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Male immunization champions: Using “male immunization champions” as immunization promoters

Promoting male partner involvement in immunization services using “male immunization champions”

Photo of BAGAYA MONICA

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Describe what you intend to do and how you'll do it in one sentence (required 250 Characters)

Engaging fathers who are actively involved in their children’s full immunization “ male immunization champions” as key influencers for empowering male peers and accelerating male partner involvement in immunization services in Uganda.

Explain the idea (less than 2,000 characters)

Male partner involvement in RCI services influences women’s immunization behavior, utilization and timely completion of an infant’s RCI schedule. From a study conducted by Baguma (2011) in rural, Uganda , only 29% of all male participants were highly involved in RCI. This is partly associated with the fact that interventions that generate demand for immunization services in Uganda have traditionally targeted women neglecting the involvement of men due to the general belief that women are typically responsible for child immunization. Paradoxically, male involvement is particularly emphasized in MCH with little attention to child vaccination, one of the world’s most cost-effective child survival strategies.Therefore, this project seeks to identify and train male immunization champions to empower male peers with immunization information and accelerate male involvement in Immunization services in rural Uganda. Male immunization champions will be fathers who are actively involved in insuring that their children receive the full immunization package on time. These will be identified by conducting clustered household surveys in rural and urban Uganda. During the clustered household surveys, fathers with children in the bracket of (12-23) months will be interviewed to assess male involvement. Male involvement in immunization will be estimated basing on an involvement index developed from five indicators: 1 if the male partner takes their children for RCT, 2 accompanies his partner for RCT, 3 provides financial support for a child’s routine immunization visits, 4 discusses with the partner about the child’s immunization schedule,Involvement score of each respondent will range from 0=no involvement to 4=involved in all 4 areas at least once. score of at least 3 will be considered as high male involvement and ≤2 as low male involvement. Fathers with score of 4 ana influeential will be selected as immunization champions and will be trained to engage and empower male peer

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

  • Eastern Africa

Geographic Focus (less than 250 Characters)

This projects targets rural Uganda with emphasis on rural areas within Wakiso and Mukono district Uganda.

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

This project will be implemented by Preventive Care International in partnership with public health facilities. We expect mothers especially those who are not economically empowered and their children to primarily benefit. From increased male involvement in immunization services, mothers will receive necessary support (transport money, permission) form their partners while taking their children for immunization. With approximately 40 male immunization champions, we anticipate being able to reach approximately 20,000 male partners with discussions centered on male involvement in RCI services. PCI through its partnerships has implemented similar projects targeting male involvement in HIV prevention services using a peer led model.

How is the idea unique? (750 Characters)

From a study conducted by (Babirye et al., 2011) on factors affecting immunization behavior in Kampala, Uganda, male partners involvement in immunization services was pointed out as key in increasing timely and full immunization of children. Mothers who reported to have received support from their husbands during their children’s immunization had fully immunized their children compared to those whose partners were not involved. Despite the relevancy of male partner’s involvement in utilization of immunization services, majority of the interventions that generate demand for immunization services in Uganda have traditionally targeted women neglecting men.Unique from other programs, this idea relies on accelerating male involvement in RCI.

Idea Proposal Stage (Select 1)

  • Prototype: We have done some small tests or experiments with prospective users to continue developing the idea.

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

12 months,to identify male immunization champions through the clustered household survey and reach out to approximately 20,000 male partners

Organization Name (less than 140 characters)

Preventive Care International (PCI)

Type of Submitter

  • We are a registered NGO or Non-Profit Organization

Organizational Characteristics

  • Women’s health/rights focused
  • Youth-led organization
  • Locally/community-led organization

Organization Location (less than 140 Characters)

Kampala, Uganda- East Africa

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

  • National (expansive reach within one country)

Website URL

http://preventivecareinternational.com/

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

Preventive Care International (PCI) is a non-government organization that focuses on promoting healthcare through Research, Training and Advocacy.

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

The project will be implemented by Preventive Care International in partnership with public health facilities. Preventive Care International has been collaborating with public health Facilities in mobilizing community especially Fishing communities, Slum areas, Plantation areas, Incarcerated people and Displaced people to utilize public health interventions for approximately 4 years.

How many people are on your team?

