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Impact evaluation of a community engagement intervention in improving childhood immunization coverage: a cluster randomized controlled trial in Assam, India

BACKGROUND: To improve immunization coverage, most interventions that are part of the national immunization program in India address supply-side challenges. But, there is growing evidence that addressing demand-side factors can potentially contribute to improvement in childhood vaccination coverage...

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Autores principales: Pramanik, Santanu, Ghosh, Arpita, Nanda, Rituu B., de Rouw, Marlou, Forth, Philip, Albert, Sandra
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5913885/
https://www.ncbi.nlm.nih.gov/pubmed/29688845
http://dx.doi.org/10.1186/s12889-018-5458-x
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author Pramanik, Santanu
Ghosh, Arpita
Nanda, Rituu B.
de Rouw, Marlou
Forth, Philip
Albert, Sandra
author_facet Pramanik, Santanu
Ghosh, Arpita
Nanda, Rituu B.
de Rouw, Marlou
Forth, Philip
Albert, Sandra
author_sort Pramanik, Santanu
collection PubMed
description BACKGROUND: To improve immunization coverage, most interventions that are part of the national immunization program in India address supply-side challenges. But, there is growing evidence that addressing demand-side factors can potentially contribute to improvement in childhood vaccination coverage in low- and middle-income countries. Participatory engagement of communities can address demand-side barriers while also mobilizing the community to advocate for better service delivery. The objective of this study is to evaluate the impact of a novel community engagement approach in improving immunization coverage. In our proposed intervention, we go a step beyond merely engaging the community and strive towards increasing ‘ownership’ by the communities. METHODS/DESIGN: We adopt a cluster randomized design with two groups to evaluate the intervention in Assam, a state in the northeast region of India. To recruit villages and participants at baseline, we used a two-stage stratified random sampling method. We stratified villages; our unit of randomization, based on census data and randomly selected villages from each of the four strata. At the second-stage, we selected random sub-sample of eligible households (having children in the age group of 6–23 months) from each selected village. The study uses a repeated cross sectional design where we track the same sampled villages but draw independent random samples of households at baseline and endline. Total number of villages required for the study is 180 with 15 eligible HHs from each village. Post-baseline survey, we adopt a stratified randomization strategy to achieve better balance in intervention and control groups, leveraging information from the extensive baseline survey. DISCUSSION: The proposed intervention can help identify barriers to vaccination at the local level and potentially lead to more sustainable solutions over the long term. Our sampling design, sample size calculation, and randomization strategy address internal validity of our evaluation design. We believe that it would allow us to causally relate any observed changes in immunization coverage to the intervention. TRIAL REGISTRATION: The trial has been registered on 7th February, 2017 under the Clinical Trials Registry- India (CTRI), hosted at the ICMR’s National Institute of Medical Statistics, having registration number CTRI/2017/02/007792. This is the original study protocol.
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spelling pubmed-59138852018-04-30 Impact evaluation of a community engagement intervention in improving childhood immunization coverage: a cluster randomized controlled trial in Assam, India Pramanik, Santanu Ghosh, Arpita Nanda, Rituu B. de Rouw, Marlou Forth, Philip Albert, Sandra BMC Public Health Study Protocol BACKGROUND: To improve immunization coverage, most interventions that are part of the national immunization program in India address supply-side challenges. But, there is growing evidence that addressing demand-side factors can potentially contribute to improvement in childhood vaccination coverage in low- and middle-income countries. Participatory engagement of communities can address demand-side barriers while also mobilizing the community to advocate for better service delivery. The objective of this study is to evaluate the impact of a novel community engagement approach in improving immunization coverage. In our proposed intervention, we go a step beyond merely engaging the community and strive towards increasing ‘ownership’ by the communities. METHODS/DESIGN: We adopt a cluster randomized design with two groups to evaluate the intervention in Assam, a state in the northeast region of India. To recruit villages and participants at baseline, we used a two-stage stratified random sampling method. We stratified villages; our unit of randomization, based on census data and randomly selected villages from each of the four strata. At the second-stage, we selected random sub-sample of eligible households (having children in the age group of 6–23 months) from each selected village. The study uses a repeated cross sectional design where we track the same sampled villages but draw independent random samples of households at baseline and endline. Total number of villages required for the study is 180 with 15 eligible HHs from each village. Post-baseline survey, we adopt a stratified randomization strategy to achieve better balance in intervention and control groups, leveraging information from the extensive baseline survey. DISCUSSION: The proposed intervention can help identify barriers to vaccination at the local level and potentially lead to more sustainable solutions over the long term. Our sampling design, sample size calculation, and randomization strategy address internal validity of our evaluation design. We believe that it would allow us to causally relate any observed changes in immunization coverage to the intervention. TRIAL REGISTRATION: The trial has been registered on 7th February, 2017 under the Clinical Trials Registry- India (CTRI), hosted at the ICMR’s National Institute of Medical Statistics, having registration number CTRI/2017/02/007792. This is the original study protocol. BioMed Central 2018-04-23 /pmc/articles/PMC5913885/ /pubmed/29688845 http://dx.doi.org/10.1186/s12889-018-5458-x Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Study Protocol
Pramanik, Santanu
Ghosh, Arpita
Nanda, Rituu B.
de Rouw, Marlou
Forth, Philip
Albert, Sandra
Impact evaluation of a community engagement intervention in improving childhood immunization coverage: a cluster randomized controlled trial in Assam, India
title Impact evaluation of a community engagement intervention in improving childhood immunization coverage: a cluster randomized controlled trial in Assam, India
title_full Impact evaluation of a community engagement intervention in improving childhood immunization coverage: a cluster randomized controlled trial in Assam, India
title_fullStr Impact evaluation of a community engagement intervention in improving childhood immunization coverage: a cluster randomized controlled trial in Assam, India
title_full_unstemmed Impact evaluation of a community engagement intervention in improving childhood immunization coverage: a cluster randomized controlled trial in Assam, India
title_short Impact evaluation of a community engagement intervention in improving childhood immunization coverage: a cluster randomized controlled trial in Assam, India
title_sort impact evaluation of a community engagement intervention in improving childhood immunization coverage: a cluster randomized controlled trial in assam, india
topic Study Protocol
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5913885/
https://www.ncbi.nlm.nih.gov/pubmed/29688845
http://dx.doi.org/10.1186/s12889-018-5458-x
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