Last-mile delivery increases vaccine uptake in Sierra Leone

Less than 30% of people in Africa received a dose of the COVID-19 vaccine even 18 months after vaccine development 1 . Here, motivated by the observation that residents of remote, rural areas of Sierra Leone faced severe access difficulties 2 , we conducted an intervention with last-mile delivery of...

Full description

Saved in:

Bibliographic Details
Published in:	Nature (London) Vol. 627; no. 8004; pp. 612 - 619
Main Authors:	Meriggi, Niccolò F., Voors, Maarten, Levine, Madison, Ramakrishna, Vasudha, Kangbai, Desmond Maada, Rozelle, Michael, Tyler, Ella, Kallon, Sellu, Nabieu, Junisa, Cundy, Sarah, Mobarak, Ahmed Mushfiq
Format:	Journal Article
Language:	English
Published:	London Nature Publishing Group UK 21-03-2024 Nature Publishing Group
Subjects:	706/134 706/689/159 Child mortality Childrens health Clinical trials Community Costs COVID-19 vaccines Developing countries False information Health promotion High income Humanities and Social Sciences Immunization Industrialized nations Inoculation Intervention LDCs Literature reviews Maternal & child health Medical personnel multidisciplinary Populations Remote observing Rural areas Science Science (multidisciplinary) Teams Towns Vaccines West Africa Sierra Leone Africa
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Less than 30% of people in Africa received a dose of the COVID-19 vaccine even 18 months after vaccine development 1 . Here, motivated by the observation that residents of remote, rural areas of Sierra Leone faced severe access difficulties 2 , we conducted an intervention with last-mile delivery of doses and health professionals to the most inaccessible areas, along with community mobilization. A cluster randomized controlled trial in 150 communities showed that this intervention with mobile vaccination teams increased the immunization rate by about 26 percentage points within 48–72 h. Moreover, auxiliary populations visited our community vaccination points, which more than doubled the number of inoculations administered. The additional people vaccinated per intervention site translated to an implementation cost of US $33 per person vaccinated. Transportation to reach remote villages accounted for a large share of total intervention costs. Therefore, bundling multiple maternal and child health interventions in the same visit would further reduce costs per person treated. Current research on vaccine delivery maintains a large focus on individual behavioural issues such as hesitancy. Our study demonstrates that prioritizing mobile services to overcome access difficulties faced by remote populations in developing countries can generate increased returns in terms of uptake of health services 3 . A cluster randomized controlled trial in Sierra Leone shows that targeting access to vaccines in remote areas increases uptake, an approach that can be used to improve vaccine equity in developing countries.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3
ISSN:	0028-0836 1476-4687
DOI:	10.1038/s41586-024-07158-w