Bringing the social into vaccination research: Community-led ethnography and trust-building in immunization programs in Sierra Leone

<h4>Background</h4> Vaccine hesitancy is a complex, contested social phenomenon and existing research highlights the multifaceted role of trust in strengthening vaccine confidence. However, understanding public engagement with vaccination through the lens of (mis)trust requires more cont...

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Autores principales:	Luisa Enria, Joseph S. Bangura, Hassan M. Kanu, Joseph A. Kalokoh, Alie D. Timbo, Mohamed Kamara, Maligie Fofanah, Alhassan N. Kamara, Adikalie I. Kamara, Morlai M. Kamara, Ibrahim Sorie Suma, Osman M. Kamara, Alusine M. Kamara, Alhajie O. Kamara, Abu B. Kamara, Emmah Kamara, Shelley Lees, Mark Marchant, Mariama Murray
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/74a3da6646cc470db59decd0da044f15
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spelling	oai:doaj.org-article:74a3da6646cc470db59decd0da044f152021-11-04T06:07:13ZBringing the social into vaccination research: Community-led ethnography and trust-building in immunization programs in Sierra Leone1932-6203https://doaj.org/article/74a3da6646cc470db59decd0da044f152021-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8535180/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4> Vaccine hesitancy is a complex, contested social phenomenon and existing research highlights the multifaceted role of trust in strengthening vaccine confidence. However, understanding public engagement with vaccination through the lens of (mis)trust requires more contextual evidence on trust’s qualitative determinants. This includes expanding the geographic focus beyond current studies’ focus on High Income Countries. Furthermore, obstacles remain in effectively integrating social science findings in the design of vaccine deployment strategies, and in ensuring that those who implement interventions and are affected by them are directly involved in producing knowledge about vaccination challenges. <h4>Methods</h4> We piloted a community-led ethnographic approach, training Community Health Workers (CHWs) in Kambia District, Sierra Leone, in qualitative social science methods. Methods included participant observation, participatory power mapping and rumour tracking, focus group discussions and key stakeholder interviews. CHWs, with the support of public health officials and professional social scientists, conducted research on vaccination challenges, analysed data, tested new community engagement strategies based on their findings and elicited local perspectives on these approaches. <h4>Results</h4> Our findings on vaccine confidence in five border communities highlighted three key themes: the impact of prior experiences with the health system on (mis)trust; relevance of livelihood strategies and power dynamics for vaccine uptake and access; and the contextual nature of knowledge around vaccines. Across these themes, we show how expressions of trust centered on social proximity, reliability and respect and the role of structural issues affecting both vaccine access and confidence. The pilot also highlighted the value and practical challenges to meaningfully co-designed research. <h4>Conclusion</h4> There is scope for broader application of a community-led ethnographic approach will help redesign programming that is responsive to local knowledge and experience. Involving communities and low-cadre service providers in generating knowledge and solutions can strengthen relationships and sustain dialogue to bolster vaccine confidence.Luisa EnriaJoseph S. BanguraHassan M. KanuJoseph A. KalokohAlie D. TimboMohamed KamaraMaligie FofanahAlhassan N. KamaraAdikalie I. KamaraMorlai M. KamaraIbrahim Sorie SumaOsman M. KamaraAlusine M. KamaraAlhajie O. KamaraAbu B. KamaraEmmah KamaraShelley LeesMark MarchantMariama MurrayPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Luisa Enria Joseph S. Bangura Hassan M. Kanu Joseph A. Kalokoh Alie D. Timbo Mohamed Kamara Maligie Fofanah Alhassan N. Kamara Adikalie I. Kamara Morlai M. Kamara Ibrahim Sorie Suma Osman M. Kamara Alusine M. Kamara Alhajie O. Kamara Abu B. Kamara Emmah Kamara Shelley Lees Mark Marchant Mariama Murray Bringing the social into vaccination research: Community-led ethnography and trust-building in immunization programs in Sierra Leone
description	<h4>Background</h4> Vaccine hesitancy is a complex, contested social phenomenon and existing research highlights the multifaceted role of trust in strengthening vaccine confidence. However, understanding public engagement with vaccination through the lens of (mis)trust requires more contextual evidence on trust’s qualitative determinants. This includes expanding the geographic focus beyond current studies’ focus on High Income Countries. Furthermore, obstacles remain in effectively integrating social science findings in the design of vaccine deployment strategies, and in ensuring that those who implement interventions and are affected by them are directly involved in producing knowledge about vaccination challenges. <h4>Methods</h4> We piloted a community-led ethnographic approach, training Community Health Workers (CHWs) in Kambia District, Sierra Leone, in qualitative social science methods. Methods included participant observation, participatory power mapping and rumour tracking, focus group discussions and key stakeholder interviews. CHWs, with the support of public health officials and professional social scientists, conducted research on vaccination challenges, analysed data, tested new community engagement strategies based on their findings and elicited local perspectives on these approaches. <h4>Results</h4> Our findings on vaccine confidence in five border communities highlighted three key themes: the impact of prior experiences with the health system on (mis)trust; relevance of livelihood strategies and power dynamics for vaccine uptake and access; and the contextual nature of knowledge around vaccines. Across these themes, we show how expressions of trust centered on social proximity, reliability and respect and the role of structural issues affecting both vaccine access and confidence. The pilot also highlighted the value and practical challenges to meaningfully co-designed research. <h4>Conclusion</h4> There is scope for broader application of a community-led ethnographic approach will help redesign programming that is responsive to local knowledge and experience. Involving communities and low-cadre service providers in generating knowledge and solutions can strengthen relationships and sustain dialogue to bolster vaccine confidence.
format	article
author	Luisa Enria Joseph S. Bangura Hassan M. Kanu Joseph A. Kalokoh Alie D. Timbo Mohamed Kamara Maligie Fofanah Alhassan N. Kamara Adikalie I. Kamara Morlai M. Kamara Ibrahim Sorie Suma Osman M. Kamara Alusine M. Kamara Alhajie O. Kamara Abu B. Kamara Emmah Kamara Shelley Lees Mark Marchant Mariama Murray
author_facet	Luisa Enria Joseph S. Bangura Hassan M. Kanu Joseph A. Kalokoh Alie D. Timbo Mohamed Kamara Maligie Fofanah Alhassan N. Kamara Adikalie I. Kamara Morlai M. Kamara Ibrahim Sorie Suma Osman M. Kamara Alusine M. Kamara Alhajie O. Kamara Abu B. Kamara Emmah Kamara Shelley Lees Mark Marchant Mariama Murray
author_sort	Luisa Enria
title	Bringing the social into vaccination research: Community-led ethnography and trust-building in immunization programs in Sierra Leone
title_short	Bringing the social into vaccination research: Community-led ethnography and trust-building in immunization programs in Sierra Leone
title_full	Bringing the social into vaccination research: Community-led ethnography and trust-building in immunization programs in Sierra Leone
title_fullStr	Bringing the social into vaccination research: Community-led ethnography and trust-building in immunization programs in Sierra Leone
title_full_unstemmed	Bringing the social into vaccination research: Community-led ethnography and trust-building in immunization programs in Sierra Leone
title_sort	bringing the social into vaccination research: community-led ethnography and trust-building in immunization programs in sierra leone
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/74a3da6646cc470db59decd0da044f15
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Bringing the social into vaccination research: Community-led ethnography and trust-building in immunization programs in Sierra Leone

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