Journal of Religion and Health

, Volume 56, Issue 2, pp 635–648 | Cite as

Muslim Scholars’ Knowledge, Attitudes and Perceived Barriers Towards Polio Immunization in Pakistan

  • Muhammad Umair Khan
  • Akram Ahmad
  • Saad Salman
  • Maria Ayub
  • Talieha Aqeel
  • Noman-ul Haq
  • Fahad Saleem
  • Muhammad Ubaid Khan
Original Paper


Pakistan is one of the two countries where polio remains endemic. Among multiple reasons of polio prevalence, false religious beliefs are accounted as major barriers towards polio immunization in Pakistan. Within this context, religious scholars are now engaged in polio immunization campaigns to dismantle the myths and battle the resurgence of polio in Pakistan. The objective of this study was to assess knowledge, attitudes and perceived barriers of Muslim scholars towards polio immunization in Pakistan. A descriptive, cross-sectional survey of Muslim scholars was conducted in Quetta and Peshawar divisions of Pakistan. From October to December 2015, a convenience sample of 770 Muslim scholars was recruited from the local mosques and religious institutions to participate in this study. Knowledge, attitudes, and perceived barriers were assessed by using self-administered, anonymous and pretested questionnaire. Descriptive and regression analyses were used to express the results with p < 0.05 taken as significant. Three hundred and forty-eight (45.2 %) participants exhibited good knowledge about polio with a mean score of 7.16 ± 2.12 (based on 14 questions). Knowledge gaps were identified about the transmission (32.6 %) and consequences of poliovirus (39.9 %). Overall, 527 (68.4 %) participants showed positive attitudes towards polio immunization with a mean attitude score of 27.35 ± 2.68 (based on nine statements). The majority of participants agreed on the need of depoliticizing polio immunization issues (87.1 %), while reservations were noted about their willingness to participate in future polio immunization programs (44.6 %). Security (75.8 %) and vaccine management issues (64 %) were reported by the participants as the major barriers towards polio immunization in Pakistan. The findings showed poor knowledge of Muslim scholars towards polio; however, their attitudes were positive towards polio immunization. More studies are required to assess the knowledge and attitudes of Muslim scholars at the national level to validate the findings of this study.


Muslim scholars Knowledge Attitudes Barriers Polio Immunization Pakistan 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.


The authors did not receive any funding for this study.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


