JMIR Publications

ABSTRACT

Background:

The World Health Organization (WHO) recommends that countries routinely collect data on the behavioral and social drivers (BeSD) of vaccination to inform responsive public health interventions that increase vaccine uptake. There is a need to identify data collection methods that can rapidly and inexpensively collect representative data, particularly in low and middle-Income countries (LMICs).

Objective:

To understand BeSD drivers of vaccination in the Philippines and assess the trade-offs between survey methods, we compared responses to household, mobile, and online data surveys by demographics, vaccination status, responses to BeSD questions, and cost.

Methods:

We conducted concurrent household, mobile, and online surveys among caregivers of children two years and below in the Philippines Regions V and XII, with sampling differing by survey method. We assessed, for each survey method, 1) respondent demographics by sex, age, region, and socio-economic status of respondents, and 2) the weighted proportion of responses from caregivers of children that received at least one dose of diphtheria-pertussis, tetanus (DPT) vaccine. We estimated the weighted proportion of each BeSD survey response option. We calculated the financial cost (monetary outlays) to conduct the survey per survey response from an implementer’s perspective by summing the cost incurred in each survey method and dividing by the number of responses received.

Results:

We surveyed a total of 1,201 household respondents, 2,153 mobile respondents, and 398 online respondents during January—March 2025. We found that online and mobile survey respondents were more likely to be male and have completed high school than household survey respondents. The weighted proportion of respondents indicating that their child had received at least one dose of DPT vaccine was 91.8% for the household survey, 90.3% for the mobile survey, and 85.0% for the online survey. With regards to vaccine demand, more than 85% of respondents in each survey method indicated that vaccines are very important, very safe, supported by family, and knew where to bring a child for vaccination. More than 30% of mobile and online survey respondents indicated it was not at all easy to pay for vaccination. The financial cost to conduct the survey per survey response was $2.61 USD for the online survey, $6.93 USD for the mobile survey, and $29.38 USD for the household survey.

Conclusions:

Within context of an LMIC, we found that each of the survey methods reached caregivers of children who were unvaccinated against DPT, and these proportions were similar for household and mobile survey respondents. BeSD responses indicated high vaccine demand and were consistent across methods, with challenges reported in caregivers’ cost to access vaccination. Despite limitations in representativeness for demographics and DPT vaccination status, mobile and online methods can be considered as a lower-cost alternative to rapidly collect BeSD data in LMICs.