Data Sheet 1_Strengthening vaccine uptake: a qualitative assessment of community health worker educational resource needs and community perspectives on vaccination in Western Kenya.docx

IntroductionVaccination strengthens health systems by preventing the spread of infectious diseases and reducing morbidity and mortality. The introduction of the malaria vaccine in Kenya, alongside the growing access to technological tools, offers a timely opportunity to explore the educational needs of community health workers (CHWs) and the feasibility of digital training and health education resources for CHWs.
MethodsA qualitative descriptive study was conducted among CHWs and community members in two sub-counties in Migori County. In-depth interviews were held with 20 CHWs selected through stratified random sampling from 72 community health units grouped into eight strata. Additionally, four focus group discussions were conducted with 32 community members. Thematic analysis was conducted using both inductive and deductive coding approaches.
ResultsCHWs strongly preferred in-person training with visual aids but showed cautious interest in digital learning tools. Key barriers to digital training include limited digital literacy, language constraints, smartphone access, and associated costs. Community members supported vaccination and trusted CHWs due to their training and affiliation with health facilities. However, vaccine hesitancy persists, driven by fears of side effects, cultural beliefs, and misinformation. Confusion surrounding the limited geographic rollout of the malaria vaccine has contributed to skepticism, with some misinformation linking the vaccine to family planning and other health risks.
DiscussionA comprehensive, community-centred communication strategy addressing the geographic rollout of the malaria vaccine is necessary. Overcoming the ‘digital divide’ through targeted training, improved technology infrastructure, and user-friendly technology may enhance CHWs’ capacity to deliver effective vaccine education within communities.

引言 疫苗接种可通过阻断传染病传播、降低发病率与死亡率，强化医疗卫生系统运行效能。肯尼亚引入疟疾疫苗，加之技术工具的可及性不断提升，为探索社区卫生工作者（community health workers, CHWs）的教育需求，以及面向CHWs的数字化培训与健康教育资源的可行性提供了适时契机。
方法 本研究在米戈里县（Migori County）的两个分区开展定性描述性研究。研究采用分层随机抽样法，从划分为8个层的72个社区卫生单元中抽取20名CHWs开展深度访谈；此外，还针对32名社区成员组织了4组焦点小组讨论。本研究采用归纳与演绎编码相结合的方式开展主题分析。
结果 CHWs普遍偏好配备视觉辅助工具的线下培训，但对数字化学习工具仅持谨慎的接纳态度。数字化培训的主要阻碍包括数字素养不足、语言适配限制、智能手机获取困难及相关使用成本。社区成员支持疫苗接种，并因CHWs的专业培训背景与所属医疗机构的官方属性而信任其服务；但受副作用担忧、文化信仰与错误信息的影响，疫苗犹豫问题依然存在。疟疾疫苗有限的地理推广范围引发认知混淆，进一步加剧了公众质疑情绪，部分错误信息将该疫苗与计划生育及其他健康风险进行不当关联。
讨论 需制定以社区为中心的综合性传播策略，针对疟疾疫苗的地理推广范围进行针对性科普澄清。通过开展针对性培训、完善技术基础设施及优化技术易用性，破除‘数字鸿沟’，可有效提升CHWs在社区内开展高效疫苗健康教育的能力。