Minneapolis is the largest city in the state of Minnesota with a population of 411,000 residents. The State of Minnesota has been a home for a large number of immigrants since the late 1800s. There was a huge growth in the population of Minnesota between the years 2000 and 2010 and this was mostly by the people of color who were immigrants. As seen in the demographic overview of Minnesota, in the year 2009-2011, the foreign-born population in Minnesota was very diverse with an equal number of people from Oceania, North America, Africa, Latin America, Asia, and Europe.
In the year 2013, the top 3 groups who lived in Minnesota by country of birth were from Mexico, Somalia, and India respectively.
Minnesota has always been very welcoming to the people of Somalia. The immigration of Somalis to Minnesota started in the year 1992. A large number of Somalis migrated to the United States as refugees when the civil war began. As of 2018, Minnesota is a home for the highest number of Somalis living in the United States.
The majority of these people live in the city of Minneapolis. The most concerning thing about the Somali community in Minneapolis is that the Somali children are more susceptible to Measles infection. There have been two Measles outbreak in Minneapolis, Minnesota. It was found that the majority of children affected were of Somali descent. Therefore, it is important to understand the factors that could play an important role in making the Somali children more susceptible to Measles infection.
Somalis started migrating to the United States in the year 1992 to seek a safer place during the civil war.
They decided to live in Minnesota for better job opportunities, educational opportunities, for the social network and for many other services. Over the years, several factors played an important role in making the Somali children highly susceptible to the health outcome which is Measles. The relationship between how Somalis experienced Minneapolis (Minnesota) and the impact of Minneapolis on their health can help us understand the social determinants that were influencing the health outcome observed in this community.
One of the social determinants that can influence this health behavior can be education. In the year 2008-2012, on an average, less than 10% of Somali Minnesotans attended graduate school or had an advanced degree. This may have had an influence on the health behaviors as the Somali Minnesotans are less educated they are less exposed to new ideas and new practices in the protection of health. This can restrict what the parents think about their child’s health. In the year 2004, almost 94% of the Somali children in Minnesota were vaccinated against Measles. In the year 2014, however, this number decreased to 35.6% vaccination rate in the Somali children. The reason behind the decreased rate in vaccination was found to be the parent’s concern about the relationship of Vaccination against Measles with autism disorder.
Another factor that could influence this health behavior could be of sacred practices. Somalis have migrated to the United States from East Africa and they are Sunni Muslims. They mostly speak in Somali or Arabic. Being a Muslim in Minnesota has not been easy from the Somali community. When Somalis first came to Minnesota, people were not aware of their religious practices of Muslims. Since then, Somalis have faced various difficulties in practicing their faith in Minnesota. The reason why this could influence the health behaviors in the Somali community is that the older generation wants the younger generation of Somalis to practice all the religious practices of Islam. Therefore, the majority of Somali Minnesotans follow the traditional therapies along with modern medicine. Some of the Somali Minnesotans still have conservative thinking when it comes to the idea of vaccination. As mentioned in the article by the CDC on Measles outbreak, the majority of the parents believed that there was some relationship between Measles vaccine and Autism disorder and therefore, the parents refrained from giving any measles vaccine to their children.
Following these practices and perceiving a particular health protection program as a risk factor for another disease by the Somali parents puts the Somali children at risk for Measles infection.
The type of intervention that could address this problem of more and more Somali children being affected by measles is the community level intervention. This community-level intervention will be called as the community outreach program. It will focus on working with important members of the Somali community in Minneapolis. This will concentrate on changing the perception about the measles vaccine by educating the parents about the effects of vaccines on the health of their children.
The reason why this type of intervention is selected is that of the bond that Somali members have among each other. Somalis have created their own social networks and organizations that help them to find their way in Minnesota. Most Somalis want to stick to their traditional culture and their sacred practices and they like to live very near to their own community members. Therefore, a community level intervention that focuses on inviting the important and very educated members of the Somali community to help us spread the correct knowledge about the Measles vaccination has a high possibility of showing some positive results.
In this intervention, the meeting will be held in the Somali community hall after the community member’s visit to the mosque. This intervention will address both the social determinants mentioned above that may have had an influence on this health behavior in the Somali community. The meeting will educate parents about the new ideas and new treatment in medicine and also educate them on the traditional practices that should not be followed in regards to their Children’s health. This intervention has a high possibility of working in the Somali community of Minneapolis because most parents seem to be influenced by the incorrect spread of knowledge about the vaccine against measles. Therefore, this intervention focuses on giving the parents the right knowledge about the vaccine. It also focuses on telling the Somali members who attend the meeting to spread this knowledge to the other community members and therefore ensures that more and more parents vaccinate their children against measles.
This community outreach program focuses on working with the important stakeholders in the Somali community like community health workers, health care providers, faith leaders, important community members in Minneapolis. The intervention will work in the form of creating an event in the Somali community hall just after their visit to the mosque on Fridays. The meeting will focus on the important aspects of the measles vaccine. Parents will be educated regarding the usefulness of measles vaccination in their children. Education will be given in the form of an audio-visual presentation given by the pediatricians from the Somali community. This will an interactive session so, all the questions from the parents will be answered. Pamphlets will also be given, which will include all the information related to Measles vaccine so that the parents can take it home and also distribute it to more people in their community. Special emphasis will be given to Measles vaccination. Parents will also be taught about the signs and symptoms of Measles and who can they approach for help if they notice any symptoms in their children.
The cultural values and practices in the Somali community in regards to the health of their children will also be addressed. Many parents don’t believe in modern medicine as the only treatment for their child’s illness. Therefore, various traditional therapies are practiced in addition to taking prescription drugs. These practices will be addressed by the community health workers and parents will be explained about what traditional therapies should not be followed.
The spread of knowledge will be ensured in the form of having a programme on the radio and television which will educate a large number of people regarding the MMR vaccine. Pamphlets will also be sent to the pre-schools and care centers and schools of the Somali community so that teachers can educate their students as well as the parents about the vaccine. Vaccination will be scheduled near the local Somali community hall as it will become easier for parents to get their children vaccinated without any difficulty with transportation.
The way in which this community outreach program will be evaluated is in the form of a pre- and post-intervention survey. It will focus on two important aspects of an evaluation model that is output evaluation and outcome evaluation.
A pre-intervention survey will be distributed amongst the Somali community (participants) who come to attend the sessions on Friday. They will be asked to answer several questions like their knowledge about the MMR vaccine, whether they have vaccinated the child against measles, if not then the reason behind not vaccinating their children. It will also ask them about the signs and symptoms of Measles and ask them to write whatever they know about it. It will also ask them about any particular traditional therapy they follow in regards to their child’s health. This pre-intervention survey will help us in knowing what the parents already know about Measles and vaccination and if there is any gap in their knowledge. It will also help us to know what areas of knowledge about measles and vaccination should be focused on during the sessions. This survey will also give us the information about what and how many participants practice traditional therapies as treatment for their children.
There will also be a post-intervention survey which will be given to the (Somali community members) participants after they have attended the Friday session. Questions like misconceptions that were cleared in the session, if they would want to vaccinate their children against Measles, what new information did they get about Measles and vaccination. This post-intervention survey will help us to evaluate if the the knowledge that the participants had is enhanced or not, it will also help us to know if the session was helpful in changing their perception about Vaccination against Measles.
A pre- and a post-survey will help in output and outcome evaluation of this community outreach program.