  1. A summary report on the consultation with Islamic scholars on polio eradication. (2013). Islamabad: Islamic Republic of Pakistan. Accessed 10 Feb 2016.
  2. Abimbola, S., Malik, A. U., & Mansoor, G. F. (2013). The final push for polio eradication: addressing the challenge of violence in Afghanistan, Pakistan, and Nigeria. PLoS Med, 10, e1001529.CrossRefPubMedPubMedCentralGoogle Scholar
  3. Bowering, G., Crone, P., & Kadi, W. (2012). The princeton encyclopedia of islamic political thought (1st ed.). Princeton: Princeton University Press.Google Scholar
  4. Consultation with Islamic scholars on polio eradication. (2013). Islamabad: Islamic Republic of Pakistan 5–6 June 2013. Accessed 10 Feb 2016.
  5. Fenner, F., Henderson, D. A., Arita, I., Jezek, Z., Ladnyi, I. D. (1988). Smallpox and its eradication. Geneva World Health Organization. Accessed 20 Jan 2016.
  6. Global Polio Eradication Initiative. (2016). Data and monitoring Accessed 15 Jan 2016.
  7. Global Polio Emergency Action Plan. (2012–13). Polio global eradication initiative. Accessed 15 Jan 2016.
  8. Grabenstein, J. D. (2013). What the world’s religions teach, applied to vaccines and immune globulins. Vaccine, 31, 2011–2023.CrossRefPubMedGoogle Scholar
  9. Harkness, J. A., & Schoua-Glusberg, A. (1998). Questionnaires in translation. ZUMA-Nachrichten Spezial, 3, 87–127.Google Scholar
  10. Helleringer, S., Abdelwahab, J., & Vandenent, M. (2014). Polio supplementary immunization activities and equity in access to vaccination: evidence from the demographic and health surveys. Journal of Infectious Diseases, 210 (suppl 1), S531–S539.CrossRefPubMedGoogle Scholar
  11. Jegede, A. S. (2007). What led to the Nigerian boycott of the polio vaccination campaign? PLoS Med, 4, e73.CrossRefPubMedPubMedCentralGoogle Scholar
  12. Jheeta, M., & Newell, J. (2008). Childhood vaccination in Africa and Asia: the effects of parents’ knowledge and attitudes. Bulletin of the World Health Organization, 86, 419.CrossRefPubMedPubMedCentralGoogle Scholar
  13. Junaidi, I. (2015). Spoiled vaccines worth millions sealed in FIA raid. Dawn. 28 April 2015. Accessed 20 Mar 2016.
  14. Khan, M. U., Ahmad, A., Aqeel, T., Akbar, N., Salman, S., & Idress, J. (2015). A cross-sectional survey of healthcare workers on the knowledge and attitudes towards polio vaccination in Pakistan. PLoS ONE, 10, e0142485.CrossRefPubMedPubMedCentralGoogle Scholar
  15. Khan, M. U., Ahmad, A., Aqeel, T., Salman, S., Ibrahim, Q., Idrees, J., et al. (2015). Knowledge, attitudes and perceptions towards polio immunization among residents of two highly affected regions of Pakistan. BMC Public Health, 15, 1100.CrossRefPubMedPubMedCentralGoogle Scholar
  16. Khan, T. M., & Chiau, L. M. (2015). Polio vaccination in Pakistan: By force or by volition? The Lancet, 386, 1733.CrossRefGoogle Scholar
  17. Khan, M. A., & Kanwal, N. (2015). Is unending polio because of religious militancy in Pakistan? A case of federally administrated tribal areas. International Journal of Development and Conflict, 5, 32–47.Google Scholar
  18. Khowaja, A. R., Khan, S. A., Nizam, N., Omer, S. B., & Zaidi, A. (2012). Parental perceptions surrounding polio and self-reported non-participation in polio supplementary immunization activities in Karachi, Pakistan: a mixed methods study. Bulletin of the World Health Organization, 90, 822–830.CrossRefPubMedPubMedCentralGoogle Scholar
  19. Makinde, T. (2005). Problems of policy implementation in developing nations: the Nigerian experience. Journal of Social sciences, 1, 63–69.Google Scholar
  20. Mushtaq, M. U., Majrooh, M. A., Ullah, M. Z., Akram, J., Siddiqui, A. M., Shad, M. A., et al. (2010). Are we doing enough? Evaluation of the polio eradication initiative in a district of Pakistan’s Punjab province: a LQAS study. BMC Public Health, 10, 60.CrossRefPubMedPubMedCentralGoogle Scholar
  21. Naeem, M., Adil, M., Abbas, S. H., Khan, A., Khan, M. U., & Naz, S. M. (2011). Coverage and causes of non immunization in national immunization days for polio; a consumer and provider perspective study in Peshawar. Journal of Postgraduate Medical Institute, 96, 48–54.Google Scholar
  22. Nishtar, S. (2010). Pakistan, politics and polio. Bulletin of the World Health Organization, 88, 159–160.CrossRefPubMedGoogle Scholar
  23. Obregón, R., Chitnis, K., Morry, C., Feek, W., Bates, J., Galway, M., et al. (2009). Achieving polio eradication: a review of health communication evidence and lessons learned in India and Pakistan. Bulletin of the World Health Organization, 87, 624–630.CrossRefPubMedPubMedCentralGoogle Scholar
  24. Polio in Pakistan. (2016). Accessed 02 Feb 2016.
  25. Raosoft. (2008). An online sample size calculator. Accessed 05 July 2015.
  26. Ruijs, W. L., Hautvast, J. L., van IJzendoorn, G., van Ansem, W. J., Elwyn, G., Van der Velden, K., et al. (2012). How healthcare professionals respond to parents with religious objections to vaccination: a qualitative study. BMC Health Services Research, 12, 231.CrossRefPubMedPubMedCentralGoogle Scholar
  27. Shah, S. U., Kausar, S. W., & Sial, A. (2014). Need base education and madrassa system: a comprehensive analysis of mainstream schools of thought in Pakistan. Merit Research Journal of Education and Review, 2, 19–27.Google Scholar
  28. UNICEF. (2012). In Pakistan, religious leaders help change misconceptions about the polio vaccine. Accessed 20 Mar 2016.
  29. Warraich, H. J. (2009). Religious opposition to polio vaccination. Emerging Infectious Diseases, 15, 978.CrossRefPubMedPubMedCentralGoogle Scholar
  30. Wilson, K., Mills, E. J., Norman, G., & Tomlinson, G. (2005). Changing attitudes towards polio vaccination: a randomized trial of an evidence-based presentation versus a presentation from a polio survivor. Vaccine, 23, 3010–3015.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Muhammad Umair Khan
    • 1
  • Akram Ahmad
    • 1
  • Saad Salman
    • 2
  • Maria Ayub
    • 3
  • Talieha Aqeel
    • 4
  • Noman-ul Haq
    • 5
  • Fahad Saleem
    • 5
  • Muhammad Ubaid Khan
    • 6
  1. 1.Department of Clinical Pharmacy, Faculty of PharmacyUCSI UniversityKuala LumpurMalaysia
  2. 2.Department of PharmacyAbasyn UniversityPeshawarPakistan
  3. 3.Department of Pharmacology, Faculty of PharmacyJinnah University for WomenKarachiPakistan
  4. 4.District Headquarter HospitalDistrict LoralaiPakistan
  5. 5.Department of Pharmacy Practice, Faculty of Pharmacy and Health SciencesUniversity of BalochistanQuettaPakistan
  6. 6.Department of SurgeryAga Khan University HospitalKarachiPakistan

Personalised recommendations