title: Mapping how information about childhood vaccination is communicated in two regions of Cameroon: What is done and where are the gaps?
abstract: BACKGROUND
  The 'Communicate to vaccinate' (COMMVAC) project builds research evidence for improving communication with parents and communities about childhood vaccinations in low- and middle-income countries. Understanding and mapping the range of vaccination communication strategies used in different settings is an important component of this work. In this part of the COMMVAC project, our objectives were: (1) to identify the vaccination communication interventions used in two regions of Cameroon; (2) to apply the COMMVAC taxonomy, a global taxonomy of vaccination communication interventions, to these communication interventions to help us classify these interventions, including their purposes and target audiences; and identify whether gaps in purpose or target audiences exist; (3) to assess the COMMVAC taxonomy as a research tool for data collection and analysis.
  
  
  METHODS
  We used the following qualitative methods to identify communication strategies in the Central and North West Regions of Cameroon in the first half of 2014: interviews with program managers, non-governmental organizations, vaccinators, parents and community members; observations and informal conversations during routine immunization clinics and three rounds of the National Polio Immunization Campaign; and document analysis of reports and mass media communications about vaccination. A survey of parents and caregivers was also done. We organised the strategies using the COMMVAC taxonomy and produced a map of Cameroon-specific interventions, which we presented to local stakeholders for feedback.
  
  
  RESULTS
  Our map of the interventions used in Cameroon suggests that most childhood vaccination communication interventions focus on national campaigns against polio rather than routine immunisation. The map also indicates that most communication interventions target communities more broadly, rather than parents, and that very few interventions target health workers. The majority of the communication interventions aimed to inform or educate or remind or recall members of the community about vaccination. The COMMVAC taxonomy provided a useful framework for quickly and simply mapping existing vaccination communication strategies.
  
  
  CONCLUSIONS
  By identifying the interventions used in Cameroon and developing an intervention map, we allowed stakeholders to see where they were concentrating their communication efforts and where gaps exist, allowing them to reflect on whether changes are needed to the communication strategies they are using.
authors.affiliation: Global Health Unit, Norwegian Knowledge Centre for the Health Services, Boks 7004, St Olavs plass, N/0130, Oslo, Norway. heather.ames@nokc.no.
authors.forename: Heather
authors.initials: H
authors.lastname: Ames
authors.affiliation: Department of Anthropology, University of Yaoundé 1, BP 337, Yaoundé, Central Province, Cameroon, Africa. diangham@yahoo.com.
authors.forename: Diangha Mabel
authors.initials: DM
authors.lastname: Njang
authors.affiliation: Global Health Unit, Norwegian Knowledge Centre for the Health Services, Boks 7004, St Olavs plass, N/0130, Oslo, Norway. Claire.glenton@nokc.no.
authors.forename: Claire
authors.initials: C
authors.lastname: Glenton
authors.affiliation: Global Health Unit, Norwegian Knowledge Centre for the Health Services, Boks 7004, St Olavs plass, N/0130, Oslo, Norway. atle.fretheim@nokc.no.|Institute of Health and Society, University of Oslo, P.O box 1130 Blindern 0318, Oslo, Norway. atle.fretheim@nokc.no.
authors.forename: Atle
authors.initials: A
authors.lastname: Fretheim
authors.affiliation: Centre for Health Communication and Participation, C/o Department of Human Biosciences, College of Science, Health and Engineering, La Trobe University, Melbourne campus, 3086, VIC, Australia. J.Kaufman@latrobe.edu.au.
authors.forename: Jessica
authors.initials: J
authors.lastname: Kaufman
authors.affiliation: Centre for Health Communication and Participation, C/o Department of Human Biosciences, College of Science, Health and Engineering, La Trobe University, Melbourne campus, 3086, VIC, Australia. sophie.hill@latrobe.edu.au.
authors.forename: Sophie
authors.initials: S
authors.lastname: Hill
authors.affiliation: University of Calabar, Nigeria, P.M.B 1115, Calabar Municipal, Cross River State, Nigeria. afyoku@yahoo.com.
authors.forename: Afiong
authors.initials: A
authors.lastname: Oku
authors.affiliation: Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique, Africa. Julie.cliff@gmail.com.
authors.forename: Julie
authors.initials: J
authors.lastname: Cliff
authors.affiliation: International Union for Health Promotion and Education, 42 Blvd. de la Libération, 95203 St, Denis, Cedex, France. ycartier@iuhpe.org.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Cartier
authors.affiliation: Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051, Basel, Switzerland. x.bosch@unibas.ch.|University of Basel, Petersplatz 1, 4003, Basel, Switzerland. x.bosch@unibas.ch.
authors.forename: Xavier
authors.initials: X
authors.lastname: Bosch-Capblanch
authors.affiliation: Evidence-based Healthcare Program, Pontificia Universidad Católica de Chile, Avda. Libertador Bernardo O'Higgins 340, Santiago, Chile. radagabriel@gmail.com.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Rada
authors.affiliation: Direcção Provincial de Saúde de Nampula, Departamento de Saúde, Av. Samora Machel n° 1016 R/C, C.P. N° 14, Nampula-Moçambique, Africa. muloliwa@yahoo.com.br.
authors.forename: Artur
authors.initials: A
authors.lastname: Muloliwa
authors.affiliation: University of Calabar, Nigeria, P.M.B 1115, Calabar Municipal, Cross River State, Nigeria. oyo_ita@yahoo.com.
authors.forename: Angela
authors.initials: A
authors.lastname: Oyo-Ita
authors.affiliation: Global Health Unit, Norwegian Knowledge Centre for the Health Services, Boks 7004, St Olavs plass, N/0130, Oslo, Norway. simon.lewin@nokc.no.|Health Systems Research Unit, South African Medical Research Council, Francie van Zijl Drive, Parowvallei, Cape Town, PO Box 19070, 7505, Tygerberg, South Africa. simon.lewin@nokc.no.
authors.forename: Simon
authors.initials: S
authors.lastname: Lewin
mesh_terms: D000328:Adult; D002163:Cameroon; D003142:Communication; D058015:Health Communication / Q000379:methods*; D006282:Health Personnel; D006801:Humans; D008297:Male; D010290:Parents; D036301:Qualitative Research; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000706:statistics & numerical data*