Social and Behaviour Change Section, UNICEF Ghana Country Office, Accra, Ghana.
Cogent, Lahore, Pakistan.
PLoS One. 2023 Feb 10;18(2):e0279809. doi: 10.1371/journal.pone.0279809. eCollection 2023.
Ghana has experienced recent polio outbreaks. Behavioral insights can be used to understand behavior and create demand for the polio vaccine.
This cross-sectional study is based on an interactive mobile phone survey that explored factors influencing the uptake of the polio vaccine among Ghanaian mothers with children younger than five years old. The survey also explores the mothers' intention to vaccinate their children in the future as well as an experiment with short polio vaccine voice message nudges to identify the most effective message frames in encouraging vaccination. The study sample was drawn from volunteers from a mobile service platform. Linear probability model regressions with Ordinary Least Squares (OLS) estimates were used to analyze the data.
In total, data from 708 caregivers was assessed. Out of the sample, 35% (n = 250) had not vaccinated their children against polio, around 8% (n = 53) of respondents stated they did not plan to do so, while 28% expressed intent to do so during the next polio vaccination campaign. Higher vaccination of children against polio, i.e. better uptake of the polio vaccine, appeared to be associated with children's caregivers knowing that polio causes paralysis (with a coefficient of 0.13 (95% CI: 0.02, 0.24), i.e. 13% more likely than not to have their child vaccinated). Higher vaccine uptake also appeared to be associated with the perception that the polio vaccine is safe (with a coefficient of 0.11 (95% CI: 0.01, 0.22), i.e. 11% more likely than not to have their child vaccinated). Another factor in increasing vaccine uptake is whether caregivers receive support from healthcare workers with a coefficient of 0.11 (95% CI: 0.02, 0.20), i.e. 11% more likely than not to have their child vaccinated. Crucially, difficulty accessing the polio vaccine appeared to be associate with a negative change in vaccine uptake (with a coefficient of -0.16 (95% CI: -0.23, -0.08), i.e. 16% less likely to have their child vaccinated). Satisfaction with the information provided by vaccinators was also associated with better vaccine uptake (with a coefficient of 0.12 (95% CI: 0.05, 0.20) i.e. 12% more likely than not to have their child vaccinated); and having seen or heard something negative about the polio vaccine with a coefficient of 0.10 (95% CI: 0.03, 0.17), i.e. 10% more likely than not to have their child vaccinated. The social norms message frame was statistically significant with a coefficient of 0.06 (95% CI: -0.004, 012).
The findings from this study suggest that most women with children under the age of 5 appear to have vaccinated their children against polio. Many more caregivers express an intention to vaccinate their children, never having done so before. The behavior and the intention to vaccinate are both driven by a number of factors that must be addressed to create demand for the polio vaccine. Targeted message frames appeared to be statistically significant drivers of vaccine uptake. However, more research is required to understand how they impact vaccine behavior and future intention for vaccination.
加纳最近爆发了小儿麻痹症疫情。行为洞察力可用于了解行为并创造对小儿麻痹症疫苗的需求。
本横断面研究基于一项互动式手机调查，该调查旨在探讨影响加纳五岁以下儿童母亲接种小儿麻痹症疫苗的因素。该调查还探讨了母亲未来为孩子接种疫苗的意愿，以及小儿麻痹症语音短消息提示的实验，以确定鼓励接种的最有效信息框架。研究样本来自移动服务平台的志愿者。使用普通最小二乘法（OLS）估计的线性概率模型回归来分析数据。
共评估了 708 名照顾者的数据。在样本中，35%（n=250）的儿童未接种小儿麻痹症疫苗，约 8%（n=53）的受访者表示他们不打算这样做，而 28%的人表示在下次小儿麻痹症疫苗接种活动中有意这样做。儿童更好地接种小儿麻痹症疫苗（即更好地接种小儿麻痹症疫苗）似乎与儿童照顾者知道小儿麻痹症会导致瘫痪有关（系数为 0.13（95%CI：0.02，0.24），即比不接种的可能性高 13%）。更高的疫苗接种率似乎也与认为小儿麻痹症疫苗是安全的有关（系数为 0.11（95%CI：0.01，0.22），即比不接种的可能性高 11%）。增加疫苗接种率的另一个因素是照顾者是否得到卫生保健工作者的支持，其系数为 0.11（95%CI：0.02，0.20），即比不接种的可能性高 11%。至关重要的是，获得小儿麻痹症疫苗的困难似乎与疫苗接种率的负面变化有关（系数为-0.16（95%CI：-0.23，-0.08），即比不接种的可能性低 16%）。接种者提供的信息满意度也与更好的疫苗接种率有关（系数为 0.12（95%CI：0.05，0.20），即比不接种的可能性高 12%）；并且看到或听到有关小儿麻痹症疫苗的负面信息，其系数为 0.10（95%CI：0.03，0.17），即比不接种的可能性高 10%）。社会规范信息框架具有统计学意义，系数为 0.06（95%CI：-0.004，0.12）。
本研究结果表明，大多数 5 岁以下儿童的母亲似乎已经为孩子接种了小儿麻痹症疫苗。更多的照顾者表示以前从未为孩子接种过疫苗，打算为孩子接种疫苗。接种疫苗的行为和意愿均由一些必须加以解决的因素驱动，以创造对小儿麻痹症疫苗的需求。目标信息框架似乎是疫苗接种率的统计学上显著驱动因素。但是，需要进一步研究以了解它们如何影响疫苗接种行为和未来的接种意愿。
