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Empowering Caregivers in Immunization through Citizen Science: Community-School-Primary Health Care Unit Network (PHCUN)

Use citizen science to make 8th graders active participants in research to increase immunization amidst political mistrust in rural Ethiopia

Photo of Muluken Azage Yenesew
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Describe what you intend to do and how you'll do it in one sentence (required 250 Characters)

Community-School-PHCUN uses citizen science to mobilize schools to fight vaccine uptake resistance in Amhara. We will partner with two primary schools to bridge between mothers, healthcare facilities, and Bahir Dar University School of Public Health.

Explain the idea (less than 2,000 characters)

On October 23, two researchers falsely believed to be inoculating school children were killed by a mob in the Amhara region, Ethiopia. Beyond caregivers’ lack of knowledge about vaccine and vaccine preventable diseases and fear of adverse effects, negative social norms and rumors rooted in political unrest have lead to a full vaccination rate of only 46.7%, far below the national average. In this difficult context, we will draw on already established community ties to create a new Community-School-PHCU network. The network uses a citizen science approach to make 7th and 8th graders, the highest grade level in the rural communities, a bridge between caregivers and PHCUN. 96 pregnant mothers and 96 mothers with neonates will be identified and followed for one year. 24 primary students and 4 teachers will be trained about vaccine preventable diseases, benefits of vaccines and immunization schedules using a “citizen science” model that treats students not just as passive recipients of knowledge but active participants who help researchers identify problems, analyze and propose solutions, and look for implementation options. Primary students will be paired with graduate researchers to interview pregnant mothers and mothers with neonates and link to PHCUN in their locality. A primary student will follow 8 pregnant mothers and mothers with neonates. After data collection, primary students will travel to Bahir Dar University to participate in a workshop to brainstorm interventions, while also introducing them to university experiences. Primary teachers will supervise and provide feedback at all stages. Researchers will provide training, supportive supervision, feedback, and cross check the process and overall activities. The intervention aims not only to increase the vaccination rates for the mothers in the study but also the future vaccination rates for the students involved and their families

Which part(s) of the world does this idea target?

  • Eastern Africa

Geographic Focus (less than 250 Characters)

This project will be done in two rural kebeles of Amhara Region, Ethiopia with longstanding relationships with Bahir Dar University. It targets 96 pregnant women and 96 mothers with neonates, 24 7th and 8th graders, and 4 primary school teachers.

Who are your end users and how well do you know them? (750 characters)

The end users of the project are pregnant women on 3rd trimester and mothers with neonates and the primary students who reside in Mecha District, northwest Ethiopia. The researchers at Bahir Dar University have provided community services in the selected kebeles in the Mecha District to model village and to transfer best knowledge and skills on health and economic development to the other rural kebeles for over 5 years. The researchers have also already piloted a citizen science approach targeting weather forecasting with four high schools in nearby towns.

How is the idea unique? (750 Characters)

Existing initiatives use health extension workers, but this has lead to overburdened personnel. Our project brings a new social group not ordinarily empowered with scientific training into the process to combat the growing political mistrust of vaccinations. The 7th and 8th grade students, the most advanced grades in the local communities, engage fully from data collection to analysis and discussion to become community changing agents that promote healthy understandings of vaccinations for mothers and themselves. The approach is community centered, and we have found it effective in other science fields. We believe that the approach will bring paradigm shift in existing public health initiatives.

Idea Proposal Stage (Select 1)

  • Pilot: We have started to implement the idea as a whole with a first set of real users. The feasibility of an innovation is tested in a small-scale and real world application (i.e. 3-15% of the target population)

How many months are required for the project idea? (140 characters)

The intervention requires 12 months for complete implementation that will start at 3rdtrimester to finish basic vaccination.

Organization Name (less than 140 characters)

Community-School-Primary Health Care Unit Network administered through Bahir Dar University, School of Public Health, Bahir Dar, Ethiopia

Type of Submitter

  • We are a formal part of a University or Research Institution

Organization Location (less than 140 Characters)

The new network is administered through BDU School of Public Health. The university is found in Bahir Dar, the capital city of Amhara Region

What is the current scale of your organization’s work?

  • Regional (reach within 1 geographic region)

Website URL

Tell us more about your organization/company (1-2 sentences)

The network is developed from longstanding ties between the University and the two kebeles following the three arms of the university (teaching-learning, research and community services) and as such, the objective of this grant is directly linked with the last two responsibilities and goals of the university. The university contributes its own share to solve the challenges by allowing the research team involved in the project as well as allow some logistics like seminar room.

