Understanding the risk factors associated with Polio Vaccination refusals in Pakistan

Posted On Mar 30 2021

I am writing for a social medicine class. This paper is also my background paper for the research. My position is that for the people. I do not consider the people refusing polio vaccinations as illiterate, ignorant people. Rather, I believe they have valid reasons to refuse and these reasons should be understood and addressed by in-depth understanding of the social context.
I have to include the social theory too. The three social scientists that have relevant work and you should quote include, Paul Farmer, Arthur Kleinman, Merton ( Theory of unintended consequences).
The citation style is APA. Please follow it thoroughly.

I have written my thesis statement which will give you a good start.

I have outlined how I would like the paper to be. Please follow that. Incase of any issues/concerns- please reach out! Make sure it is ABSOLUTELY PLAIGIASRISM FREE!

The page limit is 20 pages double spaced. I am also sending in what I have already written. You can take help from that and include parts of it after improving in the relevant sections. But do not simply copy paste!

Title: Understanding the risk factors associated with polio vaccination refusals in Rawalpindi, Pakistan
Thesis statement:
The policies and interventions designed to eradicate polio from Pakistan should shift their focus from only achieving quantitative targets of increased coverage to an in-depth understanding of the historical and socio-political aspects of the Pathan communities which shapes their decision to refuse or accept the polio vaccinations.

For help writing the bio-social analysis.


1. Vignette  Small, Vignette used as a literary device helping people to become emotionally invested in the topic- A composite of multiple people’s experience: Can be used as an illustrative tool. Use it in the beginning to introduce the topic. Try do be descriptive. Show don’t tell, try to illustrate.. not just sad and mad, describe what are they doing, feeling.. 1-1.5 page.) I have already shared two vignettes. You can use any of the two.

1. Central Thesis  Thesis statement. I have written that you can see scroll up pls
Overview of the thesis’s structure- A broad overview of the thesis structure in the form of paragraphs.

2. Overview of the thesis’s structure (can be a broad and general overview in the form of paragraphs or a few sentences/road map. Not necessarily chapter wise )
1. Literature Reviews – share enough so that people with enough information to understand the argument
i. Literature on disease burdens. A general overview of disease burden in Pakistan. IMR, MMR, DALY , Life expectancy, under-5 mortality etc., polio, vaccine preventable disease
(pages-2 or more).
ii. Literature on Health Care Systems in Pakistan –current health care system of Pakistan. Contemporary + history. Briefly.

1. Community health care systems: briefly, just enough information then go to front line polio eradication campaigns

iii. Literature on Polio eradication campaigns in Pakistan. For this start from when the polio campaigns began in Pakistan, what used to happen and how have things changed.
What were the major road blocks for the polio campaign, strategies deployed.
Chronologically. Also talk about how different events have shaped the policy decisions about the polio campaigns, mention the April 2019 school incident too.
Challenges faced in Pakistan and where the country is standing now.
History of Polio in the Country ( can this be combined with lit review on polio eradication campaigns in Pakistan?)
Policy Approaches to Polio Interventions in the Country.
This can be more pages like 3 or so. Also, include how the polio program is structured. The organization structure etc.
2. Contextual Overviews briefly. Assume the reader doesn’t know about pakistan a lot.

This portion will be talking about Pakistan’s history briefly. Then more about the history of the pathan population in pakistan, How did KPK form etc. What was the role of the British in Durand line, also talk about significant political events for the pathan community. Including, war on terror. Mention osama bin laden incident too
i. Geography
1. General description and demographics. briefly include
2. Description of Rawalpindi.
ii. Historical Context Overview
1. Formation of Pakistan
2. History of the Pathan People Pakistan (From Afghanistan to Pakistan)
iii. Political Overview
1. Geography (where are people located and why)
2. Significant Political Events of the Country: formation of pakistan, war on terror, wars, political events that were significant in KPK. Some idea about the formation of pakistan, sub-continent, separation between east and west.
colonialism about the British rule
3. Significant Political Events of the Pathan People in Pakistan.

Biosocial Analysis. in terms of inequities, tailored toward the research question, with some analyzing. Social theory included here.

Use the WHO bio-social analysis toolkit to describe all the aspect of Fauji Colony. T
your arguments, your interpretation, we can use theories to explain what is happening. Your voice, social theory. Social forces, structural violence while discussing the traumatic experiences,
1. Socioeconomic and Political Analysis (Use social theory to explore societal structures)
Housing: Not regularized.
Governance: Lack of local govt body why?
Labor: Daily wagers, street hawkers
Public policies: Lack of public education and health system

i. Structural Forces (e.g., economic systems, political systems, ideologies, etc.)
1. How are the current challenges related to this issue impacted by historical, economic, and political processes?
ii. Systemic Forces (e.g., public policies, institutional practices, cultural norms, etc.)
1. What specific system and institutional mechanisms (e.g., policies, laws, norms, etcetera) are involved with this issue, and why?
2. Experiential Analyses (Use social theory to explore peoples experiences)
i. Explain how the complex structural inequities and social determinants of health mechanisms intersect around your topic area: polio vaccination refusals in Rawalpindi.
1. What are the social determinants relating to space and place that influence this outcome? (Wouldn’t this overlap with point 1?)

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