith healers and to identify barriers and facilitators in integrating vaccination with traditional healing practices. Methods: This qualitative study employed one-on-one interviews with five Meranaw faith healers in Marawi City, Lanao Del Sur. The study aimed to explore their beliefs and practices regarding vaccination, as well as how these are influenced by their religious and cultural backgrounds. The data were analyzed thematically to identify common patterns and unique insights. Results: Findings indicate general support for vaccination among faith healers, driven by Islamic teachings on disease prevention. However, barriers such as mistrust in modern medicine, fear of adverse effects, and misinformation hinder full acceptance. Religious leaders significantly influence public perceptions and vaccine acceptance. Conclusion: Strengthening culturally sensitive health education and fostering collaboration between healthcare professionals and faith healers are essential for improving vaccination uptake. Integrating traditional healing practices with modern medical interventions can bridge gaps in healthcare delivery and enhance public health outcomes in the Meranaw community.
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Frontiers in Health Informatics
ISSN-Online: 2676-7104
2025; Vol 14: Issue 2
www.healthinformaticsjournal.com
Open Access
36
Bridging Tradition and Modern Medicine: Health Beliefs and Practices
of Meranaw Faith Healers Toward Vaccination Against Preventable
Communicable Diseases
*1Hamdoni K. Pangandaman , 1Sittie Ainah Mai-Alauya , 1Raquel del Rosario Macarambon,
1Samiel P. Macalaba , 1Norhanie A. Ali , 2Nursidar P. Mukattil , 2Magna Anissa A. Hayudini
, 4Andramaida Hairon Sadjail, 2Jara Nieca A. Abdurasul , 2Ziradar M. Adjilani-Misah
1College of Health Sciences, Mindanao State University, Marawi, Lanao Del Sur, 9700, Philippines.
2College of Health Sciences, Mindanao State University - Sulu, Jolo-Sulu,7400, Philippines.
3School of Nursing, Sulu State College, Sulu, Jolo-Sulu,7400, Philippines.
4Research Office, Sulu State College, Sulu, Jolo-Sulu,7400, Philippines.
*Corresponding Author:
Hamdoni K. Pangandaman
Mindanao State University, Main Campus, Marawi City, 9700, Philippines.
*Email ID: hamdoni.pangandaman@msumain.edu.ph
Cite this paper as: Hamdoni K. Pangandaman, Sittie Ainah Mai-Alauya, Raquel del Rosario Macarambon, Samiel
P. Macalaba, Norhanie A. Ali, Nursidar P. Mukattil, Magna Anissa A. Hayudini, Andramaida Hairon Sadjail, Jara
Nieca A. Abdurasul, Ziradar M. Adjilani-Misah, (2024) Bridging Tradition and Modern Medicine: Health Beliefs
and Practices of Meranaw Faith Healers Toward Vaccination Against Preventable Communicable Diseases.
Frontiers in Health Informatics, Vol.14, No.2, 36-43
ABSTRACT
Background: The study explores the health beliefs and practices of Meranaw faith healers in Marawi City, Lanao
del Sur, regarding vaccination against preventable communicable diseases. The cultural and religious values of
the Meranaw community significantly influence the acceptance and integration of modern medical practices,
including vaccination.
Objectives: To understand how cultural and religious values affect the acceptance of vaccination among Meranaw
faith healers and to identify barriers and facilitators in integrating vaccination with traditional healing practices.
Methods: This qualitative study employed one-on-one interviews with five Meranaw faith healers in Marawi City,
Lanao Del Sur. The study aimed to explore their beliefs and practices regarding vaccination, as well as how these
are influenced by their religious and cultural backgrounds. The data were analyzed thematically to identify
common patterns and unique insights.
Results: Findings indicate general support for vaccination among faith healers, driven by Islamic teachings on
disease prevention. However, barriers such as mistrust in modern medicine, fear of adverse effects, and
misinformation hinder full acceptance. Religious leaders significantly influence public perceptions and vaccine
acceptance.
Conclusion: Strengthening culturally sensitive health education and fostering collaboration between healthcare
professionals and faith healers are essential for improving vaccination uptake. Integrating traditional healing
practices with modern medical interventions can bridge gaps in healthcare delivery and enhance public health
outcomes in the Meranaw community.
