Table 4 Phase V key findings from CHWs

Physical items (videos and pamphlets) were most helpful to CHWs in their communication with parent and child caregivers

CHWs shared that when they were attempting to address caregiver concerns, they were most convinced by seeing evidence of other members of their community who benefited from vaccination or from others advocating for vaccination

“Now I don’t have [a] fear of going alone since I have these [pamphlets], I feel like a helper is coming along with me.”

Communication training was a helpful method of training for CHWs

CHWs described that they previously had not been provided with effective communication training. When speaking with hesitant parent and child caregivers, CHWs previously found it difficult to understand how to speak effectively and in a way that parent and child caregivers responded well to

“Communicating about the vaccination has always been a challenge for us, but now this problem has been lightened through this intervention”

Strengthened connections with community leaders facilitated improvements in community-level discussions

CHWs shared that their links with community leaders were improved, and they felt that they had additional support with parent and child caregivers who were hesitant about vaccination

“Earlier only we were working all alone. Now we have helping hands”

CHWs felt that community members were more willing to accept vaccines after the implementation of this intervention

CHWs shared that there were improvements in both routine immunization services and COVID-19 vaccination. They credited this improvement to some aspects of the intervention including communication, coordination, and strengthened connections

“Earlier people refused to take vaccines. Now people are voluntarily coming to the session and taking vaccines.”

CHWs felt that the intervention allowed them to develop new technological and general communication skills

CHWs shared that the intervention allowed them to feel more confident in themselves to use online platforms, discuss issues with parent and child caregivers beyond vaccination, and improve relationships with parent and child caregivers by leveraging support from the CAB

“I learnt to be patient with parent and child caregivers, talk peacefully, give them time to think and react, and communicate to them about vaccines properly.”

“The online exposure was also a wonderful experience sitting in home itself meeting people [from] far [away], [helped with] learning.”

CHWs felt increased ownership and empowerment over vaccine uptake in Mewat

CHWs shared that they feel more empowered to apply skills to facilitate change. They also shared that they feel more prepared to help with larger health issues

“[When] training is provided to us for developing our skills, we learn and implement it in our field. We are helping to bring [in gradual] change.”

“We would like to [have] more materials later also, as through [these strategies] we can explain the caregiver in a better way. Pamphlets regarding pregnant women, nutrition, vaccines. Religious leaders’ messages can also be added.”