Formative Research and Development of an Evidence-Based Communication Strategy: The Introduction of Vi Typhoid Fever Vaccine Among School-Aged Children in Karachi, Pakistan

Abstract

The authors conducted formative research (a) to identify stakeholders' concerns related to typhoid fever and the need for disease information and (b) to develop a communication strategy to inform stakeholders and address their concerns and motivate for support of a school-based vaccination program in Pakistan. Data were collected during interactive and semi-structured focus group discussions and interviews, followed by a qualitative analysis and multidisciplinary consultative process to identify an effective social mobilization strategy comprised of relevant media channels and messages. The authors conducted 14 focus group discussions with the parents of school-aged children and their teachers, and 13 individual interviews with school, religious, and political leaders. Parents thought that typhoid fever was a dangerous disease, but were unsure of their children's risk. They were interested in vaccination and were comfortable with a school-based vaccination if conducted under the supervision of trained and qualified staff. Teachers and leaders needed information on typhoid fever, the vaccine, procedures, and sponsors of the vaccination program. Meetings were considered the best form of information dissemination, followed by printed materials and mass media. This study shows how qualitative research findings can be translated into an effective social mobilization and communication approach. The findings of the research indicated the importance of increasing awareness of typhoid fever and the benefits of vaccination against the disease. Identification and dissemination of relevant, community-based disease and vaccination information will increase demand and use of vaccination.

Acknowledgments

The authors are thankful to the head teachers and principals of the schools for providing information presented in this article. The authors thank the Ministry of Health and Ministry of Education Sindh, Private School Association, and Wafaq-ul-Madaris for their support of the conduct of the survey in schools. The authors appreciate the assistance of Ms. Deborah Hong for her assistance in English language editing, and the authors are very thankful to the administrative staff of International Vaccine Institute and Aga Khan University for making every effort toward the smooth running of the field activities.

The project was funded by the Bill & Melinda Gates Foundation as part of the Vi-based Vaccines for Asia Initiative.

The authors declare no competing interest.

Notes

Note. High-fee schools were those that charged fees of 1,000 or more rupees per student., Low-fee schools (which included public schools, low-fee private schools, and Madrasah charged no fees or 300 – less than 1,000 rupees per student.

Note. High-fee schools were those that charged fees of 1,000 or more rupees per student. Low-fee schools (which included public schools, low-fee private schools, and Madrasah) charged no fees or 300 – less than 1,000 rupees per student.

Note. FGD = focus group discussion; IDI = in-depth interviews.