With nearly 1.1 million unimmunized children, Ethiopia is among the top ten countries in the world with the highest number of unvaccinated and under-vaccinated children. Geographic and socioeconomic inequalities, in particular, create significant barriers to childhood immunization and caregivers often lack the necessary information to vaccinate their children.

This year 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 that adolescent parents routinely use to shift their knowledge, attitudes and behaviors.

The campaign, delivered through our youth brand Yegna, compared the effectiveness of different messengers in delivering behavior change communication on routine immunization. The campaign features two video series, one following a health professional as she interacts with her patients and one where a parental role model highlights her motherhood journey and realizes the importance of routine immunization.

The campaign ran from September 1st to December 12th, 2022 and targeted men and women aged 18 to 40 in the Addis Ababa, Oromia, Amhara and Somali regions. In total it reached upwards of 5.5 million people and generated over 370,000 engagements. The content featuring a health professional reached over 2.5 million people with an engagement rate of 5.1% and the content featuring a mother reached over 3 million people with an engagement rate of 8.1%.

TL;DR Lessons Learned

1. Campaigns should be designed to facilitate two-way communications and scale-ready.
2. Matching demand generation with supply is key to sustainable service uptake.

The Context

In 2021, Girl Effect partnered with Meta to develop and launch social behavior change campaigns targeting adolescents in 9 countries with an aim of shifting knowledge, attitudes and behaviors for COVID-19 preventative measures and vaccine uptake.

Building on the success of this partnership and harnessing our learnings, we expanded our focus in 2022 to routine immunization.

1. Campaigns should be designed to facilitate two-way communications and scale-ready.

Throughout this campaign, demand for targeted real-time responses from healthcare providers surpassed our expectations.

We received questions about what could be done if a child missed one or more vaccines, if they moved to another area or lost their vaccination cards. Some of our audience wanted to know whether the vaccines were free in private hospitals and asked about the vaccination dates and specific availability. Others cited challenges communicating with healthcare professionals.

This feedback indicates that the campaign both resonated with our audience and that there was sustained interest in real-time answers from health professionals on the topic of routine immunization. It also showcases a level of trust between our audience and our youth brand, Yegna.

To develop campaigns that facilitate two-way communications consider:

• Running long-term social behavior change campaigns that deliver consistent and relevant messaging over time.
• Conducting in-depth listening exercises in order to gain an understanding of the audiences’ perceptions and fears.
• Involve your audience in content design, development and testing.

To scale a successful campaign that has generated two-way communications, we suggest:

• Exploring options to provide a high volume of answers to a large number of people at one time, perhaps through a chatbot. Girl Effect’s chatbots Bol Behen in India and Big Sis, in South Africa, connect girls with life-changing knowledge and services and have been proven effective in reaching millions of girls. Timing constraints meant we weren’t able to develop a youth-friendly gender-sensitive chatbot for these campaigns – something we’d like to explore in future work.

2. Matching demand generation with supply is key to sustainable service uptake.

During this campaign, members of our audience reported issues accessing vaccines for their children because health centers were out of doses. Despite our success in generating demand, the mismatch with supply posed a challenge to the campaign and encouraged us to consider how we might prevent it in the future so as to avoid losing the hard-earned trust with our target audience.

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

• Building the audiences’ resilience to confront issues they may encounter while attempting to uptake vaccines, including issues with stock-outs. This includes providing information on the importance of continuing to try to access a vaccine.
• Wherever possible, keeping track of service availability to ensure the vaccine supply is adequate.
• Developing relationships with partners to push for more up-to-date information on vaccine availability including leveraging digital technologies to share live updates.

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.