Digital Platform for Child Immunization: Triple Engagement Strategy (DPCI-TES)
DPCI-TES uses the COM-B approach to nudge demand for child immunization services in rural north-western Burundi
This framework, which was developed by Mitchie et al. Implementation Science (2011) and recommended by WHO TIP (Tailoring Immunization Programmes), helps to operate a behavior change. It will be used to nudge immunization seeking and full utilization behavior in a rural setting of Burundi suffering from a chronic under-immunization rate.
Describe what you intend to do and how you'll do it in one sentence (required 250 Characters)
HHNB aims to implement a COM-B digital platform that enables capability, motivation, and opportunity for mothers, community health workers, and nurses in order to nudge the seeking and full utilization of child immunization services in rural Burundi
Explain the idea (less than 2,000 characters)
Cibitoke Health Province is one of the rural settings of Burundi most suffering from chronic low rate of child immunization. For instance, 32% of children did not received immunization between 2012 and 2017 (DHS 2017). Despite the absence of setting-tailored research evidence, the lack of a system to nudge vaccine active demand and respond to vaccine hesitancy due to complacency (low perceived risk of vaccine-preventable diseases, and vaccination not deemed necessary) might be the leading cause of failure to attain child vaccination targets in this rural, traditionally-rooted, least educated, and poor setting. Child vaccination services are freely available and accessible but less valued, sought or demanded, and utilized by consumers.
This idea will benefit expectant women, mothers, babies and people who care for babies in Cibitoke. End users ─ whose physical and psychological capabilities, physical and social opportunities, and automatic and reflective motivations will be enhanced ─ will change hesitancy behavior on child vaccination. This change will be operated through the digital platform that uses community engagement, trust-building, and active hesitancy prevention to increase acceptance and demand for child vaccination. It is expected that the intervention reaches more than 1000 end users aged between 18 and 50 years old.
Through the DPCI-TES, end users will receive nudging communication messages and schedules for child vaccination appointments (where, when). Also, a monthly community gathering of end users will be organised to complement the engagement through DPCI-TES. A CHW and a Nurse will log into the DPCI-TES to schedule or reschedule end users’ appointments, send them reminders and nudging messages, and log a direct call to check on end users in case of “no show” to appointments. Similarly, using the DPCI-TES, end users will have an option to log a call linking to the nurse or CHW. This interactive communication is our "Triple Engagement Strategy"
Nurses and CHWs log in the DPCI to schedule end users for child vaccination, send nudging messages, send appointments reminders, and log calls to check on end users in case of "no show". End users receive behavioral change communication from CHWs and Nurses and can log a call to link back to CHWs and Nurses for a question (Triple Engagement Strategy).
Which part(s) of the world does this idea target?
Geographic Focus (less than 250 Characters)
This idea target the East Africa region. Specifically, the idea will be implemented in a rural community in north-western Burundi (Cibitoke) which suffers from chronic low rates of child vaccination.
Who are your end users and how well do you know them? (750 characters)
The end users are pregnant women, mothers, and people providing care to children in the target community. I have been working in this community since almost 7 years which means that I know the setting very well. Currently, I am implementing a similar idea in a subcommunity of Cibitoke (Murwi) funded by GIZ and the East African Community through IIDEA initiative. The current idea is a "Mobile Platform 4 Maternal Health" which seeks to contribute to the implementation of the Open Health Initiative of the EAC Reproductive Health Unit (whose ultimate goal is the improvement of RMNCAH and the achievement of SDG 3 within the EAC Partner States) through improving MNH in the EAC region and, particularly, in Burundi and Rwanda.
How is the idea unique? (750 Characters)
The idea is unique in the sense that it uses digital technology (which allows remote and instant interaction) to stimulate a triple engagement (end users, Community Health Workers, and Nurses) that seeks to prevent vaccination hesitancy and increase the demand for child vaccine services. In our settings, it is common that engagement be done through mass communication, which has led to little impact. Trying a new venture is worth our time and resources and, the evidence has shown that tailored (targeted) interventions using mobile technologies have potential to achieve positive outcomes.
Idea Proposal Stage (Select 1)
Blueprint: We are exploring the idea and gathering the inspiration and information we need to test it with real users.
How many months are required for the project idea? (140 characters)
It will take us almost 20 months to implement our phase one of the idea and achieve the desired impact (full child immunization calendar).
Organization Name (less than 140 characters)
Health Healing Network Burundi (HHNB)
Type of Submitter
We are a registered NGO or Non-Profit Organization
Organization Location (less than 140 Characters)
What is the current scale of your organization’s work?
National (expansive reach within one country)
Tell us more about your organization/company (1-2 sentences)
HHNB is a community-focused health initiative that seeks to improve community health through digital and other innovative solutions. HHNB, which received a WHO Special Recognition Award 2018 (http://whoburundi-whoafroccmaster.newsweaver.com/burundiflyer/ye5cwnxabia1kmpjls3jf6?email=true&a=11&p=53470899), was established in 2012.
Who will work alongside your organization in the project idea? (750 characters)
Our key partners will include, mainly, the Ministry of Health and the Expanded Programme for Immunization, GIVI, UNICEF, and UNFPA. Other partners such as GIZ, The East African Community Health Department, local NGOs, etc. will also be involved.
How many people are on your team?
Tell us more about you and your team
1. Dr Desire Habonimana, Team Lead. I am a Medical Doctor and WHO/TDR Alumni. In addition, I possess a MSc in Epidemiology (Implementation Science) obtained from the University of the Witwatersrand of Johannesburg, and am almost completing a second MSc in Health Economics and Decision Science at the University College London (UCL).
2. Dr Roger Ciza, MD, MSc Epidemiology (Implementation Science)
3. Dr Nadine Misago, MD , MPH
4. Dr Romeo Irankunda, MD
5. Ms. Petronie Nyawenda, Psychologist
6. Ms. Flavie Mugerinkoko, Economics
This is a multidisciplinary team that was established 5 years back, working together in the fight for community-oriented health challenges. We have needed skills and expertise from medical point of view, and financial and social point of views.