Year of Publication



Public Health

Date Available


Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Dr. Angela Carman

Committee Member

Dr. Jerod Stapleton

Committee Member

Dr. John Watkins



Globally, Pakistan ranks third among countries with the most unvaccinated and under-vaccinated children. Within the country, there are huge regional disparities, and the Khyber Pakhtunkhwa region (KPK FATA) has one of the lowest vaccination rates in the country. Low vaccination rates contribute to the high burden of childhood infectious diseases in Pakistan that cause 70% of childhood deaths. Addressing the issue requires an understanding of the barriers towards vaccinations; 30% of refusals are due to religious reasons and other misconceptions that are compounded by low literacy rates. Since religion has a critical authority in shaping the population’s beliefs, attitudes, and perceptions towards vaccination, mosques will be used as one of the central components for our program. We will partner with the Council of Islamic Ideology, a religious and constitutional body in Pakistan, who have already released a religious ruling to declare vaccines a religious responsibility. Hence, partnering with them will allow us to integrate local mosques into our program for education and as a venue for vaccine camps to enhance access. On the other hand, we will collaborate with the local hospital to facilitate vaccines and to implement a client recall system to increase vaccine demand. We will train our staff and monitor fidelity through pretest posttest surveys, random observations, and monthly meetings. Formative evaluation measures will include staff recruitment and their attitudes towards vaccines so inform program feasibility. Process evaluation will measure program success such as participant characteristics, vaccines administered, and successful recalls; feedback from staff and participants will also be considered. Outcome evaluations will be conducted using an interrupted time series to measure changes in vaccine acceptability in parents and to see positive changes in attitudes, beliefs, and perceptions towards vaccines. This will provide an understanding for changing social norms towards vaccination and program sustainability. The short-term outcome for our program is to see an increase in vaccine uptake and a decrease in vaccine hesitancy, while the long-term outcome is to see a decrease in childhood infectious diseases.

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Public Health Commons