Abstract:

This study examines the influence of cultural beliefs and social norms on the uptake of preventive health measures against measles-related child mortality in five high-burden African countries: Nigeria, the Democratic Republic of Congo (DRC), Chad, Ethiopia, and South Sudan. Drawing on a systematic review of peer-reviewed literature and global health databases, the study explores how sociocultural factors interact with vaccine acceptance and health-seeking behaviors across diverse settings. Despite measles vaccine efficacy exceeding 98% in infants, uptake remains suboptimal. As of 2023, the estimated measles immunization coverage (MCV1) stood at 54% in Chad, 56% in South Sudan, 61% in DRC, 65% in Ethiopia, and 63% in Nigeria - far below the 95% threshold needed for herd immunity (WHO/UNICEF, 2023). Cultural determinants - such as religious conservatism in northern Nigeria, traditional healing preferences in Ethiopia, and vaccine-related myths in the DRC and Chad - significantly hinder immunization efforts. In conflict-affected regions like the DRC and South Sudan, systemic health service collapse has amplified distrust and misinformation, contributing to over 7,000 measles-related deaths in DRC’s 2019–2020 outbreak alone. Conversely, the study identifies cultural enablers: religious leaders, community elders, and localized communication (e.g., radio, storytelling) have successfully bolstered vaccine uptake when effectively mobilized. However, a critical gap remains in longitudinal and participatory research needed to guide culturally responsive policy. The study concludes that measles prevention in Africa requires not only biomedical solutions but also culturally embedded strategies that foster trust, inclusivity, and local ownership of health interventions.

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