Lights, Camera, Vaccination: The Impact of Interactive Theater in Reaching the Unreached

The more people who are vaccinated against COVID-19, the fewer opportunities the disease has to spread. In Bangladesh, the government, through a partnership with USAID-funded Breakthrough ACTION social and behavior change project, is using an innovative tool to ensure that even hard-to-reach individuals, especially children and ethnic minorities in rural areas, are vaccinated against COVID-19: interactive popular theater.

In November 2022, Breakthrough ACTION conducted a comprehensive rapid assessment to explore people’s perceptions of the COVID-19 vaccination booster dose and vaccination for children aged five to 11 years in Bangladesh. These findings shed light on the existing hesitations and barriers that need to be addressed to ensure comprehensive vaccine coverage. Among the sample of 1,009 community members who participated in the assessment, almost all (99%) expressed their acceptance of vaccinating children aged five to 11 years against COVID-19. However, a small proportion of respondents—particularly those in rural and hard-to-reach areas—remained hesitant, citing concerns about the safety and potential side effects of the vaccine.

With its ability to grab attention and entertain while delivering information, interactive popular theater (IPT) is the perfect tool to break through people’s lingering doubts and fears. And because IPT does not depend on the written word to deliver information, it is especially suited for addressing vaccine hesitancy among young children and in rural areas, where literacy levels are low.From November 2022 to February 2023, Breakthrough ACTION has put on 54 IPT shows across Shariatpur, Netrokona, and Jhalokathi in Bangladesh, the three districts with lowest vaccination rates according to Bangladesh government’s COVID-19 vaccination dashboard. The project tailored the shows’ content to motivate people who were hesitant either to take the vaccine or to get their children between the ages of five and 11 vaccinated.

The IPT shows first enacted a story that reflected vaccination hesitancy in the community. The IPT show facilitator then conducted interactive sessions where the audience was asked questions based on what they observed throughout the show. Participants who answered correctly were given prizes, reinforcing encouragement to the audience to get the vaccine for themselves and to encourage their friends and family, young and old, to get vaccinated.

Breakthrough ACTION also conducted two shows specifically for the Garo people, an ethnic community of Bangladesh located in Birishiri, Netrokona. A local theatre group consisting of people from the same community performed in the shows developed by Breakthrough ACTION. Sinthiya Maji (24), a theatre artist from the district who played the character of a health worker in the IPT shows, said:

“It was easier to spread crucial messages of COVID-19 vaccination among people in hard-to-reach areas this way. They were able to understand and grab the information shared through entertainment. A few people from the audience even came up to us (performers and facilitator) to re-check information and promised to go back to their family members for further vaccination (booster doses and vaccine registration for their children).”

~ Sinthiya Maji, theater artist, Netrokona District

In total, the 54 IPT shows reached more than 8,000 people, including many young children and their parents. These shows were an integral component of a comprehensive outreach campaign conducted by Breakthrough ACTION that used creative approaches such as puppet shows, boat campaigns, and community sessions. These diverse approaches were strategically designed to reach a wide range of audiences and engage communities in conversations about COVID-19 vaccination. By using entertainment as a medium to convey important messages, Breakthrough ACTION has encouraged local artists to spread awareness and encourage communities to act and get vaccinated. This initiative exemplifies how even significant health challenges like the COVID-19 pandemic can be tackled with thoughtful creativity. It is also a reminder that community engagement and participation are key to achieving healthy outcomes that benefit everyone.

Written by: Rakhshindah Akhtar, Program Officer, Breakthrough ACTION, and Zakia Haq Neela, Senior Program Officer, Breakthrough ACTION