In Saudi Arabia, doctors participated in the conduction of two National Immunization Days (NIDs), a critical strategy for global poliomyelitis eradication. The objectives of this study are to find out the level of awareness of doctors working in Riyadh city, Kingdom of Saudi Arabia (KSA), about the objective of conducting NIDs, and to find out their knowledge, attitudes and practices toward NIDs.
Methodology
The doctors' community was divided into three strata according to their place of work: hospitals, primary health centers and private polyclinics. From each stratum a probability sample was selected. Using a self-administered questionnaire, 175 doctors working in 23 health facilities were interviewed. In analysis, doctors were further stratified according to their nationalities and specialization.
Results
Of all doctors interviewed; 149 (85%) were from Arab countries and 106 (61%) were males. About 51% of pediatricians (Peds), 27% of general practitioners (GPs) and 36% of doctors of other specialties (OS) thought NIDs were for developing countries only. Between 9% to 23% of Peds, 15%-28% of GPs and 22%-29% of OS were unaware of the main objective of NIDs, considered NIDs a simple booster dose for an already vaccinated child, and would not advise vaccinated children to receive additional oral polio vaccine (OPV) doses during NIDs scheduled for 1997. Five percent of doctors did not vaccinate their children during the NIDs of 1996. Five doctors (3%) stated that eradication of wild poliovirus in KSA was impossible due to the dynamic and continuous flow of religious visitors and expatriate workers. Peds, GPs and OS thought breast-feeding (9%), current routine childhood immunization, having three doses of OPV in the first year of life, and/or protein-energy malnutrition (9%-11% of Peds, 15%-22% of GPs, 19%-26% of OS) were contraindications for OPV. Two Peds (6%) did not know that prompt reporting of cases of acute flaccid paralysis was required. Reading MOH circulars was associated with awareness about NIDs (p<0.05, chi-square test).
Conclusion
Failure to differentiate between the objectives of routine OPV vaccination and NIDs could be due to inadequate communications between MOH and doctors. Doctors, especially pediatricians, need to be more involved in planning, executing and evaluating any community outreach programs that relate to a child's health.