A public map of the 2026 Bundibugyo virus outbreak
An interactive record of how Bundibugyo virus disease spread in 2026, limited to claims a person has approved.
Cases, contacts, and sources on one map
Field research
Childhood immunization and vaccine hesitancy in Pampanga, Philippines
A mixed-methods field study of childhood immunization in three areas of Pampanga, Philippines, conducted in collaboration with NGO Reaching Zero-Dose Children.
- Study field
- Global health
- Discipline
- Field research
- Year
- 2026
- Duration
- Fieldwork 1–19 June 2026; analysis ongoing
The challenge
National and provincial vaccination rates give an overall picture. Looking at individual communities and households shows children who still have few chances to be vaccinated. Whether a child is vaccinated depends on vaccine supply, distance to a health facility, floods and other conditions, family and work, the information families meet, and their relationship with health services.
The study, carried out in collaboration with NGO Reaching Zero-Dose Children, a youth-led NGO incorporated in Japan, set out to understand these factors in three areas of Pampanga Province: the municipalities of Masantol and Macabebe, and Barangay Sapangbato in Angeles City. Masantol and Macabebe face chronic flooding. Sapangbato lies in the hilly foothills of Mount Pinatubo.
What we did
The team spent one week in each area, from 1 to 19 June 2026, working with local medical students, local government, and Barangay Health Workers (BHWs). Parents and primary caregivers of children aged two or younger, including fathers and grandparents, answered a face-to-face questionnaire based on the WHO SAGE Vaccine Hesitancy Scale, as adapted for the Philippines. A subset of caregivers, and BHWs, took part in semi-structured interviews. The study used Filipino, English, and Kapampangan as each situation required.
Matt, Diaphana’s founder and one of the report’s four authors, managed the study and collected data in the field. Diaphana also built and provided a web tool for annotating the qualitative data. A reviewer plays an interview, checks its transcript and English translation segment by segment, and corrects them. Each change is logged, so the record shows who changed what. We are considering releasing the tool as open source.
The study began with a focus on vaccine hesitancy. In the communities, the team found that the question “Why do families choose not to vaccinate?” was not enough. It was just as important to ask “Why are families unable to vaccinate even when they want to?” A few kilometres mean different things when roads flood, when a boat is needed, or when a caregiver cannot take time off work. Decisions were also made with grandparents, neighbours, and BHWs, not by caregivers alone.
Analysis of the questionnaires and interviews is under way. The findings will be published in papers and at conferences, and shared with BHWs and local government in each area. The report states its aim this way: not to tell communities from outside that they should vaccinate, but to understand what keeps each family and community from vaccination services, and to reduce those barriers one by one.
The study was conducted in collaboration with NGO Reaching Zero-Dose Children , which publishes the report.
Results
- 417 caregivers surveyed across the three areas
- Barriers differed by area: floods and water transport, unstable vaccine supply, mountain roads and travel costs
- Delayed or incomplete vaccination did not necessarily reflect negative views of vaccines
- Trusted BHWs linked households and the health system
- Preliminary findings presented to about 50 staff in Masantol
- A web tool for annotating interview transcripts and translations
Contact
Write to Diaphana
For questions about our work, or about working with us, write to [email protected].