Investigator(s)
| WHO Technical Officer |
Vineet Goyal WHO India Vineet Goyal 
|
| Principal Investigator |
Tigran Avagyan WHO India Tigran Avagyan
|
| Co-Investigator(s) |
Vineet Goyal WHO India Vineet Goyal
|
Title(s) and abstract
| Scientific title | Survey of Behavioural and Social Drivers (BeSD) of Vaccination in Zero Dose and Partially Vaccinated Children in Select High-priority Districts of India |
| Public title | Survey of Behavioural and Social Drivers (BeSD) of Vaccination in Zero Dose Districts of India |
| Background | India’s Immunization Programme is the largest Public Health Initiative globally with the overarching goal of reducing vaccine-preventable diseases and child mortality. Despite significant progress in vaccination, the under-five mortality rate remains high at 32 per 1000 live births (Sample Registration System, 2020). Over time several initiatives were taken to strengthen its universal immunization programme, viz. Mission-Indradhanush, additional catch up campaigns. Introduction of combination and newer vaccines like the pentavalent vaccine (protecting against five diseases) and the inactivated polio vaccine (IPV) have improved efficiency and protection. In India, although considerable progress has been made, an estimated 1.6 million zero dose children in 2023, still remain a critical concern with disparity existing across states and districts. The World Health Organization's Strategic Advisory Group of Experts (SAGE), in October 2021 highlighted the need to understand the factors influencing the Behavioral and Social Drivers (BeSD) contributing to low vaccine uptake and changes over-time by continuous monitoring, evaluation and adaptation of interventions to address evolving trends |
| Objectives | The primary objective of the survey is to assess the baseline status of behavioural and social drivers (BeSD) influencing vaccination uptake among zero-dose and partially vaccinated children in select high-priority districts of India. Secondary objectives include: • To generate contextual insights into the behavioural and social drivers of vaccination -covering perceptions and attitudes (thinking and feeling), social influences (social processes), motivation to vaccinate, and practical issues such as access, affordability, and service quality. • To inform programme planning by generating district-level evidence on behavioural and social drivers of immunization, enabling tailored strategies to increase vaccine uptake. |
| Study Methods | A cross-sectional, multistage household cluster survey will be conducted among under-immunized (Zero Dose or Partially Immunized) children aged 12-23 months and children aged 14 weeks to 11 months who didn’t receive Penta-1 dose (potential zero-dose children) in 143 priority districts across 11 states of India. Selection of states and districts done based on the estimated number of zero dose children as per country’s Zero Dose Implementation Plan (ZIP). Within these 143 districts, sampling will be non-probabilistic and directed towards blocks/villages/urban wards with a higher likelihood of encountering zero-dose children or partially vaccinated children. A non-probabilistic sampling method has been planned for the survey based on practical considerations, specific objectives, and resources available rather than statistical formulas aimed at achieving representativeness. For quantitative data collection, total sample size of around 150 children would be targeted in 25 identified clusters (villages/wards) in selected 5 blocks per district except northeast hilly states having fewer blocks (2-3). For qualitative information, In-Depth Interviews (IDIs) will be conducted among 3 to 5 caregivers of zero-dose children aged 12-23 months or potential zero-dose children aged 14 weeks to 11 months, in each district. |
| Expected outcomes and use of results | This survey is purposed to determine the impact of interventions leading to discernible positive impact on progress in vaccination demand in children identified as zero dozers and prospective zero dozers. This process thus enables the program to assess, design, target and evaluate interventions to achieve greater impact with more efficiency and to understand trend over time. Results from this could also help identify wider vaccination policy and programming applications across regions. The compiled reports and feedback will be prepared and submitted to MoHFW, GoI and other partners and stakeholders at national and state level through wide dissemination. This will help to: o Inform the design of interventions to increase uptake o Develop targeted approaches to address context-specific drivers and barriers in different population groups o Prioritize interventions under conditions of limited resources o Evaluate effectiveness of strategies and track trends through routine BeSD assessments o Advocate and mobilize for resources o Contribute to triangulated or comparative analysis and guide programme planning |
| Keywords | Zero dose, drivers of vaccination, behavioral drivers, social drivers |
Research Details
| Student research | No |
| Start Date | 01-May-2025 |
| End Date | 30-Sep-2025 |
| Key Implementing Institution | WHO Country Office India |
| Multi-country research | No |
| Nationwide research | Yes |
| Research Domain(s) | Communicable Disease Research, Maternal, Reproductive and Child Health |
| Research field(s) | Immunization/Vaccine Preventable Disease |
| Involves human subjects | Yes |
| Population-Based Survey | |
| Data Collection | Primary data |
| Proposal reviewed by other Committee | Under Review |