Keywords: Traditional Faith Healers, Vaccination, Transcultural Nursing, Communicable Disease, Muslim
Community Health Practices
INTRODUCTION
Vaccination has been instrumental in reducing the global burden of communicable diseases, preventing an
estimated 2 to 3 million deaths annually (Carter et al., 2024; Montero et al., 2024). Despite this success, vaccine
hesitancy remains a significant public health challenge worldwide (Dubé et al., 2021; Galagali et al., 2022;
Nuwarda et al., 2022). The World Health Organization (WHO) identified vaccine hesitancy as one of the top ten
global health threats in 2019 (Galagali et al., 2022; Nuwarda et al., 2022). This reluctance or refusal to vaccinate,
despite the availability of vaccines, threatens to reverse progress made in combating vaccine-preventable
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In the Philippines, vaccine hesitancy has been a growing concern. A 2020 survey revealed that only 32% of
Filipinos were willing to get vaccinated against COVID-19, citing safety concerns and mistrust in vaccines (Jhoys
et al., 2021; Migriño et al., 2020; Yu et al., 2021). This skepticism is not limited to new vaccines; routine
immunization programs have also faced challenges, leading to outbreaks of diseases such as measles (Carter et
al., 2024; Kennedy et al., 2020). The situation is particularly complex in regions with diverse cultural and religious
landscapes, where traditional beliefs and practices significantly influence health behaviors (Migriño et al., 2020;
Nuwarda et al., 2022).
The Bangsamoro Autonomous Region in Muslim Mindanao (BARMM) has the lowest vaccination rate among all
regions in the Philippines, partly attributed to beliefs and misconceptions about vaccines (Agojo & Teehankee,
2023). Engaging with Muslim religious leaders has been identified as a crucial strategy in clarifying these
misconceptions and improving vaccine acceptance (Dubé et al., 2021; Suryadevara, 2021). Religious perspectives
significantly shape community responses to vaccination, making it essential to address cultural and faith-based
concerns (Pangandaman et al., 2021; Yu et al., 2021).
Faith healers among the Meranaw people of Lanao del Sur, play a pivotal role in the community's health-seeking
behaviors. They are often the first point of contact for health issues and are deeply respected for their spiritual and
healing practices. Their influence extends beyond health to various aspects of daily life, making them key
stakeholders in public health initiatives (Cerio, 2020; Kisa & Kisa, 2024; Sadang et al., 2021). The intersection of
religious beliefs and vaccine acceptance is complex. While Islamic teachings emphasize the preservation of life
and can support vaccination, misconceptions persist (Kisa & Kisa, 2024). Some individuals believe that vaccines
contain haram (forbidden) substances or that reliance on vaccination contradicts faith in divine protection. These
beliefs contribute to vaccine hesitancy within Muslim communities (Agojo & Teehankee, 2023; Kisa & Kisa,
2024).
Studies have shown that collaboration with faith-based organizations can enhance vaccine acceptance (Dubé et
al., 2021; Suryadevara, 2021). Religious leaders possess the cultural competencies and trust to foster open dialogue
about vaccines, dispel myths, and promote uptake (UNICEF-Philippines, 2022). In various communities, such
collaborations have built confidence in public health systems and increased vaccination rates (Agojo & Teehankee,
2023).
Understanding the health beliefs and practices of Meranaw faith healers toward vaccination is essential for
developing culturally sensitive health interventions. By acknowledging and integrating traditional healing
practices with modern medicine, public health programs can become more effective and acceptable to the
community (Migriño et al., 2020). This approach not only addresses vaccine hesitancy but also strengthens the
overall health system by building trust and cooperation between healthcare providers and the community (Jhoys
et al., 2021; Yu et al., 2021). Thus, this study aimed to explore the perspectives of Meranaw faith healers on
vaccination against preventable communicable diseases.
METHODS
Study Design
This study employed a qualitative descriptive research design to explore the health beliefs and practices of
Meranaw faith healers toward vaccination against preventable communicable diseases. This design was chosen to
provide a comprehensive understanding of how cultural and religious factors influence vaccination decisions
among Meranaw faith healers. This approach allowed for an in-depth exploration of how deeply rooted beliefs
shape health behaviors, providing meaningful insights into how vaccine hesitancy can be addressed within this
cultural context.
