Accepted for/Published in: JMIR Formative Research
Date Submitted: Oct 24, 2025
Date Accepted: Apr 7, 2026
Stakeholder Experiences with the PCV Chatbot as a Complementary Capacity-Building Tool for Frontline Health Workers in India: a Qualitative Study
ABSTRACT
Background:
Pneumonia remains the leading cause of under-five mortality globally, with India bearing a disproportionately high burden. The introduction of the Pneumococcal Conjugate Vaccine (PCV) in India necessitated innovative approaches to support frontline health workers (FLHWs), particularly in remote settings. To address this, a customizable WhatsApp-based PCV chatbot was developed as a complementary tool to traditional training and reference materials.
Objective:
To document the opportunities, challenges, and mitigation measures encountered during the development and roll-out of the PCV chatbot, and to assess its utility and user experience as a capacity-building and support tool for FLHWs during new vaccine introduction.
Methods:
A qualitative study was conducted across four Indian states—Arunachal Pradesh, Delhi, Karnataka, and West Bengal—using purposive sampling at the district and block levels. Data collection involved key informant interviews (KIIs) with immunization officials and chatbot developers, and focus group discussions (FGDs) with Auxiliary Nurse Midwives (ANMs). A Likert scale-based tool captured quantitative feedback on user satisfaction.
Results:
Stakeholders appreciated the chatbot’s accessibility, familiarity (through WhatsApp), and multilingual functionality. Most ANMs found it easy to use and rated responses highly for completeness and usefulness. The chatbot enabled immediate access to information, saving time and bridging gaps, especially when traditional training was delayed or unavailable in hard-to-reach areas. Challenges included occasional technical issues, limited content related to dropout and left-out scenarios, and difficulties in typing regional languages. Recommendations included implementing predictive text, expanding scenario coverage, and strengthening user-centered design and field testing.
Conclusions:
The PCV chatbot demonstrated acceptability and perceived value as an on-demand knowledge tool among FLHWs. Continuous user-driven refinement, expanded content, and enhanced usability are essential for its scalability and sustained utility in vaccine introduction and capacity-building efforts. Clinical Trial: IRB Certificate Number: Convergent IRB/2024-25/015
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