4

Tell us more about you and your team

MONICA BAGAYA: Project coordinator is a trained Public Health Officer with experience in community mobilization for uptake of public health interventions in Uganda especially hard to reach areas. She has been involved in community health programming and participated in a number of community based health projects (mainly Sexual and Reproductive Health, HIV/AIDS prevention, malaria and maternal and child health) in Uganda Charles Brown: PROJECT COORDINATOR. Masters in Public Administration. He has been involved in a number of HIV prevention research activities Diego Izizinga Head of community operations he is a trained public health officer Timothy Ssebuliba Project Officer: He is a clinician

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

We were able to design a training guide for the male immunization champions after conducting consultation meetings with the key stakeholders including fathers and health workers. From the comments we received, we were able to come up with a sustainable plan for motivating the male immunization champions and also strategies for engaging men while they are the health facilities. The webinars enabled us to expand our focus beyond the fathers we are targeting to a wider community context and also appreciate the rationale of data as means for evaluating our strategy. Also from support of our prototype (Tina) we were able to come up with a user journey guide and a business model for our project

Viability (3-4 sentences and activity upload):

https://canvanizer.com/canvas/wTtUeo3fNfwU5 Within the business model canvas, we developed set of activities adapting the existing peer led model we use to engage men in PMTCT. If we can leverage the already existing collaborations we have with public health facilities and community support, we will achieve the project aim at low cost.

Feasibility (3-4 sentences):

During the refinement phase, we engaged some fathers asking them their views of the project, they welcomed the idea as they pointed out that they are reluctant to engage in their children's immunization as they believe that it's the mothers role. They highlighted that because of the health education talks women get during ANC and PNC, they tend to know a lot about immunization and fathers know less yet they are the sole decision makers. So they advised us to select immunization champions who will engage them from wherever they are as they cannot spend all day at facility without work.

Desirability (3-4 sentences and activity upload):

From the beneficiaries feedback sessions, fathers asked to train immunization on w best to engage them. They advised us to design brochures that specially target the fathers with detailed information on immunization. At the health facility level, we were advised to come up with innovative approaches for engaging the male partners like board games as they wait for family during immunization.

Community Focus (2-3 sentences):

This project intends to leverage the positive impact of male partner involvement in immunization. Fathers play a vital role in accelerating uptake of immunization as they are the sole decision makers. Despite this they are often left out in the immunization puzzle. This project will adapt a gender transformative approach to sensitizing fathers of the key role they hold in their childrens health. Male immunization champions will be selected from their respective communities. Their peer involvements will be intergrted within their existing community engagements and meetings

Community Impact (2-3 sentences):

This project will promote male partners involvement in immunization. This will be evidenced from the support mothers will receive from their partners regarding their children's immunization. At the health facilities a linkage form will be used to capture fathers who have brought their children for immunization as a result of the project. Since we are mimicking the already existing peer led model for male involvement in PMTCT and leveraging the already built collaborations, we expect to notice projects impacts within a short period of time and also sustain the project beyond donor funding.

19 comments

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Comment
Photo of Marichu Carstensen
Team

Thanks Bagaya for including the board game suggestion. Congratulations! If there is anything that you might need from me, do not hesitate to reach out.

Photo of Marichu Carstensen
Team

Hi Bagaya Monica, I have read your idea and find it very interesting. In the Philippines, men in the vaccination session sites are also very rare, I wonder if we can add some activities in the vaccination area that men can do while waiting for the vaccination to start or waiting for their number to be called. What usually interests men in your community? Can we put some chess board games, or local games that they can play with while waiting thus making the experience something to look forward to in the future?
Congratulations and I hope you can get more inspiration that can enhance your idea in the future.

Photo of BAGAYA MONICA
Team

Dear Marichu Carstensen,

Thank you very much for your feedback. Actually this is the same situation in Uganda not only in Immunization but even other maternal and child health programmes like ANC. True we can engage men at the health facilities through board games as men are actively involved in these games to an extent that they pay a small fee for participating. This has been adapted and included in our user journey and business model

Photo of Amanda Patterson, World Relief
Team

BAGAYA MONICA I like this idea for so many reasons. First, it creates a greater focus on gender equality and empowers men in non-traditional ways to take lead over the well-being of their families. Men often get left out of the equation in a bid to achieve faster results, but ideas may not always be culturally relevant or sustainable in the long-term without the positive involvement of men. My initial questions around cultural biases echo those of commenters below which you have already addressed; I think the peer led model is great and pertinent. Have you noticed a difference between this model used in urban Kampala vs. rural locations in Uganda? Is there a component to your idea that engages women in either encouraging their husbands/fathers or reminding them of immunization schedules to strengthen and unify the role of men and women in sustaining their family's health? I'm very interested in seeing where your idea goes during this refinement phase!