Participants and Study Setting
The study was conducted in four selected barangays in Marawi City, Lanao del Sur: Barangay Bangon, Barangay
Sarimanok, Barangay Lancaf, and Barangay Basak Malutlut. These areas were chosen due to their dense Meranaw
populations and the presence of known faith healers actively engaged in traditional healing practices. Five
Meranaw faith healers were selected through purposive sampling based on the following criteria: (1) they must
identify as Meranaw, (2) have received Islamic education, (3) be recognized in the community for practicing faith
healing, and (4) have been performing healing practices for at least ten years. All participants were male, aged
between 41 and 60 years, and were known for their influence in their respective communities. The selection
ensured that the participants had extensive experience and cultural authority to provide meaningful insights into
their health beliefs and practices.
Instruments or Tool
Data were collected using a semi-structured interview guide specifically developed for this study. The guide
consisted of open-ended questions designed to explore the participants’ beliefs about vaccination, their healing
practices, and the barriers they perceive in complying with vaccination programs. The interview questions focused
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on understanding how religious teachings influence their views on vaccination, how they perceive modern medical
practices, and how they reconcile these with their traditional healing methods. The interviews were conducted in
the Meranaw language to ensure comfort and authenticity in responses. All interviews were audio-recorded, with
the participants' consent, and later transcribed and translated into English for analysis.
Data Collection
The data collection process took place over a one-month period. Each participant was interviewed individually in
a private and comfortable setting, typically at their residence or a quiet community space to ensure privacy and
openness. Each interview lasted between 30 minutes to an hour, allowing participants ample time to share their
thoughts and experiences. The researchers built rapport with the participants to foster a sense of trust, ensuring
that the discussions were genuine and reflective of their true beliefs and practices. Verbal and written informed
consent was obtained from each participant before the interview commenced, and they were assured that their
responses would remain confidential and solely used for academic purposes.
Data Analysis
Thematic analysis was utilized to interpret the data, following Braun and Clarke’s (2006) six-phase framework.
The process began with the researchers familiarizing themselves with the transcribed interviews through repeated
readings. Initial codes were then generated by identifying significant phrases and statements related to the
participants’ beliefs and practices toward vaccination. These codes were reviewed and clustered into broader
themes, reflecting recurring patterns and insights. The themes were refined and validated to ensure they accurately
represented the participants' views. This iterative process allowed the researchers to capture the complex interplay
between traditional healing practices and vaccination acceptance within the Meranaw community.
Ethical Consideration
Ethical approval for this study was secured from the Ethics Review Committee of the College of Health Sciences
at Mindanao State University, following the guidelines outlined in the Philippine National Ethical Guidelines for
Health and Health-Related Research (PNHRS, 2017). Before data collection, participants were fully informed
about the study's objectives, procedures, potential risks, and benefits. Informed consent was obtained in both verbal
and written forms, ensuring that participants understood their right to withdraw from the study at any point without
facing any consequences. Confidentiality was strictly maintained by assigning pseudonyms to participants and
securely storing all data, including audio recordings and transcripts. This study strictly adhered to the ethical
principles of respect for persons, beneficence, and justice as outlined in the Declaration of Helsinki and the
Philippine Health Research Ethics Code (PHREC).
RESULTS
There were five Meranaw faith healers participated in this study (Table 1), all of whom were male, married, and
aged between 41 and 60 years old. Their professional backgrounds included Islamic education, with most serving
as Shari’ah lawyers or graduates of Islamic colleges, and their length of practice ranged from 11 years to over 31
years. Through in-depth interviews, four key themes emerged: Acceptance and Support for Vaccination, Barriers
to Vaccination Compliance, Integration of Traditional and Modern Healing Practices, and The Role of Religious
Influence in Health Decision-Making.
