title: Communication strategies to promote the uptake of childhood vaccination in Nigeria: a systematic map.
abstract: BACKGROUND
  Effective communication is a critical component in ensuring that children are fully vaccinated. Although numerous communication interventions have been proposed and implemented in various parts of Nigeria, the range of communication strategies used has not yet been mapped systematically. This study forms part of the 'Communicate to vaccinate' (COMMVAC) project, an initiative aimed at building research evidence for improving communication with parents and communities about childhood vaccinations in low- and middle-income countries.
  
  
  OBJECTIVE
  This study aims to: 1) identify the communication strategies used in two states in Nigeria; 2) map these strategies against the existing COMMVAC taxonomy, a global taxonomy of vaccination communication interventions; 3) create a specific Nigerian country map of interventions organised by purpose and target; and 4) analyse gaps between the COMMVAC taxonomy and the Nigerian map.
  
  
  METHODS
  We conducted the study in two Nigerian states: Bauchi State in Northern Nigeria and Cross River State in Southern Nigeria. We identified vaccination communication interventions through interviews carried out among purposively selected stakeholders in the health services and relevant agencies involved in vaccination information delivery; through observations and through relevant documents. We used the COMMVAC taxonomy to organise the interventions we identified based on the intended purpose of the communication and the group to which the intervention was targeted.
  
  
  RESULTS
  The Nigerian map revealed that most of the communication strategies identified aimed to inform and educate and remind or recall. Few aimed to teach skills, enhance community ownership, and enable communication. We did not identify any intervention that aimed to provide support or facilitate decision-making. Many interventions had more than one purpose. The main targets for most interventions were caregivers and community members, with few interventions directed at health workers. Most interventions identified were used in the context of campaigns rather than routine immunisation programmes.
  
  
  CONCLUSIONS
  The identification and development of the Nigerian vaccination communication interventions map could assist programme managers to identify gaps in vaccination communication. The map may be a useful tool as part of efforts to address vaccine hesitancy and improve vaccination coverage in Nigeria and similar settings.
authors.affiliation: Community Medicine Department, University of Calabar, Calabar, Nigeria; afyoku@yahoo.com.
authors.forename: Afiong
authors.initials: A
authors.lastname: Oku
authors.affiliation: Community Medicine Department, University of Calabar, Calabar, Nigeria.
authors.forename: Angela
authors.initials: A
authors.lastname: Oyo-Ita
authors.affiliation: Global Health Unit, Norwegian Knowledge Centre for the Health Services, Oslo, Norway.
authors.forename: Claire
authors.initials: C
authors.lastname: Glenton
authors.affiliation: Global Health Unit, Norwegian Knowledge Centre for the Health Services, Oslo, Norway.|Institute of Health and Society, University of Oslo, Oslo, Norway.
authors.forename: Atle
authors.initials: A
authors.lastname: Fretheim
authors.affiliation: Global Health Unit, Norwegian Knowledge Centre for the Health Services, Oslo, Norway.
authors.forename: Heather
authors.initials: H
authors.lastname: Ames
authors.affiliation: Departamento de Saúde, Direcção Provincial de Saúde de Nampula, Nampula, Mozambique.
authors.forename: Artur
authors.initials: A
authors.lastname: Muloliwa
authors.affiliation: Department of Human Biosciences, Centre for Health Communication and Participation, College of Science, Health and Engineering La Trobe University, Melbourne, Australia.
authors.forename: Jessica
authors.initials: J
authors.lastname: Kaufman
authors.affiliation: Department of Human Biosciences, Centre for Health Communication and Participation, College of Science, Health and Engineering La Trobe University, Melbourne, Australia.
authors.forename: Sophie
authors.initials: S
authors.lastname: Hill
authors.affiliation: Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique.
authors.forename: Julie
authors.initials: J
authors.lastname: Cliff
authors.affiliation: International Union for Health Promotion and Education, Cedex, France.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Cartier
authors.affiliation: Swiss Tropical and Public Health Institute, Basel, Switzerland.|University of Basel, Basel, Switzerland.
authors.forename: Xavier
authors.initials: X
authors.lastname: Bosch-Capblanch
authors.affiliation: Evidence-based Healthcare Program, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Rada
authors.affiliation: Global Health Unit, Norwegian Knowledge Centre for the Health Services, Oslo, Norway.|Health Systems Research Unit, South African Medical Research Council, Tygerberg, South Africa.
authors.forename: Simon
authors.initials: S
authors.lastname: Lewin
mesh_terms: D058015:Health Communication / Q000379:methods*; D006266:Health Education / Q000379:methods*; D006801:Humans; D007223:Infant; D007407:Interviews as Topic; D009549:Nigeria; D036301:Qualitative Research; D014611:Vaccination / Q000706:statistics & numerical data*
keywords: Nigeria; childhood vaccination; communication interventions