In poor areas of Pakistan, low parental literacy presents vaccination programs with a challenge. In Karachi, the site of an intervention in 2008, only 24% of the population in the study areas was literate

Acknowledging this barrier, researchers made a minor re-design to educational materials provided to carers during home-based outreach efforts. The re-designed materials consisted of easy-to-understand pictorial cards with only three messages for mothers to process. The messages conveyed included:

  • That vaccines save children’s lives.
  • The location of local vaccination centers.
  • The significance of retaining home-based health records — including how they could help at the time of a child’s admission to school.

The messages took just five minutes to communicate, and a copy of the materials designed for low literacy audiences was given to mothers after the interaction. Each set cost Pakistan Rs. 80 (US $1).

The study tapped into an important insight about the presentation of information. In addition to addressing low literacy, the pictorial messages, which took little time to explain, eased the cognitive burden on stressed and busy mothers; they didn’t require mothers to think too hard about them. Pictures proved easier to process and recall than the verbal messages that mothers in a control group received.

72% of infants in the intervention group completed the vaccination program, compared to 52% in the control group. (Additionally, 81% in the intervention group retained their home-based records, whereas 69% did so in the control.) The program’s design exhibited empathy with mothers whose attention is often stretched thin by many other responsibilities. The low-cost intervention asked less from mothers, providing comprehensible information in a concise timeframe and simple format.

Source: Owais et al (2011), Does improving maternal knowledge of vaccines impact infant immunization rates? A community-based randomized-controlled trial in Karachi, Pakistan