@article{fdi:010091069,
  title = {{R}eaching the unreached through building trust : a mixed-method study on {COVID}-19 vaccination in rural {L}ao {PDR}},
  author = {{P}hrasisombath, {K}. and {K}ubota, {S}. and {E}lliott, {E}. {M}. and {H}oriuchi, {S}. and {O}unaphom, {P}. and {P}himmachak, {L}. and {S}ouksavanh, {O}. and {V}ongsouvanh, {P}. and {R}obinson, {D}. {R}. and {C}hannavong, {S}. and {D}eharo, {E}ric and {S}eal, {W}. {R}. {E}. and {L}o, {Y}. {R}. {J}. and {P}hoummalaysith, {B}.},
  editor = {},
  language = {{ENG}},
  abstract = {{I}ntroduction {T}he global {COVID}-19 vaccine rollout has been impacted by socioeconomic disparities and vaccine hesitancy, but few studies examine reasons for changed attitudes. {I}n {L}ao {P}eople's {D}emocratic {R}epublic ({L}ao {PDR}), a nationwide government-led initiative was developed in response to {COVID}-19, focused on community health ownership and trust in primary healthcare. {T}he intervention team including health and governance sectors conducted capacity-building workshops with local staff and community representatives and visited villages for vaccination outreach. {T}his study investigates the impact of this intervention on {COVID}-19 vaccine acceptance in rural communities. {M}ethods {C}onducted in {X}iengkhuang province, {L}ao {PDR}, from {D}ecember 2022 to {F}ebruary 2023, the study employed a sequential mixed-methods research design. {D}ata on vaccinated individuals from 25 villages were collected from 11 primary healthcare units; pre-post analysis was applied. {Q}ualitative data, gathered through interviews and focus group discussions with villagers, village authorities, health staff and local government (n=102) in six villages, underwent inductive thematic analysis.{R}esults {F}irst-dose vaccine uptake after the intervention increased significantly (6.9 times). {Q}ualitative analysis identified key reasons for vaccination hesitancy: (1) mistrust due to rumours and past experiences; (2) poor communication and inconsistent messaging and (3) challenges in access for priority groups. {I}nfluencing factors during the intervention included (1) effective local-context communication; (2) leveraging existing community structures and influential individuals in a multisectoral approach and (3) increased community motivation through improved satisfaction, ownership and relationships. {C}onclusion {T}his study highlights the impact and methods of building trust with unreached populations in health interventions, emphasising locally led solutions. {S}uccessful reversal of vaccine hesitancy was achieved by addressing root causes and fostering ownership at community and local government levels through a 'positive approach'. {T}his diverges from conventional supplemental immunisation activities and holds potential for systematically building trust between unreached populations and health systems. {F}urther research could explore the impacts of routine vaccination for sustained improvements in health equity.},
  keywords = {{COVID}-19 ; {V}accines ; {Q}ualitative study ; {P}revention strategies ; {LAOS}},
  booktitle = {},
  journal = {{BMJ} {G}lobal {H}ealth},
  volume = {9},
  numero = {6},
  pages = {e014680 [13 p.]},
  ISSN = {2059-7908},
  year = {2024},
  DOI = {10.1136/bmjgh-2023-014680},
  URL = {https://www.documentation.ird.fr/hor/fdi:010091069},
}