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Are there foods, clothing, sanitation practices, or language differences (vernacular phrases, intonations, regional or tribal accents) that could be barriers to vaccination? Is there geography or history that has contributed to the problem under study?

Sociocultural System Policies that are studied without regard to the human systems in which they function have little relevance. One must start by identifying the context—that is, the values of those who are affected by and affect the policy.

1. In the rural area in which you are practicing, is vaccination an accepted method of disease prevention? If not, what are the arguments against it?

2. If the procedure is accepted, was this child vaccinated? If not, why not?

3. Who was responsible for vaccinating the child?

4. Does polio hold a special meaning in this culture?

5. Is there a clear system of patriarchy or matriarchy? Does family hold a special meaning? Is the family a nuclear unit or an extended unit?

6. Is the patient/family part of a minority group that is treated differently from the majority? Is that person/family adherent in other areas of health care?

7. Are there religious or personal philosophical reasons why vaccination was not administered?

8. Are there myths about polio that keep some people from accepting vaccination? Do you believe these myths? If not, how can you help others dispel the myths?

9. Are there foods, clothing, sanitation practices, or language differences (vernacular phrases, intonations, regional or tribal accents) that could be barriers to vaccination? Is there geography or history that has contributed to the problem under study?