Respectful Jirga Dialogue Brings Six Year Vaccine Refusing Community Into Immunization Fold
PESHAWAR, (APP - UrduPoint / Pakistan Point News - 25th Aug, 2026) A trust-based and respectful dialogue approach, rooted in the traditional Pashtun jirga system, helped bring a community in Akhoonabad Union Council of Peshawar back into the immunization fold after a six-year gap in childhood vaccination caused by persistent resistance.
*"The breakthrough was achieved by field team of MERF (Medical Emergency Resilience Foundation), with the support of District Health Officer, Peshawar district and other stakeholders," says Dr. Abdul Basit, Programme Manager MERF.
The refusal had become deeply entrenched within the community, with households collectively restricting access of both Polio and routine immunization teams to the area. "Previous efforts not only included community engagement efforts but also stricter legal actions against the refusing families including registration of First Information Reports (FIRs) against some family members, however, these measures did not result in acceptance of vaccination," Basit shared.
The persistence of refusals demonstrated that conventional campaign based, behavioral, and administrative approaches were insufficient to address the underlying concerns and resistance. Given the local social and cultural context, the vaccination team adopted a trust-first, relationship based and community-led approach, drawing on the importance of personal relationships, respectful dialogue and jirga-based engagement within Pashtun culture.
A multidisciplinary team comprising of a medical officer, vaccinator, local influential, and a religious leader was constituted. It was decided to adopt a direct face-to-face visit to demonstrate seriousness, respect, and willingness to listen. For female members, an all-female jirga interaction was used accommodating local cultural norms and purdah considerations. The initial interactions were solely with the female members by the medical officers.
A total of eight structured engagements were undertaken between August 4 and August 12, 2026, moving progressively from rapport-building to formal negotiation to full household coverage.
The community was encouraged to visit the health facility and become familiar with its services so that they could access care whenever needed. Respectful, meaningful, knowledge based conversations were held along with political and religious backing of respective elders, leading to a final willingness of the households to vaccinate their children.
On August 12, 2026, all eligible children in the target street of UC Akhoonabad were vaccinated, overcoming a refusal that had persisted for approximately six years. Family members actively brought their children to the baitak for vaccination and, notably, some household members voluntarily recorded videos of the vaccination process.