Effects of engaging communities in decision-making and action through traditional and religious leaders on vaccination coverage in Cross River State, Nigeria: A cluster-randomised control trial

Background Vaccination coverage levels fall short of the Global Vaccine and Action Plan 90% target in low- middle- income countries (LMICs). Having identified traditional religious leaders (TRLs) as potential public health change agents, this study aimed at assessing effect training them to support routine immunisation for purpose improving uptake childhood vaccines Cross River State, Nigeria. Methods A cluster-randomised controlled was conducted between 2016 2019. Of 18 Local Government Areas (LGA) eight (four urban four rural LGAs) were randomized into intervention control arms. multi-component involving implemented LGAs. Baseline, midline endline surveys collected information on children aged 0–23 months. The outcomes including proportion fully up-to-date with vaccination, timely vaccination pentavalent measles vaccines, 1–3 dropout rates estimated using logistic regression models random effects account clustered data. Results total 2598 baseline, 2570 midline, 2550 included. effective increasing least one vaccine (OR 12.13 95% CI 6.03–24.41p<0.001). However, there no evidence an impact (p = 0.69). It timeliness Pentavalent 3 1.55; CI: 1.14, 2.12; p 0.005) Measles 2.81; 96% 1.93–4.1; p<0.001) vaccination. odds completing increased 1.66 1.08,2.55). Conclusion Informal enhance leaders’ knowledge their leadership role can empower be good influencers They constitute untapped resources community boost immunisation. Pan African Clinical Trial Registry (PACTR) PACTR202008784222254.