Culturally Tailored Women’s Empowerment Strategies to Improve Immunization Uptake: Formative Research Using a Human-Centered Design Approach
Bibliographic record
Abstract
BACKGROUND: Human-centered design (HCD) is vital for crafting impactful and successful health interventions. This approach has been effective in enhancing the uptake of health services, especially in rural areas. The Routine Immunization Buddy System (RIBS) is an HCD-driven intervention designed to support economically disadvantaged caregivers by empowering them to take greater responsibility for their own health and the immunization of their children. OBJECTIVE: Through a community-based participatory approach (CBPA), this study seeks to understand the economic, social, and health lifestyles and the impact on the health-seeking attributes of the potential beneficiaries of the project. This ensures that the identified intervention and its strategy will be implemented in a way that is of utmost benefit to the users. METHODS: Employing a three-step HCD process, including the Discovery, Ideation, and Formulation phases, the study conducted Focus Group Discussions (FGDs) and Key Informant Interviews (KIIs) for caregivers and stakeholders capable of influencing the woman's decision within a health setting. Semi-structured interviews facilitated an in-depth exploration of participants' experiences. Data collection utilized audio/video recordings, detailed notes, and observation sessions. Data analysis encompassed transcription, descriptive, and thematic analysis to inform evidence-based interventions. RESULTS: Four key interconnected barriers to routine immunization were identified from the formative research: vaccine hesitancy which is driven by safety concerns and inconsistency in vaccine-related messaging; gender-based decision-making constraints, where male approval often influenced access to care; financial limitations affecting transport and medical costs; and unequal access to healthcare due to geographic disparities. Caregivers emphasized the need for economic empowerment and trusted community-based health education. These findings informed a critical redesign of the intervention from a two-arm to a three-arm model, with peer support groups, and financial empowerment components added to address both economic barriers and vaccine misinformation through culturally tailored approaches. CONCLUSIONS: The use of human-centered design (HCD)-informed formative research has helped identify tailored women's empowerment strategies, such as economic support, community-led advocacy, and peer networks, that show promise in addressing health disparities among caregivers. These approaches are hoped to enhance caregivers' ability to make informed health decisions, ultimately contributing to improved immunization uptake and broader community well-being. The insights from this research are actively informing the design of our upcoming cluster-randomized controlled trial (cRCT), which aims to strengthen women's decision-making power around immunization services.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.082 | 0.056 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.003 | 0.005 |
| Scholarly communication | 0.004 | 0.003 |
| Open science | 0.003 | 0.004 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".