Building trust and empathy: communication intervention improving provider skills, resilience, and vaccine communication in Nigeria

Healthcare providers are trusted sources of vaccine information, yet community engagement on COVID-19 vaccination remained limited in Nigeria. This study evaluated the Building Trust and Empathy (BTE) intervention to strengthen providers' communication skills and resilience. A pre–post quasi-experimental study with delayed follow-up was conducted in secondary and tertiary health facilities across four Nigerian states. Of 2,637 providers trained, 501 completed matched pre- and post-training assessments, and 221 completed a follow-up survey 4–8 months later. The intervention combined two-day in-person training, 6–8 weeks of WhatsApp coaching, and four weeks of interactive voice response reinforcement. Knowledge and counselling practices improved significantly after training, with gains sustained at follow-up. Providers completing all intervention components reported greater improvements in community-provider interactions and vaccine counselling behaviours. These findings suggest that multicomponent communication interventions can strengthen provider capacity and support more effective, resilient vaccine communication programs in Nigeria and similar settings.