Polio Clinical Trial
Official title:
Improving Routine Immunization Coverage Through Educational Messages Delivered During Polio NIDs in Pakistan: A Cluster Randomized Trial
This study aims to assess if pictorial messages promoting routine immunization during supplementary campaigns for oral polio vaccine in areas with poor DTP3 vaccine coverage can improve immunization rates. A cluster randomized trial design in low literature populations will be used.
The overall objective of this study is to assess whether supplementary immunization
activities (SIAs) held for polio eradication can be used to improve routine immunization
coverage in Pakistan.
Primary research objectives:
(i) To assess effectiveness of educational messages regarding routine immunization during
SIAs held for polio on improving routine immunization coverage in Pakistan.
Secondary research objectives:
(i) To assess maternal knowledge about routine immunization in the intervention and control
arms.
(ii) To estimate vaccination card retention in the intervention and control arms.
This study will be completed in 12 months, between March 2012 to February 2013. Overall,
three major operational steps have been defined for the study as follow:
Baseline vaccine coverage survey: This is a 02-months activity in which a baseline household
vaccine coverage survey will be carried out to independently assess the immunization
coverage and socio-demographic indicators in the study areas. Participation in this survey
will be voluntary and written consent from participants will be obtained prior to
administering the study questionnaire.
Training of vaccinators/volunteers and distribution of plastic pouches: The project research
staff (Research Associate/Senior Research Assistants) will be exclusively trained by
Principal Investigator/Research Supervisor on educational material. Having completed the
baseline coverage survey, a one-day training session will be organized by trained project
staff to provide trainings to participating EPI vaccinators/volunteers on the vaccine
promotion educational messages to be delivered during intervention. These trainings will be
held at a common venue (EPI center/public hospital) in the selected towns for this study.
The messages will be low-literacy, of very short duration, and will be delivered with the
help of pictorial cards which were previously developed for and used in a similar
department-run study in Karachi. These educational messages will include the following
messages:
1. Vaccines can save a child's life
2. Children who are immunized on time are less likely to become ill
3. Unimmunized children can become disabled for life
4. Photograph of the nearest EPI center where vaccines are offered free of charge, as well
as its address and timings
Additionally, at the start of this project, all EPI centers in the study areas will be
provided with plastic pouches to be given to parents of all children coming to EPI centers
for vaccinations. These pouches will be used to store a child's immunization card. In order
to assess the likely change in vaccination card retention, we will compare the proportion of
vaccination cards available on pre-and-post coverage assessment in both intervention and
control groups.
Endline vaccine coverage survey/outcome assessment. Outcome assessment will be done through
a representative endline survey assessing vaccine coverage for Penta-3 and Measles-1 in the
study areas, 3 months after the NID was held. Participation in this survey will be voluntary
and written consent from study participants will be obtained prior too administering the
study questionnaire.
NID = National Immunization Days SNID = Sub-national Immunization Days EPI: Expanded
Programme on Immunization SIA - Supplementary Immunization Activity CHW = Community Health
Worker AKU = Aga Khan University, Karachi, Pakistan
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Health Services Research
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