Developing a taxonomy to organise and conceptualise evidence on communication interventions to improve vaccination in low- and middle-income countries

Article type
Authors
Willis N1, Hill S1, Kaufman J1, Lewin S2, Kis-Rigo J1, Bensaude De Castro Freire S3, Bosch-Capblanch X4, Glenton C5, Lin V6, Robinson P6, Wiysonge C7
1Centre for Health Communication and Participation, Australian Institute for Primary Care & Ageing, La Trobe University, Australia
2Norwegian Knowledge Centre for the Health Services, Norway and Medical Research Council of South Africa, South Africa
3International Union for Health Promotion and Education (IUHPE/UIPES), France
4Swiss Tropical and Public Health Institute, Switzerland
5Norwegian Knowledge Centre for the Health Services and Norwegian Branch of the Nordic Cochrane Centre, Norway
6School of Public Health, La Trobe University, Australia
7Division of Medical Microbiology, Department of Clinical Laboratory Sciences and Vaccines for Africa Initiative, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, South Africa
Abstract
Background: Although vaccination is a cost-effective public health measure, childhood vaccination rates remain sub-optimal in many parts of the world. A diverse range of communication interventions have been utilised with parents and communities to improve vaccination rates. Despite the importance of communication as a component of vaccination programmes, there is no comprehensive approach to organising, and therefore understanding, communication interventions related to vaccination. Developing a classification system, organised into categories based on conceptual or practical similarities (a taxonomy) will help to: understand the relationships between different types of communication interventions; facilitate conceptual mapping of these interventions; clarify the key purposes and features of interventions; and identify evidence gaps.

Objectives: To describe the development and key categories of the ‘Communicate to vaccinate’ taxonomy.

Methods: The taxonomy was developed in two stages: (1) We searched CENTRAL, Medline and the grey literature for relevant communication interventions and extracted data on their features, including the population/s targeted, communication intervention features, and outcomes assessed; (2) Building on existing taxonomies, we grouped interventions conceptually according to their purpose. An initial version of the taxonomy was then presented to a series of stakeholder forums, and refined based on their feedback.

Results: Seven main categories of interventions were identified: inform or educate, remind or recall, teach skills, provide support, facilitate decision making, enable communication, and enhance community ownership. These categories were then broken down into 43 intervention types across three targets: parents or soon-to-be-parents; communities, community members or volunteers; and health professionals.

Conclusion: We have developed a taxonomy to organise the range of ‘Communicate to vaccinate’ interventions currently in practice globally. This taxonomy enables evidence to be mapped; research gaps to be identified; and provides a language and structure so that knowledge resources can be universally understood and used to promote improvements in vaccination uptake and health outcomes.