Polio NID and Routine EPI Integration Trial Pakistan
Condition: Polio
MeSH terms: Poliomyelitis
Study type: Interventional

Summary: 
      This study aims to assess if pictorial messages promoting routine immunization during
      supplementary campaigns for oral polio vaccine in areas with poor DTP3 vaccine coverage can
      improve immunization rates. A cluster randomized trial design in low literature populations
      will be used.
    

Detailed description: 
      The overall objective of this study is to assess whether supplementary immunization
      activities (SIAs) held for polio eradication can be used to improve routine immunization
      coverage in Pakistan.

      Primary research objectives:

      (i) To assess effectiveness of educational messages regarding routine immunization during
      SIAs held for polio on improving routine immunization coverage in Pakistan.

      Secondary research objectives:

      (i) To assess maternal knowledge about routine immunization in the intervention and control
      arms.

      (ii) To estimate vaccination card retention in the intervention and control arms.

      This study will be completed in 12 months, between March 2012 to February 2013. Overall,
      three major operational steps have been defined for the study as follow:

      Baseline vaccine coverage survey: This is a 02-months activity in which a baseline household
      vaccine coverage survey will be carried out to independently assess the immunization coverage
      and socio-demographic indicators in the study areas. Participation in this survey will be
      voluntary and written consent from participants will be obtained prior to administering the
      study questionnaire.

      Training of vaccinators/volunteers and distribution of plastic pouches: The project research
      staff (Research Associate/Senior Research Assistants) will be exclusively trained by
      Principal Investigator/Research Supervisor on educational material. Having completed the
      baseline coverage survey, a one-day training session will be organized by trained project
      staff to provide trainings to participating EPI vaccinators/volunteers on the vaccine
      promotion educational messages to be delivered during intervention. These trainings will be
      held at a common venue (EPI center/public hospital) in the selected towns for this study. The
      messages will be low-literacy, of very short duration, and will be delivered with the help of
      pictorial cards which were previously developed for and used in a similar department-run
      study in Karachi. These educational messages will include the following messages:

        1. Vaccines can save a child's life

        2. Children who are immunized on time are less likely to become ill

        3. Unimmunized children can become disabled for life

        4. Photograph of the nearest EPI center where vaccines are offered free of charge, as well
           as its address and timings

      Additionally, at the start of this project, all EPI centers in the study areas will be
      provided with plastic pouches to be given to parents of all children coming to EPI centers
      for vaccinations. These pouches will be used to store a child's immunization card. In order
      to assess the likely change in vaccination card retention, we will compare the proportion of
      vaccination cards available on pre-and-post coverage assessment in both intervention and
      control groups.

      Endline vaccine coverage survey/outcome assessment. Outcome assessment will be done through a
      representative endline survey assessing vaccine coverage for Penta-3 and Measles-1 in the
      study areas, 3 months after the NID was held. Participation in this survey will be voluntary
      and written consent from study participants will be obtained prior too administering the
      study questionnaire.

      NID = National Immunization Days SNID = Sub-national Immunization Days EPI: Expanded
      Programme on Immunization SIA - Supplementary Immunization Activity CHW = Community Health
      Worker AKU = Aga Khan University, Karachi, Pakistan
    

Intervention name(s): Vaccine promotion messages; Vaccination Verification.; Distribution of Plastic Pouches to retain vaccination card
Intervention type(s): Behavioral; Other; Other
Intervention description(s): The messages will be low-literacy, of very short duration, and will be delivered with the help of pictorial cards. These educational messages will include the following messages:
Vaccines can save a child's life
Children who are immunized on time are less likely to become ill
Unimmunized children can become disabled for life
Photograph of the nearest EPI center where vaccines are offered free of charge, as well as its address and timings.; EPI vaccinators/volunteers will identify and record details of un/under-vaccinated children less than 12 months old in households they visit during an NID, and update immunization registries maintained at the local EPI centers so these children can be reached in subsequent outreach activity.; At the start of this project, all EPI centers in the study areas will be provided with plastic pouches to be given to parents of all children coming to EPI centers for vaccinations. These pouches will be used to store a child's immunization card.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Health Services Research
Keywords: Polio supplementary immunization activities; Routine EPI vaccine; Integration of polio NID and routine EPI