Protecting girls' health, one shot at a time.
There is a significant healthcare gap between urban and rural Indian communities. Since India is the most populous country in the world, government spending on healthcare is insufficient to meet the needs of all citizens. This imbalance is extremely stark, with urban areas receiving a disproportionate share of available resources. According to a United Nations report, "75% of healthcare infrastructure, medical professionals, and other health resources are concentrated in urban areas, which house only 27% of the population." Thus, for those residing in rural areas, which make up the majority of Indians, accessing adequate medical services pose significant challenges.
For example, a cross-sectional study showed that the booster vaccine coverage against Covid-19 was very poor in rural Haryana, where only 10.7% of the participants received the booster dose (mostly Covishield) compared to 98.2% and 94.8% who received the first and second dose respectively. Additionally, the study highlighted that the Covid-19 vaccine coverage was greatly influenced by education. Individuals who had only received a primary school certificate were less likely to by fully vaccinated (n = 268, 94.4%) compared to those who had received a senior secondary degree (n = 751, 95.4%).
Thus, apart from physical and financial barriers to medical services, cultural taboos and stigmas significantly exacerbate the urban-rural divide in healthcare accessibility. It is therefore important to educate rural India on maintaining good well-being and dispel any misconceptions.
One way of doing this is to create a targeted marketing campaign that resonates with rural communities. If executed well, a campaign can increase awareness and encourage more individuals to access primary care services provided by rural centers such as Anganwadis, Ashas, and Self-Help Groups (SHGs). It all depends on how well the campaigners identify their stakeholders and understand their audience.
Step 1: Mapping Stakeholders
For example, when thinking about a campaign that encourages young girls to receive the HPV vaccine, it is essential to first map who the primary, secondary, and tertiary stakeholders are. This approach provides campaigners with a clear direction that can help them achieve their goals.
Primary, secondary, and tertiary stakeholders distribution diagram
Thus, from the image above:
Primary Stakeholders:
Rural Indian girls between the ages of 9 to 14 years: The primary beneficiaries of the HPV vaccination.
Parents and local guardians: Responsible for making healthcare decisions for their children.
Healthcare providers (doctors, nurses, community health workers): Administer the HPV vaccine.
Secondary Stakeholders:
Teachers and schools who can educate girls about HPV and the HPV vaccine.
Community heads (village authorities, respected elderly, religious heads): Sway public opinion and advocate for the HPV vaccine.
Community-based organizations: Spread awareness and organize HPV vaccination drives.
Tertiary Stakeholders:
Donors and funding organizations: Cover the costs related to education, HPV vaccine distribution, and community engagement.
Pharmaceutical companies: Supply the HPV vaccine and offer support for distribution efforts.
Universities: Provide research and data on the HPV vaccine's effectiveness.
Step 2: Brainstorming Questions
After identifying the various stakeholder groups, campaigners can then brainstorm essential questions that will capture the interest of their primary audience. Such questions include:
Understanding the Audience:
What are the main cultural and social norms in the target rural areas?
What is the level of awareness about HPV and the HPV vaccine among rural families?
What language does the target audience speak, and what is level of literacy in the language?
Cultural Sensitivity:
How can the campaign be designed to adhere to local customs and beliefs?
Are there influential figures in the community who can promote the HPV vaccine?
What concerns or misconceptions could these communities have regarding the HPV vaccine?
Message Development:
What messages will have the greatest impact on young girls and their families?
What color palette will resonate well with a rural Indian audience?
How can the benefits of the HPV vaccine be communicated in a way that is both clear and compelling?
Accessibility Barriers:
What factors are restricting the target audience from accessing the HPV vaccine (transportation, cost, societal taboos)?
How can a potential campaign address and overcome these accessibility barriers?
Overview of the four main brainstorming questions
Step 3: Creating a Good Campaign
Since such a campaign aims to address a young and older audience (young girls and their parents), it is essential to think of strategies that would appeal to both sets of viewers. Additionally, the tactics used to capture the attention and persuade individuals to get the HPV vaccine vary significantly between rural and urban communities in India. For example:
Bright, Bold Colors: Indian culture, especially in rural areas, is known for using vivid colors in attire, art, and festivals. By incorporating a vibrant color palette in an HPV vaccine campaign, more viewers would be drawn to it due to their familiarity with the colors, resulting in a better understanding of the message.
More Visuals, Less Text: Only 71% of rural Indians (age 15 and older) can read and write, compared to 86% in urban India. Additionally, the literacy rate among females is much lower than males in rural areas, 50.6% compared to 74.1%. Thus, using more images than text would help individuals with limited literacy understand the message of an HPV vaccine campaign and reach a broader audience.
Location Matters: Thinking about the location of an HPV vaccine campaign is important as it ensures that the message reaches the target audience and increases its visibility. For example, positioning the campaign near local schools and shopping centers guarantees that young girls will notice it and inform their parents. Additionally, many fathers in rural India work as drivers/watchmen, and mothers as cooks/household maids. Again, to ensure parents seriously consider getting their daughter vaccinated against HPV, it would be useful to have the campaign near their places of work.
Endorsement: Parents, particularly fathers in rural India, are the primary decision-makers regarding their family's health. To encourage them to vaccinate their daughters against HPV, it is beneficial to have the campaign endorsed by trusted organizations. Endorsements from respected figures like political and religious leaders can significantly enhance the credibility of the vaccine. If they express their support, it is likely that parents will develop increased trust in the vaccine and be more inclined to ensure their daughters receive it.
Technology: In rural India, WhatsApp is a key tool for sharing information. By leveraging social media platforms for an HPV vaccination campaign, its message can reach a wider audience and have a greater impact.
Example of an HPV vaccine campaign that I made
In conclusion, crafting an effective HPV vaccine campaign for rural Indian girls and her parents is crucial. It will not only empower them with the knowledge and tools to protect herself/daughter, but also contribute to the broader goal of reducing HPV transmission rates.
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