Abstract
BACKGROUND: Despite overall progress in childhood vaccination, disparities remain across socioeconomic groups, with children from low-income communities experiencing lower coverage rates. Vaccination communication plays an important role in building trust and enhancing knowledge and awareness about the importance of vaccination. Vaccination communication strategies can shape how caregivers interpret or act on immunization messages. Previous evidence highlights gaps in vaccination messaging, especially in low-resource settings. Developing effective messaging requires careful consideration of caregiver beliefs and social dynamics. Exploring caregiver perceptions of various vaccination messaging strategies as well as the sources from which they receive this information is essential in improving childhood vaccination uptake. PURPOSE: This study explored caregiver experiences and perceptions of childhood vaccination information and messaging in a low-income urban setting in Nairobi, Kenya. METHODS: Five focus group discussions (FGDs) were conducted with female and male caregivers of children under five to explore their experiences and perceptions of childhood vaccination information and messaging. A picture elicitation exercise explored caregiver perceptions of different visual communication techniques. The FGD audio recordings were transcribed verbatim in Swahili and then translated into English. An inductive coding process was used to review and summarize the transcripts into major thematic areas. RESULTS: Thirty-nine caregivers participated in the FGDs. Primary sources of information on vaccination included one-on-one communications with healthcare workers, mass media, mother/child booklets, and door-to-door visits by community health volunteers. These sources helped to shape caregivers' perceptions by providing information and reminders about vaccination. Participants identified healthcare workers and community health volunteers as trusted messengers in delivering vaccine information. Most participants expressed the need for more in-depth vaccine information to assist in decision-making. Findings highlighted the need for clarity and simplicity in messaging and the role of emotional appeal in vaccination images and messaging. CONCLUSION: The findings underscore the importance of tailoring childhood vaccination communication strategies to resonate with caregivers' diverse needs and preferences. An ongoing and responsive approach to incorporating caregiver feedback in developing health messaging can ensure that communication strategies support caregiver needs. Healthcare workers and community health volunteers must also be equipped with practical communication tools and training to support caregivers in making informed vaccination decisions for their children.