Using Human-Centered Design to Bridge Zero-Dose Vaccine Gap: A Case Study of Ilala District in Tanzania
<b>Background:</b> Immunization plays a substantial role in reducing the under-five mortality rate. However, Tanzania still has a significant number of zero-dose and under-vaccinated children and was ranked among the top ten African countries with the highest numbers of zero-dose childre...
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MDPI AG
2025-01-01
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| Series: | Vaccines |
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| Online Access: | https://www.mdpi.com/2076-393X/13/1/38 |
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| author | Simon Martin Nzilibili Hellen Maziku Awet Araya Ruthbetha Kateule Millenium Anthony Malamla Suna Salum Furaha Kyesi Lotalis Gadau Tumaini Menson Haonga Florian Tinuga Rashid Mfaume Zaitun Hamza Georgina Joachim Alice Geofrey Mwiru Alex Benson Oscar Kapela Ona Machangu Norman Jonas Ntuli Kapologwe |
| author_facet | Simon Martin Nzilibili Hellen Maziku Awet Araya Ruthbetha Kateule Millenium Anthony Malamla Suna Salum Furaha Kyesi Lotalis Gadau Tumaini Menson Haonga Florian Tinuga Rashid Mfaume Zaitun Hamza Georgina Joachim Alice Geofrey Mwiru Alex Benson Oscar Kapela Ona Machangu Norman Jonas Ntuli Kapologwe |
| author_sort | Simon Martin Nzilibili |
| collection | DOAJ |
| description | <b>Background:</b> Immunization plays a substantial role in reducing the under-five mortality rate. However, Tanzania still has a significant number of zero-dose and under-vaccinated children and was ranked among the top ten African countries with the highest numbers of zero-dose children in 2022. The human-centered design (HCD) approach is more ethical and effective at addressing public health challenges in complex sociocultural settings. This study aimed to use the HCD approach to aid in identifying, prioritizing, and implementing community-centric interventions in Tanzania, particularly in the Ilala District of Dar es Salaam, to increase vaccine demand and close the zero-dose gap by at least 50%. <b>Methods:</b> The study involved co-creation workshops with 483 participants to identify, design, and test solutions. The study followed the UNICEF Journey to Health and Immunization framework to identify barriers and enablers influencing stakeholders in adopting and sustaining health- and immunization-related actions. <b>Results:</b> The study identified the causes of under-five defaulting and the zero-dose gap, i.e., the inadequate support of local community leaders in under-five vaccination sensitization and surveillance; poor infrastructure to new settlement areas; hesitancy and unwillingness of parents/guardians; absence of house numbers; limited/time-constrained availability of resources to facilitate mobile immunization services, etc. The participants were able to come up with 309 ideas, which were refined through multiple iterations using the impact–-effort matrix and skimmed down to three (3) solutions: (i) having health facilities to notify and alert local leaders about vaccination dates; (ii) using parents, kids, and grownups who got vaccinated to influence others; (iii) using local government leaders and house representatives for vaccine advocacy. Of these, the solution involving local government leaders and house representatives for vaccine advocacy was implemented. An advocacy strategy was used to enhance the collaboration of the District Commissioner, Council leaders, and community leaders. A home-to-home interpersonal sensitization approach accompanied by the household delivery of vaccination services was employed. The findings reveal that the HCD framework was impactful in increasing collaborations/cooperation with local government leaders and community ownership of the under-five vaccination initiative. As a result, 67,145 houses, equal to 104%, were reached, surpassing the initial target of 64,800 houses, and 131,088 families, equal to 83% of the targeted 156,995 households, were sensitized through a home-to-home campaign approach. This study demonstrates the effectiveness of the approach. Researchers and practitioners are encouraged to adopt the HCD approach when addressing public health challenges, especially in complex sociocultural settings. |
| format | Article |
| id | doaj-art-9dcb7644e7db44d48febd16a1ce4093d |
| institution | Kabale University |
| issn | 2076-393X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Vaccines |
| spelling | doaj-art-9dcb7644e7db44d48febd16a1ce4093d2025-01-24T13:51:44ZengMDPI AGVaccines2076-393X2025-01-011313810.3390/vaccines13010038Using Human-Centered Design to Bridge Zero-Dose Vaccine Gap: A Case Study of Ilala District in TanzaniaSimon Martin Nzilibili0Hellen Maziku1Awet Araya2Ruthbetha Kateule3Millenium Anthony Malamla4Suna Salum5Furaha Kyesi6Lotalis Gadau7Tumaini Menson Haonga8Florian Tinuga9Rashid Mfaume10Zaitun Hamza11Georgina Joachim12Alice Geofrey Mwiru13Alex Benson14Oscar Kapela15Ona Machangu16Norman Jonas17Ntuli Kapologwe18Health Promotion Section, Ministry of Health, Dodoma P.O. Box 743, TanzaniaDepartment of Computer Science and Engineering, College of ICT, University of Dar es Salaam, Dar es Salaam P.O. Box 35091, TanzaniaSocial Behavior Change UNICEF, Tanzania Country Office, Dar es Salaam P.O. Box 4076, TanzaniaDepartment of Computer Science and Engineering, College of ICT, University of Dar es Salaam, Dar es Salaam P.O. Box 35091, TanzaniaDepartment of Computer Science and Engineering, College of ICT, University of Dar es Salaam, Dar es Salaam P.O. Box 35091, TanzaniaDepartment of Computer Science and Engineering, College of ICT, University of Dar es Salaam, Dar es Salaam P.O. Box 