Who will work alongside your organization in the project idea? (750 characters)

By its nature citizen-science, requires the engagement of different parties. The main partners in the project are the school communities (directors, teachers and students), Bahir Dar University, district health office and kebele administrative bodies. Teachers and students are key role players in the implementation of the project. The local administrative bodies, school directors and district health office act as a mobilizer for the sensitization of the program and continuity of the intervention. The universities run the overall project activities.

How many people are on your team?


Tell us more about you and your team

Four university faculty, two graduate students, Mecha woreda health office head, 4 primary teachers, 24 students

Overview of How Your Concept Has Evolved (5-6 sentences):

The citizen science concept tested in choosing crops that best fit for planting according to climatic condition based on the information on hydro climatic variables to maximize agricultural products. Hydroclimatic data such as moisture content, hand dug well water level and river level were collected by students using the network of school communities, kebele administrators and farmers of rural kebele of Mecha district. Students analyze and interpret the data and discus its implication with their parents and neighbor farmers. Farmers can forecast moisture content in soil and to choose crops that fit the coming weather condition eg chickpea and grass pea during low moisture availability in the soil.

Viability (3-4 sentences and activity upload):

The key partners are the school communities (directors, teachers and students) which are motivated in maintaining and promoting healthy children for better education, Bahir Dar university which is motivated to provide community service, one the mandate of university, Mecha district health office and kebele administrative bodies which have a mission to create and have health community. The core value of the project is to create awareness on importance of immunization and avert the misconception towards immunization which in turn increase and sustain the uptake of immunization service by the community.

Feasibility (3-4 sentences):

The concept of citizen science is already tested and effective in proposed project area. The actors are beneficiaries which are feasible to implement the project and bring behavioral change on immunization. Primary school students are adolescents who can adapt technology and services. District health office also desires innovate approach that can able to avert the misconception of the community towards immunization.

Desirability (3-4 sentences and activity upload):

Farmers had faced extreme weather variability which leads to low crop productivity and crop failure. Following this circumstance, researchers adopt citizen science approach to cop up the challenge and then primary school students were trained on collecting, analyzing and interpreting hydro-climatic data for weather forecast. Students engaged in data collection, analysis and interpretation of the results and then discuss with their parents and neighbors about its implication on crop productivity. Finally, they made collective decision on choosing of crops that best fit for the weather condition and had effective in maximizing crop production.

Community Focus (2-3 sentences):

Immunization services already stacked due to misconception, negative social norms and rumors rooted in political unrest in the area. On top of that, outbreaks of vaccine preventable diseases (eg measles) frequently occur in the area and a numbers of deaths due to measles were recorded in the community in the past three years and it becomes the headache of Amhara Regional Health Bureau. Thus, engaging and training the citizens on immunization through citizen science is paramount to transfer the benefits of immunization and to bring behavioral change.

Community Impact (2-3 sentences):

The project idea is innovate to avert the misconception, negative social norms and rumors rooted in political unrest towards immunization service by their own community members as citizen science. One year is required to evaluate the uptake of immunization service. The project idea will be implemented together with district health office professionals and local community members and it is helpful for the idea to be mentioned as best experience and to transfer it to other districts that can be handover by the health bureau to sustain the project idea without external support.
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Team (4)

Muluken Azage's profile
Achenef's profile
Achenef Motbainor

Role added on team:

"Dr Achenef MotbainorBegosew(Co-PI) is an Assistant professor of Public Health at Bahir Dar University, Ethiopia. He is leading the overall site coordinator; facilitate the training, mentoring the intervention, data analysis and report writing."

Dabere's profile
Dabere Nigatu

Role added on team:

"Mr. Dabere Nigatu is an assistant professor of Reproductive health at Department of Reproductive Health and Population Studies, School of Public Health, Bahir Dar University. He is facilitate the training, mentoring the intervention, data analysis and report writing."

Netsanet's profile
Netsanet Fentahun

Role added on team:

"Dr Netsanet Fentahun Babbel is Associate Professor of Social behavior change communication and nutrition, Bahir Dar University, School of Public Health. He is leading one of the sites coordinator; facilitate the training, mentoring the intervention, data analysis and report writing."


Join the conversation:

Photo of Marichu Carstensen

Hi Muluken, I am impressed with the uniqueness of your idea. Linking children and actual subjects that they can observe objectively would have a life long impact on both parties. The children will provide an indisputable fact that vaccination really prevents all these diseases. This will then be spread organically as they will talk about their observation all their lives.
Children don't lie and the myths older people still believe in can be dispelled by their honest and unstained promotion.

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