BRAVO (Behavioural Research for Advancing VacciNatiOn)

Implementing organisation: Health Economics and Epidemiology Research Office 



Project objectives: To rapidly determine whether removing hassle factors, re-framing available choices, leveraging social norms and incentives have the potential to increase COVID-19 vaccine registrations and uptake.



Intervention description: We will provide technical support to the National Department of Health, the DG Murray Trust (DGMT) and existing partners involved in the current COVID-19 national vaccine programme to co-design interventions to promote adoption and sustainability of contextually relevant interventions and to increase vaccine registrations and uptake in South Africa. Technical support will include using behavioural insights to adapt existing interventions and generate evidence to support the scalability of approaches that show greatest impact.


We propose two approaches to reach the project objectives: 


Approach 1: Vaccination site BE-informed interventions 

  • District level leaderboard – will be used to encourage competition between the vaccination sites to reach vaccination targets
  • Social rewards – district managers will nominate vaccination sites to receive social rewards based on the type of interventions that they implement at site level to improve vaccine uptake and vaccination uptake rates.
  • Lucky draws – vaccination sites that create demand for vaccine uptake will  be entered into a lucky draw system.


Approach 2: Client-focussed BE-informed interventions

  • Social proof sms to encourage others to vaccinate – an sms will be sent to the vaccinated client during the 10 minutes recovery period to share with people who have not vaccinated. This sms will appeal to barriers of hesitancy
  • Support the design of EVDS messaging – Support the revision and design of BE-informed messages sent through the EVDS system. Support the design of vouchers used for the Vooma Vaccine campaign
  • Using social media as social proof to encourage others to vaccinate – We will encourage clients at vaccination sites to post their experiences as they go through the vaccination process on social media
  • Lucky draws – eligible clients who have just received a vaccine will be invited to take part in the lucky draw



Evaluation description: This will be a descriptive pre-post evaluation design that will compare differences between the pre-intervention, intervention and post-intervention periods in the selected intervention districts.


DGMT will give us access to de-identified social listening data that has been collected since May 2021. We will use this data to conduct a retrospective analysis to identify patterns and trends on barriers and facilitators to COVID-19 vaccine registration and uptake.



Project outcomes: The project outcomes will include: 1) COVID-19 vaccine registration, 2) COVID-19 vaccine uptake and 3) COVID-19 completed vaccine schedule. 



Project site: We propose setting-up demonstration sites in approximately 3 – 6 districts from 2 provinces to implement the package of interventions. Data from approximately 3-6 other districts within the selected provinces that do not use the proposed package of interventions will be identified as the comparison vaccination sites. All vaccination sites within the selected districts will be part of the project, including but are not limited to, primary health care facilities, mobile vaccination sites and mass vaccination sites.



Target population: The inclusion and exclusion criteria will be different for the 2 proposed approaches. 


Approach 1: Vaccination site BE-informed interventions

Inclusion criteriaAll vaccination sites within the selected districts will be part of the project

Exclusion criteria: There will be no exclusion criteria.


Approach 2: Client-focussed BE-informed interventions

Inclusion criteria:

  • Unvaccinated clients who are eligible for the vaccine and are receiving their vaccine dose at selected vaccination sites
  • Clients who receive the single dose vaccine at the selected vaccination sites
  • Clients who have received one dose of a 2-dose vaccine, and are receiving the second dose at the selected vaccination sites

 Exclusion criteria:

  • Clients that were fully vaccinated prior to the set-up of the project
  • For the lucky draws, 12-17 year olds will be excluded



Target sites: We will work in collaboration with NDoH to select the districts using some of the following assumptions:

  • Estimated number of individuals who are eligible to receive the vaccine 
  • Estimated percentage of eligible individuals that have already received the vaccine, prior to the intervention
  • Location of the vaccination sites (urban, peri-urban or rural settings)


The selection criteria for the districts will not be limited to these assumptions.



Duration: 12 months