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other·public health, pediatrics, immunology, infectious disease, epidemiology·PMC10311705

Leading from the frontlines: community-oriented approaches for strengthening vaccine delivery and acceptance

BMC Proceedings · 7 authors, 4 centres

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TL;DR

A community-based participatory research project in Mewat District, India, used human-centered design workshops and a community accountability board to co-create a six-pronged intervention with community leaders and health workers aimed at improving vaccine acceptance. Post-intervention data indicated improvements in caregiver knowledge of vaccines and greater willingness to vaccinate children, though survey results were not powered to demonstrate direct impact.

Full summary

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This study used community-based participatory research to co-design and implement a vaccine acceptance intervention in Mewat District, Haryana, India, a setting with extremely low immunization coverage. Over five phases, researchers collaborated with a community accountability board, community health workers, and community leaders through human-centered design workshops to develop a six-pronged intervention. Post-intervention surveys suggested improvements in caregiver knowledge of vaccine purpose and side effects, increased willingness to travel for vaccination, fewer non-logistical reasons for refusal, and decreased vaccine misinformation. Qualitative interviews indicated higher levels of community ownership among leaders and health workers. Key limitations include volunteer bias, possible confirmation bias during design workshops, and a convenience-based survey sample that was not powered to detect statistically significant impact. The COVID-19 pandemic also constrained in-person activities and diverted community health workers from project engagement.

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other

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public health

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ORIGINAL PAPER

PMC10311705

Leading from the frontlines: community-oriented approaches for strengthening vaccine delivery and acceptance

BMC Proceedings

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ABSTRACT

Background Although immunization is one of the most successful public health interventions, vaccine hesitancy and the COVID-19 pandemic have strained health systems, contributing to global reductions in immunization coverage. Existing literature suggests that involving community members in vaccine interventions has been beneficial, but efforts to facilitate community ownership to motivate vaccine acceptance have been limited. Methods Our research leveraged community-based participatory research to closely involve the community from conception to implementation of an intervention to facilitate vaccine acceptance in Mewat District in Haryana, an area in India with extremely low vaccination coverage. Through the development of a community accountability board, baseline data collection on vaccination barriers and facilitators, and two human-centered design workshops, our team co-created a six-pronged intervention with community leaders and community health workers. This intervention included involving religious leaders in vaccine discussions, creating pamphlets of local vaccine champions for dissemination to parent and child caregivers, creating short videos of local leaders advocating for vaccines, implementing communication training exercises for community health workers, and implementing strategies to strengthen coordination between health workers and supervisors. Results Post-intervention data suggested parents and child caregivers had improvements in knowledge of the purpose of vaccines and side effects of vaccines. They noted that the involvement of religious leaders was beneficial, they were more willing to travel to vaccinate their children, and they had fewer non-logistical reasons to refuse vaccination services. Interviews with community leaders and community health workers who were involved in the creation of the intervention suggested that they experienced higher levels of ownership, they were better equipped to address community concerns, and that vaccine misinformation decreased in the post-intervention period. Conclusion Through this unique intervention to strengthen vaccine uptake that incorporated the needs, interests, and expertise of local community members, we developed a community-driven approach to strengthen vaccine acceptance in a population with low uptake. This comprehensive approach is essential to amplify local voices, identify local concerns and advocates, and leverage bottom-up strategies to co-design successful interventions to facilitate long-term change.

CITATION EXPORT

Baldeep K. Dhaliwal, Rajeev Seth, Betty Thankachen et al.. Leading from the frontlines: community-oriented approaches for strengthening vaccine delivery and acceptance. BMC Proceedings. (2023). https://doi.org/10.1186/s12919-023-00259-w

AUTHORS

7 · 4 CENTRES

Baldeep K. Dhaliwal, Rajeev Seth, Betty Thankachen, Yawar Qaiyum, Svea Closser, Tyler Best, Anita Shet

1grid.21107.350000 0001 2171 9311Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
2grid.21107.350000 0001 2171 9311International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
3https://ror.org/020dpkm20grid.505961.eBal Umang Drishya Sanstha, New Delhi, India
4grid.21107.350000 0001 2171 9311Center for Communication Programs, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA