Strengthening Vaccine Uptake: A Qualitative Assessment of Community Health Worker Educational Resource Needs and Community Perspectives on Vaccination in Western Kenya

Nophiwe Job^1*Sei-Kashe M’pfunya²Sandra Mudhune²George Omondi²Benson Nyawade²Mumma Edelquinn²Moses Sadia²Erick K Odhiambo³Xian Ho⁴Nadine Skinner⁵Jamie Sewan Johnston⁶Victoria Ward^6,7Jane Wamae²

• ¹Stanford Centre for Health Education, Cape Town, South Africa
• ²Lwala Community Alliance, Rongo, Kenya
• ³County Government of Migori, Health Department, Migori County, Kenya
• ⁴Dimagi Inc, Cambridge, United States
• ⁵Stanford Centre for Health Education, Stanford University, Stanford, United States
• ⁶Stanford Centre for Health Education, Stanford, United States
• ⁷Stanford University School of Medicine, Stanford, United States

Introduction: Vaccination 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. Methods: A qualitative descriptive study was conducted among CHWs and community members in 2 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. Results: CHWs 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. Discussion: A comprehensive, community-centered 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. Keywords: community health workers; digital training; vaccine education; digital divide; malaria vaccine; community perspectives.