As trusted caregivers for millions of people, community health workers (CHWs) are vital to global vaccination efforts.
On an average day, a CHW’s tasks may include going door to door to share information about vaccine availability, conducting in-home health screenings, and directing community members to local health resources.
CHWs have a deep understanding of their communities’ needs and sentiments toward vaccination. However, they face barriers to improving vaccine uptake, including a lack of educational materials, inadequate training opportunities, and gaps in understanding about vaccines.
With this in mind, Digital Medic worked with an advisory group of CHWs to develop free digital vaccine education resources. The Supporting Vaccination toolkit aims to equip CHWs with essential knowledge and communication strategies to improve immunization rates in their communities. It includes mobile-friendly videos and other low-bandwidth multimedia covering the basics of vaccines, immunity, and side effects, and offers practical guidance for addressing misinformation and concerns around vaccination. Though the toolkit focuses on COVID-19, it can be applied to broader immunization training needs.
All elements of the toolkit stem from a fundamental understanding that with adequate support and resources, CHWs are uniquely qualified to influence behavior shifts within the communities they know and care for.
“We created materials that would, at once, build knowledge and confidence within the CHWs themselves while also offering them tools and strategies to bring into the community as they work to promote vaccination.”
- Erika Tribett, instructional designer at Digital Medic
The Groundwork: Amplifying the Voices of CHWs
In the early stages of the toolkit’s development, the Digital Medic team collaborated with partners at the Philani Maternal, Child Health and Nutrition Trust and the One to One Children’s Fund in South Africa to facilitate focus group sessions with local CHWs. During these discussions, CHWs spoke about their personal experiences of getting vaccinated as well as conducting vaccine outreach.
“Their main challenge was convincing their communities, who were overwhelmed with myths and misinformation about the vaccine, to get vaccinated. They often did not have answers for how vaccines work, why people were suddenly required to vaccinate twice and the side effects of the vaccines, particularly among vulnerable groups such as the elderly and pregnant and lactating women,” said Nophiwe Job, a Research Analyst at Digital Medic, who helped lead the CHW focus groups. “What was interesting was that their communities were still trusting them to give reliable information, even though they may have had doubts about the vaccine.”
"Their main challenge was convincing their communities, who were overwhelmed with myths and misinformation about the vaccine, to get vaccinated."
Recognizing that vaccine acceptance is a spectrum, the Supporting Vaccination toolkit helps health workers meet people where they are and thoughtfully guide them through the immunization process. The toolkit’s learning framework centers CHW experiences, relationships, and needs, placing empathy at the core of vaccine outreach.
“We tried to leverage the power of CHWs’ existing relationships with communities when outlining principles of communicating about vaccination,” said Tribett. “We also heard the exhaustion that comes with the commitment to their work, so we felt it critical to include content about caring for oneself in addition to caring for others.”
The Build: Producing Digital Vaccine Education Resources
Continued engagement with CHWs was integral to the instructional design and content development processes. Their insights informed all aspects of the toolkit, from the formats and media types used to its overall aesthetic and tone.
“It was important to hear and imagine the experience of the CHW as they are working to promote vaccination in their communities in the charged and constantly evolving environment of this pandemic,” Tribett explained. “We shared back several of the first scripts with our partners to glean feedback on the usefulness and approachability of the material.”
The Digital Medic content team addressed CHW needs and preferences in a few key ways:
- Ensuring flexible and convenient access to materials: CHWs expressed a need for educational resources they can access and revisit on their own time, e.g. during travel or between tasks, and even while working with clients.
- Creating clear, understandable visuals to use in community outreach: CHWs shared a desire for fewer paper handouts that tend to get put aside or lost, but they still had a need for visual aids to educate their communities. They responded positively to the idea of using videos, static graphics, and audio files to convey key messages.
- Incorporating CHWs’ lived experiences: It was important to embed CHW perspectives into the toolkit. Similar to the Advocacy Training for CHWs, the Supporting Vaccination videos feature Sarah, an animated CHW narrator. Her story reflects the fears, hopes, and vaccination experiences that CHWs shared during the focus groups.
An iterative production process resulted in ten mobile-friendly animated videos that learners can view in any order. The videos explain:
- The basic science of viruses and how vaccines work, emphasizing COVID-19.
- How to combat common vaccine misinformation and identify accurate, up-to-date information.
- Ways to effectively address clients’ questions and fears about vaccination, to help them understand the importance of vaccination, and to empower them throughout the vaccination process.
As a supplement to the video content, learners can download static infographics and audio files to share with clients or for personal review. This multimedia approach makes the toolkit adaptable and accessible across a wide range of languages, cultural contexts, devices, and data barriers. The toolkit is also easily shareable via mobile chat platforms such as WhatsApp.
Integrating scientific knowledge, real-world experiences, and an empathetic lens, the Supporting Vaccination toolkit forms a comprehensive, practical, and engaging guide for CHWs and the clients they serve.
“We begin the series with a look at the power of a story — both sharing one’s own and actively listening to those of our clients,” said Tribett. “In addition to providing a foundation in vaccines and side effects, several resources focus on listening to the client’s concerns, understanding and responding to beliefs, values and motivations, and an ongoing response to the client’s level of readiness to vaccinate.”
The Horizon: Aiming for Global Scale
Confident, well-equipped health workers can continue to mobilize communities to get vaccinated against COVID-19 and other vaccine-preventable illnesses. The Supporting Vaccination toolkit – a free, open access digital resource – has the potential to bolster their work.
Balancing local relevance and broad appeal, the toolkit addresses common barriers faced by CHWs, ultimately helping to reduce immunization gaps in hard-to-reach populations worldwide.
According to Tribett, “if there are two things we wanted learners to walk away with, they are (1) that CHWs are a trusted source of reliable, accurate information who can guide people through the vaccination process, and (2) that while concerns are understandable, CHWs are confident in communicating that the vaccine is safe and a necessary step to take to protect ourselves, our loved ones, and our communities.”