The IMPRINT public engagement project, led by Dr Chinedu Anthony Iwu (Imo State University/Teaching Hospital Orlu, Nigeria) and conducted in rural Southeast Nigeria, successfully used culturally tailored audio messages to improve maternal and infant vaccination knowledge among women living in selected rural communities in Imo State. It was designed to address barriers such as mistrust, misinformation, and communication gaps that contribute to low vaccine coverage in the region. By transforming evidence-based health information into traditional Igbo music, the project created messages that were relatable, trustworthy, and memorable for these women.
Two hundred women from Orlu and Owerri Zones of Imo State, Nigeria, were enrolled in the project through convenience sampling. The project was guided by the Health Belief Model (HBM) and the Diffusion of Innovations (DOI) theory. Key informant interviews revealed low perceived susceptibility to vaccine-preventable diseases, misconceptions, concerns about vaccine safety and limited decision-making autonomy among women purposively selected from rural communities outside the study area. These insights informed the development of three Igbo song versions, which were delivered in a cyclical sequence to the study participants during a training workshop session; a foundational knowledge track, a motivational slogan-style reinforcement track, and a consolidated knowledge track. This design balanced informative content with cultural and emotional resonance to optimise retention and adoption.
Pre- and post-intervention evaluation showed statistically significant improvement in study participants’ knowledge scores, with a moderate effect size, indicating a meaningful impact on vaccination knowledge. Although immediate changes in attitudes or willingness to vaccinate were not statistically significant, qualitative feedback revealed a positive shift. Participants described the songs as familiar, engaging, and trustworthy, sparking conversations and increasing openness to vaccination, suggesting potential for longer-term behaviour change if sustained.
Key outcomes included strengthened community engagement through co-creation with a multidisciplinary team including a linguist and local musical artist, the establishment of a WhatsApp group for ongoing dissemination, and the production of reusable audio tools for increasing awareness of maternal and infant vaccination for health facilities. Challenges included entrenched mistrust, women’s limited autonomy in health decisions, and logistical barriers. These challenges underscore that knowledge alone cannot drive uptake without addressing broader social and cultural constraints.
The project demonstrates that culturally resonant communication can bridge knowledge gaps in low-literacy, rural settings of Southeast Nigeria. Recommendations for future initiatives include scaling this project up across other states with local adaptations, engaging men and opinion leaders, institutionalising regular playback in health facilities, addressing misinformation through trusted voices, and integrating culturally tailored messaging into national immunisation and health promotion policies.
This initiative provides a replicable model for public health outreach. By embedding cultural aspects in communication, trust is rebuilt, conversations are stimulated, and equitable health outcomes become more achievable.
On 11-12 September 2025, our members gathered in South Africa to reflect on the state of maternal immunisation research and celebrate eight years of IMPRINT's achievements.
