Module D: Her First

⚠️ If “gender” is a sensitive terminology in your context, you can refer to “social equity” instead, or any other term used. Make sure that participant-facing materials including worksheets, posters, and prompt cards are revised accordingly. Please refer to the DSB Localisation Guidance for more details.

Welcome to Module D!

Purpose

This module helps you identify why access to vaccination may differ for men and women.

What You’ll Achieve

By the end of this module, participants will:

Learn how social equity and beliefs about women and men in a community can impact how likely someone is to vaccinate.
Identify gender-related barriers affecting caregivers and healthcare workers during and after the vaccination process.
Prioritise the main barriers your strategy will address.

What You Need

Room Set-up

Activity 1: Think about reasons women and men may not have equal vaccination

In some contexts, women and men may face different challenges accessing or supporting immunization. These differences are often influenced by community beliefs about the roles and behaviours expected of women and men. This can affect how families make decisions about vaccination. It’s important to understand if men and women may be impacted differently by the barriers to immunization.

How to Prepare

If you haven’t already, put up the header poster for Module D: Her First on the main wall.
Ensure every group has their Table Worksheet: Barriers and the Table Worksheet: Barrier Prioritisation from the previous activities.
On each table, give each group one copy of Strategy Summary Poster 2 and one set of the Prompt Cards: Her First.

Facilitation Steps

Introduce gender barriers: start by introducing what gender barriers are. You can say: “In many communities, there may be different beliefs about the role of men and women. Some of these beliefs can affect how easy it is for a woman to vaccinate their child. We’re going to look at the barriers to immunization we talked about earlier, but this time, think about how men and women might be affected differently.”
- Here are some examples:
  - In many families, mothers care for children but don’t always make decisions about their health. Fathers or other male relatives may need to agree to vaccination.
  - Women may not have the same access to health information as men, especially if they have less education.
  - Sometimes, women don’t feel comfortable going to clinics if male health workers are there, or their husbands might not let them go alone.
  - Women may not be allowed to leave their homes without a male or older family member accompanying them. When this is not possible, it may lead to missed vaccinations.
  - Female health workers might face discrimination, which can make it harder for women to work as vaccinators.
- Ask groups to review the Prompt Cards: Her First and read about reasons why men and women may have different barriers to immunization.
Guide participants to brainstorm gender barriers: ask groups to think about their community and discuss:
- “Which of the three to five priority barriers identified in Module C are experienced differently by women and men?”
- “Are there any other barriers to immunization that women in this community may experience more than men?” </aside>
- Groups should write down any new gender barriers they have identified.
Guide groups to prioritise the top three to five barriers: if groups added any new barriers related to gender, ask them to look back at their previous prioritised barriers and prioritise the top three to five total barriers that the strategy will focus on for their community.
Summarise strategy decisions on the Strategy Summary Poster 2
- It’s time to summarise the decisions made around the priority barriers for each community onto the Immunization Demand Strategy.
- Ask each group to review the Strategy Summary Poster 2 and document on it:
  - The prioritised three to five barriers the strategy will focus on for their community—this includes any barriers related to gender or social equality.
  - For each barrier, they should make a note of which category the barrier belongs to.
  - For each barrier, they should specify when the barrier happens in the column, “When does this barrier happen?”
    - Before immunization: Issues like not knowing about vaccines, fear, or trouble getting to the clinic.
    - During immunization: Problems at the clinic, like long waits, rude staff, or feeling uncomfortable.
    - After immunization: Challenges like following up for the next dose, managing side effects, or remembering future appointments.
    - Some barriers can occur at all three moments—if that’s the case, select all three.
    - For each barrier, they should mark whether the barrier has a gender component to it.
Put Strategy Summary Poster 2 on the wall:
- Ask each group to put their Strategy Summary Poster 2 on the wall next to Strategy Summary Poster 1.
- Great work! You are starting to build the Immunization Demand Strategy on the wall.
- If any group added any new barriers around gender which they prioritised for the strategy, ask them to share these with the group.

Facilitation Tip

Encourage women to speak first during discussions. Refer to the Facilitation Tips for guides on how to do this.
Make sure gender-related barriers are clearly noted as priorities.