| Summary: | Less than 30% of Africans received a dose of the COVID-19 vaccine even 18 months after
vaccine development. Motivated by the observation that residents of remote, rural areas of
Sierra Leone faced severe access difficulties, 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 shows that this intervention with mobile vaccination teams increases the vaccination rate by about 26 percentage
points within just 48-72 hours. Moreover, auxiliary populations visited our community vaccination points, more than doubling the number of shots administered. The additional people
vaccinated per intervention site translates to an implementation cost of US$ 33 per person vaccinated. Transportation to reach remote villages accounts for a large share of total intervention
costs, so bundling multiple maternal and child health interventions on the same trip would lower
costs per person treated even further. Current scholarship on vaccine delivery maintains a large
focus on individual behavioral issues like hesitancy, but this research demonstrates that prioritizing mobile services to overcome access difficulties faced by remote populations in developing
countries can generate larger returns in terms of uptake of health services.
|
|---|