Overview
The goal of this cluster, randomized controlled trial is to study the impact of mobile vaccine clinics and religious conferences on pediatric vaccination coverage. The main questions will be: does vaccination coverage change in geographic areas with the mobile vaccine clinics vs those areas without mobile vaccine clinics; and does vaccination coverage change in geographic areas with religious conferences on vaccination vs those areas without religious conferences. In repeated surveys, adult participants will respond about their children's vaccination status. Participants will not be individually randomized to the interventions. Rather, their geographical area will be randomized.
Description
This project seeks to create a paradigm shift in how the public views and utilizes vaccination services. Currently, community health centers remain the default setting for vaccination, and clinicians the default administrators. However, the general population may have difficulty accessing these clinics or trusting traditional vaccination providers, particularly if they are members of marginalized communities that have experienced medical discrimination. This project applies a two-pronged approach by addressing issues of trust and ease of access among the general population. This project is innovative by: a) mobilizing religious communities to discuss vaccines (to counter reported lack of information about vaccines among unvaccinated families) and b) training more community health workers in vaccination and in physically delivering vaccines through a "Vaccine-in-a-van" concept to facilitate ease in accessing vaccines. By mobilizing these individuals in the community settings where people live, work, worship, and learn, this project will expand vaccine information and services.
More specifically, this project plans to work with local health leaders in a low vaccination community in Aceh, Indonesia to identify social institutions that are part of children and families' daily lives; these could include houses of worship, schools, or community centers. This project will fund a mobile vaccine delivery unit to go to these locations to physically bring vaccines to the people and to link them with existing immunization clinic infrastructure. This project will also work towards changing the culture of child health and vaccination through substantial discussions and conversations with multiple levels of religious leaders at conferences.
Eligibility
Inclusion Criteria:
- Adults 18+, and
- Proficient in Bahasa Indonesia, and
- Plan to live in neighborhood for next year
- Parent of child <5, or
- Planning to have a child within next year