Providing measles vaccinations for children is essential. But to do that, caregivers must first know about the vaccines.
Sometimes, measles vaccination schedules are not effectively advertised to caregivers, or not advertised at all. But there are simple processes that health facilities can follow when advertising vaccines, in order to increase vaccination coverage.
Advertising measles vaccination schedules
In one country we work in, we found that around a quarter of health facilities are not advertising measles vaccination schedules. When facilities advertise, they sometimes create advertisements that are difficult to read. For example, posters are placed in areas where caregivers are unlikely to see them, or the text size is too small for people to read.
To improve the effectiveness of advertisements, posters should be placed in areas that caregivers frequently visit, such as waiting rooms, card room windows, hallways leading to vaccination rooms, or health facility entrances. The size of posters should also be at least equivalent to A2 paper size, in order to ensure clear visibility for caregivers.
Reminding caregivers
Two doses are needed for the best possible protection against measles. The second dose is often given six months after the first dose, meaning it can be difficult for caregivers to remember the exact date of the second vaccination. There are practices that can be followed to make the date easier to remember, but these practices are sometimes not followed.
In one country, almost half of all caregivers we surveyed stated that it was 'difficult' or 'very difficult' to remember the second measles vaccine dose date. Almost half of caregivers surveyed also noted that the appointment date had not been written on their child's Expanded Programme on Immunisation (EPI) card.
Reminding caregivers about second doses can be fixed in various ways. For example, districts in Punjab, Pakistan, operated a very hands-on reminder programme. It started with a phone call to remind caregivers of second dose dates, before health workers such as vaccinators and nurses visited the homes of caregivers on separate dates to remind them again. This individual-based approach was very effective in reminding caregivers to visit health facilities.
Next steps for measles prevention
If followed, the effective advertising of measles vaccinations to caregivers can be a life-saving measure for children across low- and middle-income countries (LMICs). Following poster recommendations and individually reminding caregivers are two key ways to raise awareness, and both methods have already been used to increase measles vaccination coverage in both developed and developing countries around the world. This is the way forward.