Table 1. Profile of Faith Healers as Participants of the Study
ID/ Code Gender Age
(years) Civil Status Educational Attainment Lenth of Practice
P 1 Male 51 Married Shari’ah Lawyer 31 years beyond
P 2 Male 43 Married Shari’ah Lawyer 21 - 30 years
P 3 Male 45 Married Shari’ah Lawyer 11 - 20 years
P 4 Male 48 Married Islamic College
Graduate 21 - 30 years
P 5 Male 46 Married College Graduate 31 years beyond
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Table 2. Summary of Themes, Subthemes, and Categories
Theme Subtheme Categories
a. Vaccination as a Form of
Disease Prevention
Vaccines prevent diseases and align
with Islamic principles
Acceptance and
Support for Vaccination
b. Alignment of Vaccination
with Islamic Teachings
Islamic teachings support the use of
vaccines for health protection
a. Misinformation and Myths
About Vaccines
Belief that vaccines cause infertility
and other myths
Barriers to Vaccination
Compliance b. Religious
Misinterpretations and Fear
of Haram Substances
Concerns over haram ingredients in
vaccines
Integration of
Traditional and Modern
Healing Practices
a.
Complementary Use of
Traditional Healing and
Modern Medicine
b.
Acknowledgement of
Medical Advice for
Preventive Health
Traditional remedies used alongside
modern medicine
Faith healers encourage adherence to
medical advice
a.
Influence of Religious
Leaders in Vaccine
Faith healers influence public health
decisions
Role of Religious
Influence in Health
Decision-Making
Promotion
b. Integration of Religious
Teachings with Public
Health Messages
Combining religious teachings with
health campaigns
THEME 1: ACCEPTANCE AND SUPPORT FOR VACCINATION
This theme reflects the overall positive perception of Meranaw faith healers toward vaccination. Participants
acknowledged that vaccination aligns with Islamic teachings and serves as an essential preventive measure for
health protection.
Subtheme 1.1: Vaccination as a Form of Disease Prevention
Meranaw faith healers recognized vaccination as a valuable tool in preventing diseases. Their support is grounded
in the belief that Islam encourages the preservation of life and health. They viewed vaccines as a means to protect
the body from illnesses, aligning with the Islamic principle of safeguarding life.
"Daa marata san ko Islam. Sii ko Islam na okay anan, daa marataon. Ugop anan sii ko p’kasakit." (There is nothing
wrong with it in Islam. That is okay with Islam, there is nothing wrong with it. That can help those who are sick.)
– P1
This statement reflects the belief that vaccination is not contradictory to Islamic teachings but rather a form of
support for health and well-being.
Subtheme 1.2: Alignment of Vaccination with Islamic Teachings
Participants highlighted how Islamic teachings support medical interventions like vaccination. They believe that
the Qur'an promotes health and healing, making vaccination acceptable within their faith.
"Lagid uto o myangauuna myangangaaloy akn, isa pn a kataro o Allah a gyoto a pitaro iyan sa Qur’an a aya maana
iyan gyoto a ayat na inituron ami so Qur’an ka bulong sii ko langonglangonan a myamaratiyaya." (As mentioned
in the Qur'an, it is a healing for those who believe. Similarly, vaccines can be seen as a form of protection.) – P2
This perspective reinforces the belief that vaccines, much like spiritual healing, are tools for preserving health and
are consistent with Islamic teachings.
Theme 2: Barriers to Vaccination Compliance
Despite overall support, several barriers hinder vaccine compliance among Meranaw faith healers and their
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communities. These barriers include misinformation, religious misconceptions, and fear of side effects.
Subtheme 2.1: Misinformation and Myths About Vaccines
Some participants reported that false beliefs and misinformation about vaccines contribute to hesitancy.
Misconceptions about vaccines causing infertility or severe health issues create fear and resistance.
"Aya pinakamyanug akun ron na gyoto a pakaito so kuwan nga, so kambabawata. Ka tig iran a mapakaito iyan ka
so bakuna." (One common belief I've heard is that the vaccine might reduce the ability to have children.) – P3
This statement highlights how misinformation spreads within the community, resulting in fear and reluctance to
get vaccinated.
Subtheme 2.2: Religious Misinterpretations and Fear of Haram Substances
Concerns about the permissibility of vaccine ingredients, specifically whether they contain haram substances, also
hinder vaccination.
"Pakaalangan sa na barang-barang. Paganay a pakaalang san na gyoto a mga tao a di iran sasarigan so bolong.
