Last-mile delivery increases vaccine uptake in Sierra Leone

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 pr...

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Main Authors: Meriggi, NF, Voors, M, Kallon, S, Tyler, E, Rozelle, M, Cundy, S, Kangbai, D, Nabieu, J, Levine, M, Ramakrishna, V, Mobarak, AM
Format: Journal article
Language:English
Published: Springer Nature 2024
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author Meriggi, NF
Voors, M
Kallon, S
Tyler, E
Rozelle, M
Cundy, S
Kangbai, D
Nabieu, J
Levine, M
Ramakrishna, V
Mobarak, AM
author_facet Meriggi, NF
Voors, M
Kallon, S
Tyler, E
Rozelle, M
Cundy, S
Kangbai, D
Nabieu, J
Levine, M
Ramakrishna, V
Mobarak, AM
author_sort Meriggi, NF
collection OXFORD
description 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.
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spelling oxford-uuid:0d910d25-3b3f-4174-b100-9349d0d8b4bd2024-05-02T11:26:24ZLast-mile delivery increases vaccine uptake in Sierra LeoneJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:0d910d25-3b3f-4174-b100-9349d0d8b4bdEnglishSymplectic ElementsSpringer Nature2024Meriggi, NFVoors, MKallon, STyler, ERozelle, MCundy, SKangbai, DNabieu, JLevine, MRamakrishna, VMobarak, AMLess 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.
spellingShingle Meriggi, NF
Voors, M
Kallon, S
Tyler, E
Rozelle, M
Cundy, S
Kangbai, D
Nabieu, J
Levine, M
Ramakrishna, V
Mobarak, AM
Last-mile delivery increases vaccine uptake in Sierra Leone
title Last-mile delivery increases vaccine uptake in Sierra Leone
title_full Last-mile delivery increases vaccine uptake in Sierra Leone
title_fullStr Last-mile delivery increases vaccine uptake in Sierra Leone
title_full_unstemmed Last-mile delivery increases vaccine uptake in Sierra Leone
title_short Last-mile delivery increases vaccine uptake in Sierra Leone
title_sort last mile delivery increases vaccine uptake in sierra leone
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