35091, TanzaniaImmunization and Vaccine Development Program, Ministry of Health, Dodoma P.O. Box 743, TanzaniaImmunization and Vaccine Development Program, Ministry of Health, Dodoma P.O. Box 743, TanzaniaHealth Promotion Section, Ministry of Health, Dodoma P.O. Box 743, TanzaniaImmunization and Vaccine Development Program, Ministry of Health, Dodoma P.O. Box 743, TanzaniaDirectorate of Health, Social Welfare and Nutrition Services at the President’s Office, Regional Administration and Local Government, Dodoma P.O. Box 1923, TanzaniaCouncil Health Management Team, Dar es Salaam City Council, Dar es Salaam P.O. Box 77742, TanzaniaImmunization and Vaccine Development Program, Ministry of Health, Dodoma P.O. Box 743, TanzaniaSocial Behavior Change UNICEF, Tanzania Country Office, Dar es Salaam P.O. Box 4076, TanzaniaSchool of Journalism and Mass Communication, University of Dar es Salaam, Dar es Salaam P.O. Box 35091, TanzaniaHealth Promotion Section, Ministry of Health, Dodoma P.O. Box 743, TanzaniaHealth Promotion Section, Ministry of Health, Dodoma P.O. Box 743, TanzaniaHealth Promotion Section, Ministry of Health, Dodoma P.O. Box 743, TanzaniaDepartment of Preventive Services, Ministry of Health, Dodoma P.O. Box 743, Tanzania<b>Background:</b> Immunization plays a substantial role in reducing the under-five mortality rate. However, Tanzania still has a significant number of zero-dose and under-vaccinated children and was ranked among the top ten African countries with the highest numbers of zero-dose children in 2022. The human-centered design (HCD) approach is more ethical and effective at addressing public health challenges in complex sociocultural settings. This study aimed to use the HCD approach to aid in identifying, prioritizing, and implementing community-centric interventions in Tanzania, particularly in the Ilala District of Dar es Salaam, to increase vaccine demand and close the zero-dose gap by at least 50%. <b>Methods:</b> The study involved co-creation workshops with 483 participants to identify, design, and test solutions. The study followed the UNICEF Journey to Health and Immunization framework to identify barriers and enablers influencing stakeholders in adopting and sustaining health- and immunization-related actions. <b>Results:</b> The study identified the causes of under-five defaulting and the zero-dose gap, i.e., the inadequate support of local community leaders in under-five vaccination sensitization and surveillance; poor infrastructure to new settlement areas; hesitancy and unwillingness of parents/guardians; absence of house numbers; limited/time-constrained availability of resources to facilitate mobile immunization services, etc. The participants were able to come up with 309 ideas, which were refined through multiple iterations using the impact–-effort matrix and skimmed down to three (3) solutions: (i) having health facilities to notify and alert local leaders about vaccination dates; (ii) using parents, kids, and grownups who got vaccinated to influence others; (iii) using local government leaders and house representatives for vaccine advocacy. Of these, the solution involving local government leaders and house representatives for vaccine advocacy was implemented. An advocacy strategy was used to enhance the collaboration of the District Commissioner, Council leaders, and community leaders. A home-to-home interpersonal sensitization approach accompanied by the household delivery of vaccination services was employed. The findings reveal that the HCD framework was impactful in increasing collaborations/cooperation with local government leaders and community ownership of the under-five vaccination initiative. As a result, 67,145 houses, equal to 104%, were reached, surpassing the initial target of 64,800 houses, and 131,088 families, equal to 83% of the targeted 156,995 households, were sensitized through a home-to-home campaign approach. This study demonstrates the effectiveness of the approach. Researchers and practitioners are encouraged to adopt the HCD approach when addressing public health challenges, especially in complex sociocultural settings.https://www.mdpi.com/2076-393X/13/1/38zero doseunder-five vaccinationhuman centered designadvocacycommunity-centric intervention |
| spellingShingle | Simon Martin Nzilibili Hellen Maziku Awet Araya Ruthbetha Kateule Millenium Anthony Malamla Suna Salum Furaha Kyesi Lotalis Gadau Tumaini Menson Haonga Florian Tinuga Rashid Mfaume Zaitun Hamza Georgina Joachim Alice Geofrey Mwiru Alex Benson Oscar Kapela Ona Machangu Norman Jonas Ntuli Kapologwe Using Human-Centered Design to Bridge Zero-Dose Vaccine Gap: A Case Study of Ilala District in Tanzania Vaccines zero dose under-five vaccination human centered design advocacy community-centric intervention |
| title | Using Human-Centered Design to Bridge Zero-Dose Vaccine Gap: A Case Study of Ilala District in Tanzania |
| title_full | Using Human-Centered Design to Bridge Zero-Dose Vaccine Gap: A Case Study of Ilala District in Tanzania |
| title_fullStr | Using Human-Centered Design to Bridge Zero-Dose Vaccine Gap: A Case Study of Ilala District in Tanzania |
| title_full_unstemmed | Using Human-Centered Design to Bridge Zero-Dose Vaccine Gap: A Case Study of Ilala District in Tanzania |
| title_short | Using Human-Centered Design to Bridge Zero-Dose Vaccine Gap: A Case Study of Ilala District in Tanzania |
| title_sort | using human centered design to bridge zero dose vaccine gap a case study of ilala district in tanzania |
| topic | zero dose under-five vaccination human centered design advocacy community-centric intervention |
| url | https://www.mdpi.com/2076-393X/13/1/38 |
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