Ikaduwa a kasabapan, na gyoto a pkalk ba kasuldi a haram so lawas iyan." (There are different barriers. The first
is people who don't trust the medicine. The second is the fear that something haram might enter their bodies.)
P1
This reflects the need for better communication about vaccine safety and its alignment with Islamic dietary and
health laws.
Theme 3: Integration of Traditional and Modern Healing Practices
Participants showed a willingness to integrate traditional healing methods with modern medical practices,
including vaccination, recognizing that both serve to promote health.
Subtheme 3.1: Complementary Use of Traditional Healing and Modern Medicine
Faith healers continue to practice traditional remedies for certain ailments but recognize the limitations of these
methods and the importance of modern treatments like vaccines.
"Na kay geto a pkabulongan amie na datar opama o inbot, inbot a old, layopan o di na so scorpion na geto na
pmbulongan amie oto na pndudaan amie." (Our treatments are only for those bitten by snakes, centipedes, or
scorpions, which we treat by spitting on the bite.) – P5
This shows how traditional methods are still used for certain conditions, but modern medicine is also accepted for
more severe health issues.
Subtheme 3.2: Acknowledgement of Medical Advice for Preventive Health
Participants emphasized the importance of following medical advice, particularly from Muslim doctors, for
preventive care such as vaccination.
"Gyanan eh ipsampay ami ko pagtaw sabap sa so mga doctor na piresearchan iran ah gyanan ah mga vaccine na
okay kamidn sa andamanaya eh kabakunae ko mga wata ka para an di pkaadn so mga sakit ah pakawma." (We
convey to the people that these vaccines have been studied by doctors, which is why we agree with vaccinating
children to protect them from diseases.) – P4
This illustrates how faith healers trust scientifically researched medical advice and advocate for community
vaccination.
Theme 4: The Role of Religious Influence in Health Decision-Making
Faith healers acknowledged their influential role in guiding health behaviors in their communities, recognizing
that their endorsements significantly impact vaccine acceptance.
Subtheme 4.1: Influence of Religious Leaders in Vaccine Promotion
Faith healers understand that their words and actions can heavily influence the community’s decision-making
regarding health interventions.
"Paganay ron na skami a mga ulama na kapakay a so tharoon amie kagya paparatiyayaan kami o tao, kapakay a
so adna paratiyaya niyan na paratiyaan kami o tao." (As scholars, what we say can be believed by people. Our
words carry weight in the community.) – P4
This underscores the responsibility of religious leaders to use their influence to encourage health-positive
behaviors like vaccination.
Subtheme 4.2: Integration of Religious Teachings with Public Health Messages
Religious teachings can be effectively integrated with public health campaigns to increase vaccine acceptance.
"Sii ko Islam, na da ba ron pakaalang, ka kagya knaba anan haram, ka halal anan."
(In Islam, nothing can be a barrier because it is not haram; it is halal.) – P1
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This emphasizes that vaccination, when deemed halal, does not conflict with Islamic beliefs and should be
supported as a public health measure.
DISCUSSION
Muslim faith healers, known for their deep-rooted influence within their communities, play a pivotal role in
shaping health behaviors, including the acceptance of vaccines. Their endorsement of vaccination is often
grounded in Islamic teachings that prioritize the preservation of life and the prevention of harm. For instance, the
principle of "preservation of life" (hifz al-nafs) in Islamic jurisprudence underscores the importance of
safeguarding human health, thereby supporting preventive measures like vaccination. Engaging these religious
leaders in public health initiatives has been shown to enhance vaccine uptake among Muslim populations, as their
guidance can effectively address religious concerns and dispel misconceptions related to vaccine safety and
permissibility.
This study emphasized the significant role of religious beliefs and leaders in influencing vaccine acceptance
among Muslim communities. Faith healers, as respected figures, can either facilitate or hinder vaccination efforts
based on their interpretations of Islamic teachings. Their endorsement of vaccines, grounded in the Islamic
principle of preserving life, can enhance public health initiatives (Cerio, 2020; Kawi et al., 2024; Sadang et al.,
2021).
