GLEAN: Gathering Learning, Evidence, Analysis and News: Issue #4: Using bulk voice messages to increase COVID-19 vaccination uptake in rural Pakistan

Save the Children Pakistan and The Center for Utilizing Behavioral Insights for Children (CUBIC) explore the use of bulk voice messaging (BVM) as a strategy to increase COVID-19 vaccination uptake in rural areas of Pakistan. The study addresses the issue of lower vaccination rates in certain districts, which are predominantly rural and face challenges such as limited digital access, lower literacy levels, and diverse languages. The team hypothesized that the population may have been missed by previous government COVID-19 communication efforts, due to the identified digital, literacy, and language barriers. The experiment consisted of a BVM trial with three variations of messages targeting specific barriers: addressing worries about side effects and vaccine brands, addressing beliefs about vaccines for pregnant or breastfeeding women, and addressing religious concerns about vaccine alignment with Islamic beliefs. The results indicate that the messages focusing on pregnancy had higher engagement and intention to get vaccinated. Additionally, messages delivered by influential religious leaders in Urdu had the highest impact. The study concludes that BVM is a cost-effective method to reach people at scale, particularly those with limited digital access or low literacy levels. Furthermore, leveraging religious leaders as health messengers can be effective in promoting vaccination uptake, although careful considerations are needed in the selection process.