Evidence needs and community involvement in policy decisions for vaccine-preventable diarrhoeal infections among children under the age of five years: Stakeholder engagement in Ethiopia, Kenya, and Malawi

Chikondi A Mwendera, Mackwellings Phiri, Rahma Osman, Shewit Weldegebriel, Beatrice Ongadi, Chisomo Msefula, Amha Mekasha, Samuel Kariuki, Catherine Beavis, Jessica A Fleming, Dan Hungerford, Nigel Cunliffe, Deborah Nyirenda, Neil French and Consortium Ghrg-Gi

PLOS Global Public Health, 2025, vol. 5, issue 12, 1-18

Abstract: Diarrhoeal diseases are a leading cause of morbidity and mortality among children under five years in low- and middle-income countries (LMICs) with Shigella and Enterotoxigenic Escherichia coli (ETEC), both targets of ongoing vaccine development, playing major roles. To inform the introduction of vaccines against these pathogens in Ethiopia, Kenya, and Malawi, we assessed evidence needs for technical policy decisions and community engagement in national policy development processes. Using qualitative methods, we conducted 27 in-depth interviews (IDIs) with institutional stakeholders (ministries of health, researchers, and partners) and one focus group discussions (FGDs) in each country with community representatives. Data were collected between May 2023 to September 2024 and analysed thematically. Institutional stakeholders emphasised the need for robust, localised evidence on disease burden, vaccine efficacy, safety, cost-effectiveness, programmatic feasibility, alongside structured mechanisms to integrate evidence into policy. They noted the absence of diarrhoeal disease-specific technical working groups in their countries and advocated for their establishment. Meanwhile, community representatives expressed vaccine acceptance but stressed the importance of clear communication of information delivered by trusted health workers and leaders. They highlighted the need for comprehensive information on new vaccines, particularly regarding their safety and potential side effects. While community involvement in national policy-making processes was deemed low, participants highlighted the value of meaningful engagement to ensure ownership and uptake. The findings highlight the importance of robust evidence generation, effective communication, and inclusive community engagement to facilitate the successful introduction of Shigella and ETEC vaccines. Addressing these gaps can accelerate adoption, improve readiness, and foster trust in vaccination programmes.

Date: 2025
References: Add references at CitEc
Citations:

Downloads: (external link)
https://journals.plos.org/globalpublichealth/artic ... journal.pgph.0004775 (text/html)
https://journals.plos.org/globalpublichealth/artic ... 04775&type=printable (application/pdf)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:plo:pgph00:0004775

DOI: 10.1371/journal.pgph.0004775

Access Statistics for this article

More articles in PLOS Global Public Health from Public Library of Science
Bibliographic data for series maintained by globalpubhealth ().