In Tanzania, children of adolescent mothers are less likely to be vaccinated, in part due to the gender barriers they face.

Recent data suggests that 27% of Tanzanian teenagers either have a child or are pregnant and only 75% of children between 12 and 13 months old have received all of their basic childhood vaccinations. Efforts to improve routine immunization are complicated by caregivers’ lack of knowledge, widespread stigma and misinformation and vaccine availability in some areas (service delivery factors), all of which have been exacerbated by the lasting effects of the COVID-19 pandemic.

In 2022, Girl Effect focused on increasing demand for and uptake of vaccines for children under two years old by reducing the barriers to immunization for young parents, specifically adolescent mothers. We developed a social behavior change campaign and distributed it on the social media platforms adolescent parents routinely use, to shift their knowledge, attitudes and behaviors.

Our campaign, Mwanzo Mwema, Swahili for “a healthy start,” positioned routine immunization as a step towards giving babies a healthy foundation, to enable them to grow up healthy and strong. The campaign featured a video series focused on the journey of two young parents who shifted from being hesitant to vaccinate to being community advocates for routine immunization.

The campaign ran from September 2nd to December 9th, 2022 and targeted women and men between 18 to 29 years old in the Pwani, Dodoma, Arusha, Shinyanga, Rukwa, Tanga, Lindi, Mtwara, Tabora, Dar Es Salaam and Mwanza regions. The campaign reached over 3 million people and garnered 500,000 engagements.

TL;DR Lessons Learned

1. Building confidence in vaccines is a long trek, not a short sprint.
2. Online campaigns must combat and foster resilience for offline issues.
3. Successful partnerships take nurturing and nurturing takes time and effort.

The Context

In 2021, Girl Effect partnered with Meta to develop and launch social behavior change campaigns focused on shifting knowledge, attitudes and behaviors for COVID-19 preventative measures and vaccine uptake.

Girl Effect ran campaigns in Nigeria, India, Kenya, Rwanda, Indonesia, South Africa, Ghana, Mozambique and the Democratic Republic of Congo – leveraging our existing youth brands. Content varied from video skits in Nigeria, to one on one conversations with our AI chatbots in South Africa and India, to illustrated content in Kenya and Rwanda.

These campaigns reached 48 million and directly engaged 4.4 million users. Building on the success of this partnership and harnessing our learnings, we expanded our focus in 2022 to tackling barriers to routine immunization uptake in Tanzania.

1. Building confidence in vaccines is a long trek, not a short sprint

Globally, the COVID-19 pandemic highlighted the ways that myths and misinformation increase vaccine hesitancy and delay the uptake of care. In Tanzania, vaccine hesitancy presented a significant barrier, in part because messages were shared and reinforced by some traditional leaders, religious leaders and community influencers. This threatened and, in some cases, succeeded in reversing the country’s decades-long efforts to eradicate preventable diseases.

To combat entrenched misinformation and distrust, we suggest:

• Running long-term social behavior change campaigns that deliver consistent messaging over time, in order to build trust between the messenger and recipient.
• Avoiding what can be perceived as ‘coercive’ messaging. This requires in-depth listening, an understanding of the audiences’ perceptions and fears, thoughtful and empathetic messaging approaches and their involvement in the content development.
• Sharing stories of people who have transitioned from anti-vaccination mindsets to become vaccination ambassadors

2. Online campaigns must both combat and foster resilience for offline issues

Long-term behavior change is dependent on both building an individual’s resilience to confront an imperfect system that currently exists, while also trying to build a better system.

In this campaign, some of our audience expressed concern that they were getting incomplete vaccination information from healthcare workers. As a result, they wanted our campaign to provide specific answers to their vaccine questions in real time.

We also shared these audience insights with supply-side partners to help promote increasingly youth-friendly and gender-sensitive offline systems.

To ensure your online campaign carefully accounts for offline issues, we suggest:

• Partnering with a trained health expert to ensure you are giving the most up-to-date and reliable information on possible side effects and the safety and efficacy of vaccination, as we did with this campaign.
• Developing relationships with supply-side partners to ensure the online and offline experiences properly complement each other and deliver high-quality, stigma-free information.

3. Successful partnerships take nurturing; nurturing takes time and effort

Girl Effect works in partnership with a variety of other organizations. This allows us to develop content that is aligned with common goals and creates opportunities to cross-promote content where appropriate. While involving partners often allows you to go farther, it doesn’t always mean you’ll go faster.

This campaign experienced significant delays, in part due to the extensive collaboration needed to ensure technical validity of content and hence, approvals. These delays required flexibility and agility on all sides.

To ensure you are adequately developing and nurturing partnerships:

• Be prepared to commit staff time to develop and maintain partnerships.
• Build partnerships on mutual trust and understanding and keep focus on the common goal.
• Anticipate and prepare for inevitable delays, especially in light of the lasting effects of COVID-19 on systems, processes and people.
• Involve government stakeholders with technical and contextual know-how from the beginning to adapt messaging to an intended audience.
• Be open to learn and adapt to shifting landscapes whether this is new knowledge or policy considerations.

What’s next?

Once the final results from these campaigns have been collected and analyzed, we will be able to incorporate lessons learned into the design and implementation of our partnerships, including our multi-year partnership with Gavi, the Vaccine Alliance, as well as any of our future work on routine immunization.