Photo of BAGAYA MONICA
Team

Dear Amanda Patterson,
Thank you very much for the feedback. We haven't noticed major differences in implementing this model in urban vs rural locations in Uganda except those concerning the engagement spots. That is; it is easier to mobilize fathers from their casual work stations like Boda Boda stages in Urban Kampala as they are clustered within a particular area and they have well established leadership structures unlike in rural Uganda where majority of fathers are involved into agriculture. As a result, they can easily be got from their social hangouts since majority of them spend quiet some time in social hangout places like local bars.
Involving mothers is key as it has been brought out by fathers during the community consultations we have held during refinement. Majority of the fathers we have consulted have welcomed the idea of empowering them through their peers as they highlight that they are often left out by the current health systems since most child health interventions are targeting mothers and leaving fathers behind. However, they advised us to identify influential male immunization champions who can be listened to by both the mothers and fathers. And they advised us to encourage the immunization champions not to leave mothers behind while they are engaging fathers. Through this they will realize that ensuring full child immunization is a joint responsibility.

Photo of Amanda Patterson, World Relief
Team

BAGAYA MONICA Apologies for not responding sooner, but thank-you for taking the time to share your idea in more depth. Having lived in Kampala for a little bit of time, that is true that there are so many men at boda boda stations who would be able to easily transport their child to the clinic since their work is not always busy! Best of luck on finalizing your idea in the next few hours!

Photo of BAGAYA MONICA
Team

Hello Amanda Patterson,
Thank you very much for your feedback and wishes.

Photo of Dorothy Kizza
Team

I like this idea. Are you planning to offer the men incentives to get them involved as champions. If you are, what kind of incentive are you thinking of? If not, what will you be doing to keep them involved in the program?

Photo of BAGAYA MONICA
Team

Hello Dorothy,
Thank you very much for the feedback. Yes we shall offer the male immunization champions some incentives as motivation. These will include certificates of attendance for the trainings, T shirts and Caps for easy identification during the field mobilization and monthly airtime pre-paid for mobilization and followup. We aim at enhancing community participation and sustainability,

Photo of Anne-Laure Fayard
Team

BAGAYA MONICA thank you for sharing your idea. I like your focus on the role of fathers in the immunization journey. While doing some research on this topic with my students at NYU, we found that indeed fathers were rarely involved in campaigns and programs although they were important decision makers. We've been wondering how to tackle this issue and I find your approach promising. You explained well how you are planning to recruit fathers, but it'd be great if you tell us more what will be the role you would want these fathers to have and how you will incentivize them (and possibly train them). From our research, the few attempts in engaging more fathers have not been very successful because of the lack of interest of fathers (often associated to cultural beliefs about the role of fathers). I wonder if you have thought about this.
Ochola Amosiah Isaac Jumba any thoughts on this idea and how to effectively involve fathers?
Juan Pablo Ramirez Xinyu Chen your team mentioned engaging fathers during the events you are planning. Any thoughts on this idea?
BAGAYA MONICA You might want to check these 2 ideas as I'm sure your expertise would be helpful to them:
https://challenges.openideo.com/challenge/briefsgates-vaccine-innovation/ideas/faithcination

https://challenges.openideo.com/challenge/briefsgates-vaccine-innovation/ideas/promoting-community-capacity-in-immunization-governance

Thanks! Good luck with the development of this idea which seems to focus on an important actor (often forgotten) in the immunization journey.

Photo of Juan Pablo Ramirez
Team

Hi BAGAYA MONICA thank you for sharing your idea. As Anne-Laure Fayard mentioned, our research showed that parents are difficult to motivate due to the traditional role or parents in the family and the importance of vaccination for them. Additionally, we also found out that they tend to rely on community knowledge, act based on suggestions, and follow the example of others. Adding onto your idea, Male Champions should have some level of influence on the community or be recognized and supported by leaders so their word could be heard and increase their impact. Finally, strategic location planning (placing Male Champions in strategic events or places) would increase the likelihood to approach more male peers and gain their trust.

From our idea, we could complement both by bringing Male Champions to our "after service" drives and give them the opportunity to share their experience and des-mistifying immunization for the ones with doubts.

Let me know your thoughts and suggestions. I am looking forward to seeing your idea in action.

