Cultural and Contextual Determinants

Cultural practices such as waiting for the umbilical cord to fall off or circumcision wounds to heal delayed birth doses and later vaccinations. Distrust of vaccines was linked to broader concerns about expired or unsafe commodities in the Nigerian health system. Home delivery and delivery by traditional birth attendants commonly delayed newborn vaccination. Rumours that vaccines were bad or killed children created fear and delayed attendance. Market days competed with weekly immunisation clinics because many mothers depended on buying and selling for income and food.