How clinical communication impacts vaccine uptake
In 2024, the Bali Health District in Cameroon faced alarmingly low uptake of the pentavalent (Penta) vaccine among children under five. This vaccine protects against five life-threatening diseases, yet gaps in clinical communication left many caregivers misinformed, hesitant, or unaware of the importance of completing the full vaccination schedule.
In this rural region, where many families travel long distances to access care, communication failures had significant consequences. Caregivers often left Infant Welfare Clinics unclear about follow-up appointments or concerned about side-effects, contributing to high drop-out rates. In 2023, the drop-out rate between Penta 1 and Penta 3 reached approximately 30%, far exceeding the recommended threshold of less than 10%.
Recognizing the need for change, eBASE Africa, with support from JBI, implemented a structured, evidence-based approach to strengthen clinical communication and improve vaccine uptake.
Clinical communication gap
Low uptake of the Penta vaccine was driven by inconsistent and ineffective communication between healthcare providers and caregivers.
Key challenges included:
- Limited caregiver understanding of vaccine benefits and schedules
- Misconceptions about side-effects and vaccine safety
- Lack of structured communication tools or protocols for health workers
- Missed follow-up appointments due to unclear guidance and lack of reminder
- Resource constraints impacting community follow-up and engagement
As one nurse reflected, “We just told the mothers to come back in a month — we didn’t explain what the vaccines were for or why it was important to return.”
Improving clinical communication with JBI PACES and GRiP
A multidisciplinary team used JBI PACES and the Getting Research into Practice (GRiP) framework to assess current practices and implement targeted, evidence-based strategies.
Key actions included:
- Conducting a baseline audit of communication practices during Infant Welfare Clinics
- Developing and implementing a standardized clinical communication protocol aligned with WHO recommendations
- Training healthcare providers in effective, evidence-based communication techniques
- Designing and distributing culturally appropriate posters and visual counselling tools
- Sending over 400 SMS reminders to caregivers to support follow-up attendance
- Engaging community health workers to track missed appointments and conduct home visits
Visual tools such as laminated flip charts were used to explain vaccination schedules and side-effects, particularly supporting caregivers with low literacy.
“We realised it wasn’t just about giving vaccines — it was about how we communicated them,” said Ngem Bede, project lead.