Photo of BAGAYA MONICA
Team

Hello Anne-Laure Fayard,
Thank you very much for the constructive feedback. Please see feedback for the above highlights.
Qn 1. Role of male immunization champions and how they will be incentivized.
Male immunization champions will be assigned to engage their male peers through social interactions like: sports tournaments (village football matches), informal work stations (bodaboda stages, construction sites), and social hangouts (drinking places, ‘Lodo’spots, sports batting outlets). Why are we targeting social interactions? From our previous experience with engaging male partners in utilizing HIV prevention services, whilst women preferred coming to the health facilities, men preferred to be met from either their work stations or social hangouts. Basing on the nature of the work they are engaged in ‘casual laborers’ receiving a daily wage, they never wanted anything to interfere with their daily work schedules
Male immunization champions will also be assigned to participate in periodic community events, such as fathers’ group meetings, meetings with clan elders and religious leaders where they will educate and create awareness among male peers about the benefits of immunization and their involvement in immunization.
Male immunization champions will also be facilitated to conduct quarterly peer led immunization supportive meetings. From these meetings immunization champions will share their experiences with involving in their children's immunization, recognize early adopters ' fathers who are now actively involved in immunizing their children', address misconceptions and cultural beliefs surrounding male involvement in immunization and support those that are not yet involved.
Qn 2. How will male immunization champions be incentivized?
The male immunization champions will be trained for two weeks at the beginning of the pilot project, and then again mid-way through the year to identify challenges in implementation and discuss solutions.
Male immunization Champions will receive a monthly stipend as motivation. This is relevant to keep the immunization promotes promoters effective.
The quarterly peer led immunization supportive meetings will be facilitated by Preventive Care International, with this the champions will not be financially constrained.
To complement their efforts, we will hire local influential artists and engage local leaders to develop tailored messaging to promote male involvement in immunization.
Qn3. From our research, the few attempts in engaging more fathers have not been very successful because of the lack of interest of fathers (often associated to cultural beliefs about the role of fathers). I wonder if you have thought about this
Yes we thought about this before designing the project thus utilizing the peer led model ‘male immunization champions’. From our experience with increasing utilization of HIV prevention services by men using the peer led model, we have managed to reach a great number of male partners to utilize the available HIV prevention services. From feedback, men were easily influenced to utilize these services after hearing from their peers who were already utilizing them.
We also aim at engaging local leaders especially the cultural and religious leaders to amplify the voices of male immunization champions in accelerating male partner involvement in immunization.

Photo of BAGAYA MONICA
Team

Hi Juan Pablo Ramirez,
Thank you very much for the feedback. You are right men follow what the examples of others and that's why we choose to use fathers who are actively involved in their children's immunization as male immunization champions. We anticipate that out of these champions some of them will be influential. We also plan to engage local leaders to help in amplifying the voices of the male immunization champions.

Photo of Ochola Amosiah
Team

Hi, Bagaya,
In my opinion, with experience from Busia, motivating fathers needs almost three level approach, may be if a man or couples go for immunization they are given first priority, level two could be through family dialogue sessions, level three could be through men's forum like social events, drinking joints, bodaboda groups this may be can work.ongatai ochola

Photo of BAGAYA MONICA
Team

Hello Ochola,
Thank you for the feedback, with the male immunization champion project we are targeting reaching male peers through men's forums.

Photo of Anne-Laure Fayard
Team

Thank you BAGAYA MONICA for this detailed response. I really like the social component (sport, hangout, etc.) and I can see this being very effective. For the honorarium, I'm curious how you would pay for it? Is it from grant money? funding from other sources?
Regarding role modeling and peer-to-peer influence, I guess my question is how do you find these role models? Your approach also made me think of positive deviance https://positivedeviance.org/ It might be useful for you as you refine your idea.
I did not realize that you had already piloted similar program for HIV. I'm curious to learn what is similar and what is different in these 2 contexts.
Good luck!

Photo of BAGAYA MONICA
Team

Hello Anne,
Thank you very much for your constructive feedback. Basing on our scope of work as Preventive care international, we have engaged communities through peers we can always find means of motivating the male immunization champions minus constraining the grant budget. The male immunization champions will be identified through household surveys as discussed above. We propose to use a similar concept as it was effective in fostering male involvement in HIV prevention through the PMTCT programme. Often times women would report to ANC clinics without their husbands. We had to identify male peers that helped in reaching out to other men and sensitising them on their role in HIV prevention

Photo of Anne-Laure Fayard
Team

Thank you BAGAYA MONICA for this clarification and for adding me to your team. I wonder if there's way to think of creating financial resources so that you don't only rely on grant funding for the honorarium. I think grants can be good to start but you need to explore options to make this idea sustainable over time, don't you think? Also I was told that the government was trying to involve men more in the immunization process. If it's the case, could you get some governmental funding (too)?
As Ochola Amosiah idea Enhance Community Capacity to access immunization services in Busia District includes both women and men, there might be some interesting ways to collaborate.
Thanks!

Photo of BAGAYA MONICA
Team

Dear Anne,
Thank you for the feedback. True we shall also share our idea with government for funding and sustainability