However, challenges persist due to vaccine hesitancy stemming from religious concerns. Misconceptions about
vaccine ingredients, particularly fears of haram substances, contribute to reluctance. Addressing these concerns
requires clear communication about vaccine composition and endorsements from Islamic scholars affirming
vaccine permissibility (Alsuwaidi et al., 2023; Mardian et al., 2021). The integration of traditional healing practices
with modern medicine among Meranaw faith healers reflects a broader trend in various cultures where both
systems are used complementarily to address health concerns. This practice acknowledges the value of both
traditional and modern medicine in promoting health (Kisa & Kisa, 2024; Samsudin et al., 2023).
Engaging faith-based organizations (FBOs) in vaccination campaigns has been recognized as a powerful strategy
to improve vaccine uptake, particularly in communities where religious beliefs strongly influence health
behaviors. FBOs effectively address the "Three Cs" of vaccine acceptance—confidence, complacency, and
convenience—by leveraging their established trust within communities. By disseminating accurate health
information and addressing vaccine-related concerns, they help build public confidence in vaccine safety and
efficacy. Also, FBOs emphasize the moral and communal responsibility of vaccination, reducing complacency by
reinforcing the importance of preventive health measures. Their involvement also improves convenience by
providing accessible vaccination sites, organizing transportation, and assisting with appointments, effectively
removing logistical barriers to vaccine access (Alsuwaidi et al., 2023; Soni et al., 2023; Syed et al., 2023).
Numerous studies have highlighted the success of partnerships between public health agencies and FBOs in
increasing vaccination rates. For instance, faith-based initiatives have been crucial in combating vaccine hesitancy
during the COVID-19 pandemic by tailoring health messages to align with religious values and community norms
(Jhoys et al., 2021; Mardian et al., 2021; Yu et al., 2021). The World Health Organization also acknowledges that
addressing confidence, complacency, and convenience through culturally sensitive approaches can significantly
enhance vaccine acceptance (Dubé et al., 2021; Kisa & Kisa, 2024). Moreso, hosting vaccination drives in
religious venues has proven effective in improving access and reassuring hesitant individuals (Datukali &
Pangandaman, 2024; Kisa & Kisa, 2024; Samsudin et al., 2023)
Educational initiatives that are culturally sensitive and respect religious beliefs are essential for improving vaccine
acceptance, particularly in Muslim communities where faith significantly influences health decisions. Providing
accurate, science-based information in a manner that aligns with religious values helps build trust and reduces
vaccine hesitancy. Collaborations between public health authorities and religious leaders are especially effective
in addressing misconceptions about vaccines, as religious leaders hold significant influence and credibility within
their communities (Carter et al., 2024; Kawi et al., 2024). By engaging these leaders in health campaigns, public
health messages can be framed in ways that resonate with religious teachings, making them more relatable and
acceptable to the community. This partnership fosters informed decision-making, empowering individuals to
prioritize their health without feeling that their religious beliefs are being compromised.
Furthermore, integrating religious perspectives into educational campaigns creates opportunities to correct
misinformation and clarify misconceptions about vaccine safety and permissibility. Studies have shown that when
health education is delivered through trusted religious figures, communities are more receptive to public health
interventions (Soni et al., 2023; Syed et al., 2023). Faith-based messages that emphasize the compatibility of
vaccination with Islamic principles, such as the duty to preserve life, can encourage greater acceptance and
participation in vaccination programs (Soni et al., 2023). This collaborative approach not only addresses scientific
concerns but also alleviates religious doubts, ultimately leading to more informed and confident health decisions.
By bridging the gap between science and faith, educational initiatives can significantly contribute to the success
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of vaccination campaigns and overall community health.
CONCLUSION
In conclusion, the interplay between Islamic faith and vaccine acceptance is complex, necessitating culturally
sensitive approaches that involve religious leaders in public health strategies. Well-known and influential faith
healers are part of biggest players to improve vaccination acceptance and contribute to the success of immunization
program in the country. With it, acknowledging and addressing religious concerns, it is possible to enhance vaccine
acceptance and improve health outcomes in Muslim communities.
ACKNOWLEDGEMENT
The researchers sincerely acknowledge and extend their heartfelt gratitude to all the Meranaw faith healers who
generously shared their time, insights, and experiences, as well as to the public health authorities and religious
leaders whose guidance and support were invaluable in the completion of this study.
Conflict of Interest
The authors declare that they have no competing interests.
