Cultural tailoring of vaccination messages: leveraging culturally adapted audio messaging in the promotion of maternal and infant vaccination uptake in rural communities in Nigeria.

BACKGROUND: Despite global gains from immunization, vaccination coverage in rural Nigeria remains suboptimal. Barriers include poor healthcare access, cultural beliefs, vaccine hesitancy, misinformation, and communication gaps. Standardized campaigns often fail to resonate with local realities. This study explored the use of culturally adapted local music, a familiar and trusted medium, to deliver relatable immunization messages. The aim was to develop and assess the impact of culturally tailored audio messages on maternal and infant vaccination knowledge, attitudes, and willingness among rural women. METHODS: A mixed-methods design was employed. Twenty caregivers participated in Key Informant Interviews guided by the Health Belief Model, and data were thematically analyzed to inform culturally relevant messages. These were adapted into three versions of local music and delivered sequentially in a single workshop session to enhance comprehension, retention, and engagement. Effectiveness was assessed immediately before and after the intervention using structured surveys. Data were analyzed with the Wilcoxon Signed-Rank Test; and effect size was calculated using Cohen's r, with significance set at p ≤ 0.05. RESULTS: Qualitative findings (N = 20) revealed low perceived susceptibility to vaccine-preventable diseases, misconceptions about vulnerability, reliance on traditional remedies, and barriers such as mistrust, limited access, and gender dynamics. Social influences and health worker guidance emerged as important cues to action. These insights shaped the culturally adapted messages. In the quantitative phase (N = 193), knowledge scores increased significantly post-intervention (Z = 4.155, p < 0.001, r ≈ 0.30), indicating a moderate effect. Attitudes showed a positive but non-significant trend (p = 0.127), and willingness to vaccinate remained unchanged (p = 0.809). Participant feedback indicated that the familiar, music-based format enhanced message relatability and perceived trustworthiness, fostering dialogue and suggesting potential cumulative effects if sustained. CONCLUSION: Culturally tailored audio messaging rooted in local music significantly enhanced vaccination knowledge and perceived trustworthiness. Although no immediate behavioural change was observed, the participatory process fostered early perceptual shifts that may facilitate long-term uptake. This approach offers a promising and replicable strategy for advancing maternal and child health while promoting health equity in similar resource-limited settings.