Immunisation is one of the most cost-effective ways of preventing death and disability from infectious diseases. There has been significant progress in recent decades in increasing immunisation coverage. However, in many countries coverage of key vaccines has stagnated at roughly 80 percent or has even started declining.

Vaccine hesitancy – meaning delay in accepting vaccination or refusal of vaccination services – remains a pressing issue.

In Myanmar, national vaccination coverage for key vaccines are relatively high, but like elsewhere in the world, in many communities (particularly those in hard to reach areas) vaccination coverage continues to hover at roughly 80 percent.

The Government of Myanmar is committed to increasing vaccination in these communities in order reach optimal vaccination coverage. This research is relevant to Myanmar, and similar places, as health service providers seek new methods to engage community members in order to increase uptake of immunisation and build demand for quality immunisations services.

The study objectives are:

Primary objective:

Test the feasibility and acceptability of the Collaborative Community Checklist intervention (‘the intervention’) for both health care providers and communities.

Secondary objectives:

1. Assess community and immunisation providers’ perceptions of the effect of the intervention on community knowledge regarding immunisation services.
2. Evaluate whether the intervention enables health care providers and communities to jointly identify barriers to immunisation, and engages community members in addressing these barriers.
3. Assess community and immunisation providers’ perceptions of the effect of the intervention on immunisation service uptake.

The Collaborative Community Checklist intervention includes three components:

1. Immunisation providers

Project staff will work with immunisation providers (midwives) to adapt a WHO Immunisation Session Checklist to the local context in Myanmar. Immunisation providers will be trained and supported to use this Provider Immunisation Checklist during an immunisation session.

2. Community members

Project staff will facilitate community workshops in each project village that will:

• Provide basic information about immunisations, including immunisation service quality.
• Support community members to identify barriers to immunisation uptake, and work with providers to identify practical solutions to these barriers.
• Facilitate design of a Community immunisation Checklist that includes items that the community thinks is important in a quality immunisation service.
• Train community members to use this Community Immunisation Checklist during or after an immunisation session.

3. Village Health Committees (VHCs)

Project staff will train and support VHCs in project villages to:

• Assist community members attending immunisation sessions to use the Community Immunisation Checklist.
• Collate data from Community Immunisation Checklists and communicate this data in a respectful and collaborative manner to immunisation providers and other community members.

Timeline

2016-2017