An Amref-Led Model for Community Integrated Vaccination Success: A Story of Buli Health Facility

by Amref Health Africa

To strengthen community health systems and increase equitable, sustainable access to quality Primary Health Care (PHC) for Universal Health Coverage, Amref Zambia has supported numerous health facilities. Among these, Buli Health Facility stands as a beacon of success, showcasing the power of community engagement and collaboration in overcoming vaccine hesitancy.

At Buli Health Facility, a pivotal moment unfolded when an expecting couple, deeply entrenched in fear and misinformation, adamantly refused to receive the COVID-19 vaccine. Their concerns centred around perceived risks to their unborn child, fears of miscarriage, and potential fertility problems. Despite the tireless efforts of Community-Based Volunteers (CBVs) who worked relentlessly to educate them, the couple remained hesitant.

However, a turning point came when a meeting was convened, bringing together influential community figures, including the village headman and church leaders. During this meeting, to demonstrate the absence of negative side effects of the vaccine, one CBV received their second dose, and a facility staff member received their booster shot in the presence of the couple and the community leaders. Recognizing the importance of their involvement, these leaders engaged with the hesitant couple, helping dispel myths and misinformation, and emphasizing the critical need and benefits of getting vaccinated against COVID-19. It was through this collaborative effort that the couple finally agreed to receive the vaccine, marking a significant victory in the fight against vaccine hesitancy.

“As an expectant couple, we had fears of the negative side effects that the COVID-19 vaccine might have on our unborn baby, such as miscarriage and infertility for my husband. We heard stories about vaccinated individuals becoming magnetic and feared it would complicate our future childbearing endeavours. However, after getting vaccinated while expecting, we had a successful delivery of a healthy baby. This dispelled all the myths within our community, and we have now become a point of reference for other families, especially those within childbearing age, who had similar concerns.” a statement from the couple who were initially hesitant to receive the vaccine.

Headman Chizimba (Red chitenge shirt centre) was involved as a champion of excellence to convince the Reverend (Lady in white shirt seated on the far right) to receive her vaccination

Building upon this momentum, CBVs seized the opportunity to extend the discussions to other vital vaccinations, particularly cholera. Leveraging the presence of influential community leaders, they emphasized the importance of preventive measures such as maintaining good hygiene alongside vaccination against cholera. This collective effort swiftly discredited misconceptions surrounding both COVID-19 and cholera vaccines, paving the way for a significant increase in vaccination uptake within the Buli catchment area.

The impact of these efforts has been profound. Not only has Buli Health Facility witnessed remarkable COVID-19 vaccination coverage, but the community has also remained resilient against cholera outbreaks with zero recorded cases. This success story underscores the power of community engagement, collaboration, and informed leadership in overcoming vaccine hesitancy and promoting public health.

Religion Meets Science – Transforming the Old Narrative

Similar to the Buli Health Facility initiatives, In Eastern Zambia’s Chama District, the Chama Hospital Affiliated Health Centre, supported by Amref, faced challenges related to COVID-19 hesitancy, particularly from a religious leader who championed vaccination. Despite concerted and personalized risk communication and community engagement efforts, and the involvement of fellow religious leaders, resistance persisted.

After several sensitization sessions supported by the project and with the assistance of a respected village headman, the religious leader acknowledged that her hesitancy was a result of the short timeframe in which the vaccine had been developed.

“The time frame made me think that the disease was man-made. Being a woman of reproductive age, the myths within the community were that women would become infertile, which was a huge concern as I still planned on having children. After my fellow clergy convinced me of the benefits of the vaccine, it still took reassurance from my husband to get convinced. I reluctantly took my first dose. Between my first and second doses, I got pregnant; this changed my whole perspective on the vaccine. The myths about infertility were cleared from my mind. Additionally, I have not developed any flu that caused me to be bedridden.” – Statement from the religious leader

A couple that was hesitant in receiving their vaccination. The wife standing (already taken the vaccine) and waiting for the husband to receive his vaccine as well.

This positive change in attitude attracted 640 church members to accept COVID-19 vaccinations, creating an opportunity for the risk communication team to offer further sensitization to the congregants.

These stories from Buli Health Facility and Chama District highlight the crucial role of community engagement, informed leadership, and collaboration in promoting vaccination and overcoming hesitancy. They serve as powerful examples of how targeted efforts can lead to significant public health successes.

Written by Chisha Chola – Communications Officer, Amref Health Africa – Zambia and Malawi

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