Examine Communication Activities Employed to Promote Routine Immunisation in Nairobi County

Abstract

This research examined the communication activities that were undertaken to promote Routine Immunisation in Nairobi County. Immunisation is a basic right and a life-saving intervention and one of the most successful and cost effective public health investment. The government of Kenya has prioritised Immunisation as one of the key health interventions, with 63% of public health facilities offering Immunisation services. Despite this, the country has not been able to achieve the national and global Immunisation coverage targets, with half of the counties achieving less than 50% coverage. Other health programmes, like HIV/AIDS, nutrition, and breastfeeding among others continue to surpass targets. To understand the dynamics of the topic, the research used theory of reasoned action and ecological model of communication. Specifically this study examined communication activities undertaken, determineed what gaps the strategies were addressing and described components of communication that should be addressed. The study adopted a mixed research approach. Key informant interviews were conducted with implementers using a Key Informant Guide; interviews were conducted using questionnaires to collect data from caregivers. Qualitative data was analysed through thematic content analysis to get main themes. Quantitative data was analysed using descriptive statistics and presented in graphs and percentages. The study was undertaken in four sub-counties in Nairobi County namely; Langata, Mathare, Embakasi East and Makadara. In 2016, Langata and Mathare had the lowest Routine Immunisation coverage whereas Embakasi East and Makadara had the highest coverage. Nairobi was selected because it is among the counties with low Immunisation coverage. The study found out that most respondents had interacted with communication activities promoting Immunisation, and that targeted health facilities and communities. Communities preferred use of interpersonal communication and radios, as opposed to use of newspapers and online platforms. Quality and quantity of information provided by the health workers to the caregivers was a major determinant of uptake of Immunisation services. Negative attitude and poor communication skills of health workers were noted as the major gaps existing at health facility level. Low risk perceptions and existing behaviors by the caregivers was the major gap identified in the study. Mapping and engagement of local stakeholders including communities was noted as key in advocating for the Immunisation agenda in the community. For behavior change to be achieved, Ministry of Health opts to understand and work within the existing community structures. Social mobilisation and community-led social change can be achieved by using sustainable programmes and activities jointly implemented by the health workers and caregivers. This research recommends inclusion of communities during planning, implementation and evaluation of communication activities undertaken to promote Immunisation; consideration and use of existing local structures; implementation of sustainable communication activities and development of a monitoring and evaluation framework for communication activities.