COVID-19 Vaccine DistributionReaching the Last Mile: a continued & expanded journey
Three years into the COVID-19 pandemic,unequal support to populations to enhance vaccine delivery and uptake continue to impact who does and does not receive protection from COVID-19 through vaccination. At present 69% of people worldwide – but still only 26% of people in low-income countries – have received at least one dose. CARE and partners continue to support vaccine equity by working to facilitate improved access to vaccines and address misinformation, concerns and other barriers to improve vaccine uptake. Increasingly, these efforts are paired with larger initiatives that strive to reduce equity gaps across a range of essential health services, including sexual and reproductive health and gender-based violence response services.
CARE’s Fast and Fair COVID-19 Vaccine Response Initiative is tackling obstacles to vaccine delivery in some of the world’s most challenging environments. Since January 2021, Fast and Fair has supported vaccine delivery in 27 countries, contributing to the vaccination of over 100 million people.
CARE’s support for vaccination has reached more than 100 million people in 27 countries:
Sub-Saharan Africa: Benin, Burundi, Cameroon, DRC, Ghana, Kenya, Malawi, Nigeria, Rwanda, Sierra Leone, South Sudan, Tanzania, Uganda, Zambia, Zimbabwe
Asia: Bangladesh, India, Nepal, Pakistan, Papua New Guinea, Philippines
Latin America/Caribbean: Ecuador, Guatemala, Haiti, Honduras
Middle East/North Africa: Iraq, Jordan
Spotlight on Guatemala
In Guatemala, CARE is working in municipalities with largely rural and indigenous populations, groups that have among the lowest vaccination rates in the country. Lack of investment and information tailored to these communities have been barriers contributing to the low rates.
To address these gaps, CARE is working with local partner, Association of Community Health Services (ASECSA), a non-governmental, non-profit association comprised of a network of 58 community health organizations, to improve access to information through campaigns and trusted community actors. Together, CARE and ASECA are working to strengthen equitable COVID-19 vaccine delivery by engaging trusted actors at the community level, developing targeted information campaigns in local languages, and supporting trainings for community-based midwives and health promoters to support vaccine delivery.
For example, after Ministry of Health reports revealed lower acceptance of the vaccine among pregnant women, CARE and partners collaborated with a health center providing prenatal care to organize culturally relevant talks with this important group. Healthcare workers shared information with members of the Kaqchikel community about the increased risks linked to COVID-19 during pregnancy, updates related to safety and protective benefits and answered questions to address specific concerns. The project supported talks with 85 pregnant women and 10 of their male partners. After the talks, the health center saw an increase in vaccination, with 80% of pregnant Kaqchikel women who attended their prenatal care appointment completing a full COVID-19 vaccination protocol.
Our priorities include:
Increasing vaccine confidence and addressing barriers:
- Working with community leaders and other influencers, and conducting dialogues to address rumors, misinformation, social and gender norms and other barriers to vaccine acceptance.
- Bringing together healthcare providers and community members to identify and address issues negatively impacting vaccine delivery.
Improving last-mile distribution by addressing the bottlenecks that cause vaccines to get stuck in capital cities and expire before getting into the arms of individuals:
- Mobilizing funding to cover logistical costs such as transportation to bring vaccines to remote areas.
- Ensuring the availability of healthcare staff and community mobilizers to provide accurate information, promote vaccine confidence and administer vaccines.
- Supporting deployment costs of vaccinators, volunteers and healthcare workers, including training, transportation, salaries and funds to offset food and travel costs.
- Providing materials and supplies such as personal protective equipment and handwashing stations.
Protecting and empowering front-line health workers (FLHWs).
- Raising awareness that the wellbeing, training and compensation of FLHWs – over 70% of whom are women – are critical to vaccine rollout.
- Working to mentor, train, compensate and support new and existing FLHWs to meet the increased demand for vaccines.
Spotlight on Zambia
CARE Zambia works in 3 districts - Mpika, Chinsali and Isoka - in Muchinga Province to support equitable availability and distribution of COVID-19 vaccines. Key actions to advance this work include influencing policy makers at national, provincial and district levels; prioritizing important risk groups such as health care providers, refugees, and other vulnerable populations; and striving to combat stigma and build trust to reduce vaccine hesitance.
At district level, CARE Zambia initiated and facilitated meetings with partners to identify areas with low COVID-19 vaccine coverage. CARE provides transport and fuel to improve COVID-19 vaccine distribution in these areas to support last mile delivery. At facility and district levels, CARE continues to provide lunch allowances for Data Entry Clerks who work overtime to ensure that data is regularly and reliably updated. CARE also continues to work closely with critical partners including community groups and influential actors such as village chiefs and clergy members to support vaccination.
At the start, Muchinga Province had a relatively low coverage rate. Through targeted efforts, it has improved to become the fourth province to reach the 70% vaccination coverage target. As of December 2022, Muchinga Province has achieved 89% coverage.
Strengthening overall health care:
- Helping ensure the continuity of sexual and reproductive health (SRH) services that have been drastically affected by impacts of the pandemic.
- Improving the overall state of primary health care systems that are critical to controlling the COVID-19 pandemic – especially in remote and marginalized communities.
- Supporting administrative functions such as additional support to key staff supporting COVID-19 vaccination efforts through training or allowances to cover overtime hours.
Leveraging CARE’s experience in epidemics
CARE has long been a leader in response to epidemics – Ebola in West Africa and DRC, cholera in Haiti and Nigeria, and many others. That experience gives CARE a strategic advantage in:
- Readiness: From prepositioned supplies and personnel to longer-term systems and infrastructure strengthening.
- Local Leadership: Management that ensures quick action but puts decision-making close to affected populations.
- Community Engagement: CARE’s trusted reputation built on decades of local relationships – enabling effective outreach for vaccines and disease surveillance.
- Sustainability: Programs designed with an exit strategy in mind – to strengthen local systems and hand over activities to local partners.
Help us maintain our momentum
The world urgently needs a renewed commitment to effective COVID-19 vaccine delivery that increases vaccine confidence, overcomes last-mile barriers, ensures access for women and marginalized communities, addresses broader health care needs, and leaves behind a stronger and more resilient primary health care system.
CARE is helping make these goals a reality in 27 countries. Your continued support to CARE’s Fast and Fair COVID-19 Vaccine Response Initiative is vital. We offer our sincere gratitude for your solidarity and generosity.
https://ourworldindata.org/covid-vaccinations, accessed February 13, 2023