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... Existing literature supports the notion that demographic characteristics such as age, gender, and marital status can significantly influence the professional experiences and practices of nurses. For instance, young and single nurses may experience higher levels of stress due to less experience and lack of familial support, impacting their ability to cope with the demanding nature of ER work (20)(21)(22)(23)(24). Furthermore, the consistent practice of Watson's caring elements aligns with studies indicating that despite challenging work conditions, nurses often uphold high standards of patient care due to strong professional commitment and intrinsic motivation (25,26). ...
... Subsequently, as identified in this study, language and cultural barriers significantly hinder effective communication, which is essential for accurate diagnosis and treatment planning. Effective communication is often impeded by these barriers, leading to misunderstandings and suboptimal patient outcomes (24,31). The involvement of families in decision-making processes further complicates the communication dynamics, requiring nurses to navigate complex family dynamics and mediate conflicts, which is a common challenge, reported in multicultural healthcare settings (8,32). ...
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Vaccination, despite being recognized as one of the most effective primary public health measures, is viewed as unsafe and unnecessary by an increasing number of individuals. Anxiety about vaccines and vaccination programs leading to vaccine hesitancy results from a complex mix of social and political influences, cultural and religious beliefs, the availability of and ability to interpret health and scientific information, and personal and population experiences of health systems and government policies. Vaccine hesitancy is becoming a serious threat to vaccination programs, and was identified as one of the World Health Organization’s top ten global health threats in 2019. The negative impact of anti-vaccination movements is frequently cited as one of the major reasons for rising vaccine hesitancy amongst the general public world-wide. This review discusses the various issues surrounding vaccine hesitancy and the anti-vaccine movement, starting with the definitions of vaccine hesitancy and the anti-vaccine movement in their early history and in the modern era, before discussing the key drivers of vaccine hesitancy, particularly across different regions of the world, with a focus on various countries with low-, middle-, or high-income economies with different socio-economic populations. The review concludes with the impact of vaccine hesitancy on herd immunity and social, psychological, and public health measures to counter vaccine hesitancy.
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Background: The Immunization Agenda 2030 (IA2030) Impact Goal 1.1. aims to reduce the number of future deaths averted through immunization in the next decade. To estimate the potential impact of the aspirational coverage targets for IA2030, we developed an analytical framework and estimated the number of deaths averted due to an ambitious vaccination coverage scenario from 2021 to 2030 in 194 countries. Method: A demographic model was used to determine annual age-specific mortality estimates associated with vaccine coverage rates. For ten pathogens (Hepatitis B virus, Haemophilus influenzae type B, human papillomavirus, Japanese encephalitis, measles, Neisseria meningitidis serogroup A, Streptococcus pneumoniae, rotavirus, rubella, yellow fever), we derived single measures of country-, age-, and pathogen-specific relative risk of deaths conditional upon coverage rates, leveraging the data from 18 modeling groups as part of the Vaccine Impact Model Consortium (VIMC) for 110 countries. We used a logistic regression model to extrapolate the relative risk estimates to countries that were not modeled by VIMC. For four pathogens (diphtheria, tetanus, pertussis and tuberculosis), we used estimates from the Global Burden of Disease 2019 study and existing literature on vaccine efficacy. A future scenario defining years of vaccine introduction and scale-up needed to reach aspirational targets was developed as an input to estimate the long-term impact of vaccination taking place from 2021 to 2030. Findings: Overall, an estimated 51.5 million (95 % CI: 44.0-63.2) deaths are expected to be averted due to vaccinations administered between the years 2021 and 2030. With immunization coverage projected to increase over 2021-2030 an average of 5.2 million per year (4.4-6.3) deaths will be averted annually, with 4.4 million (3.9-5.1) deaths be averted for the year 2021, gradually rising to 5.8 million (4.9-7.5) deaths averted in 2030. The largest proportion of deaths is attributed to Measles and Hepatitis B accounting for 18.8 million (17.8-20.0) and 14.0 million (11.5-16.9) of total deaths averted respectively. Interpretation: The results from this global analysis demonstrate the substantial potential mortality reductions achievable if the IA2030 targets are met by 2030. Deaths caused by vaccine preventable diseases disproportionately affect LMICs in the African region.