‘We All Work Together to Vaccinate the Child’: A Formative Evaluation of a Community-Engagement Strategy Aimed at Closing the Immunization Gap in North-West Ethiopia

Tracey Chantler, Emilie Karafillakis, Samuel Wodajo, Shiferaw Dechasa Demissie, Bersabeh Sile, Siraj Mohammed, Comfort Olorunsaiye, Justine Landegger and Heidi J. Larson
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Tracey Chantler: London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
Emilie Karafillakis: London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
Samuel Wodajo: Assosa Referral Hospital, Benishangul Gumuz Regional State, Assosa, Ethiopia
Shiferaw Dechasa Demissie: International Rescue Committee, Bole Sub-City, 813 Addis Ababa, Ethiopia
Bersabeh Sile: London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
Siraj Mohammed: International Rescue Committee, Bole Sub-City, 813 Addis Ababa, Ethiopia
Comfort Olorunsaiye: International Rescue Committee, New York, NY 10018, USA
Justine Landegger: International Rescue Committee, New York, NY 10018, USA
Heidi J. Larson: London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK

IJERPH, 2018, vol. 15, issue 4, 1-12

Abstract: The role of community engagement (CE) in improving demand for immunization merits investigation. The International Rescue Committee developed a CE strategy to implement a vaccine defaulter-tracing tool and a color-coded health calendar aimed at increasing uptake of immunization services in north-west Ethiopia ( ‘The Fifth Child Project’). We report findings from a formative evaluation of this project. In May/June 2016 we conducted 18 participant observations of project activities, 46 semi-structured interviews and 6 focus groups with caregivers, health workers, community members/leaders. Audio-recordings and fieldnotes were transcribed, anonymized, translated and analyzed thematically using inductive and deductive coding. Additional data was collected in November 2016 to verify findings. The project was suitably integrated within the health extension program and established a practical system for defaulter-tracing. The calendar facilitated personalized interactions between health workers and caregivers and was a catalyst for health discussions within homes. At the community level, a regulation exercise of sanctions was observed, which served as a deterrent against vaccine default. Pre-existing community accountability mechanisms supported the CE, although varying levels of engagement between leaders and health workers were observed. The benefits of shared responsibility for immunization were evident; however, more transparency was required about community self-regulatory measures to ensure health-related discussions remain positive.

Keywords: immunization; vaccination; community engagement; increasing uptake; Ethiopia; child health; qualitative research (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2018
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