In December 2021, VillageReach launched two COVID-19 specific vaccination sites – also known as “vaccinodromes” in Francophone countries – that are geared towards increasing vaccine uptake in Côte d’Ivoire and the Democratic Republic of Congo (DRC) . When planning for the sites, there were many things put into consideration to ensure community acceptance and achieve the intended outcomes. Based on our work so far, here are some logistical considerations that we learned from our experience in Abidjan, Côte d’Ivoire.
1. Buy-in is fundamental
Before a site is set up, there must be buy-in from stakeholders at different levels of the health system and from the community. These include national stakeholders such as the Ministry of Health, district officials, and the population living in the surroundings. This enables public health interventions to be more targeted and also receive much needed support. At this preliminary stage, efforts must be made to address concerns that groups may have in order to create a plan moving forward. The Abidjan team sought input from the Ministry of Health (including the Minister and General Director of Health in Côte d’Ivoire), district health officials, and community leaders. This enabled them to gain traction in launching and implementing the site.
2. Budget matters
One of the most important factors to the success of a vaccinodrome is the development of a comprehensive budget and a costing tool. After the initial consultations with key stakeholders, it became clear to the Abidjan team that the cost to set up the site would be very high. As a result, there was a pressing need to keep costs under control and stay within budget. In preparing the budget, there was a critical need to be aware of donor stipulations, regarding spending while keeping in mind unplanned costs that were not outlined at the onset of funding. Knowing how to spend against the different categories of expenditures and the allocation of financial resources will allow you the most control for maximum vaccination output of the site. When working with partners, it is critical to pay close attention to the cost-sharing options so that there can be clarity regarding financing responsibilities. Moreover, a contingency plan should be created that can address rising costs and other unforeseen circumstances.
3. Location, location, location
Arguably, the location of the vaccinodrome is the most critical logistical factor considered when planning. The current Yopougon location was chosen because that area of the city tends to have high traffic, which in turn could lead to more demand. The Abidjan team took into consideration the numerous ways that visitors can access the site – whether by car, bus, and bicycle or on foot. In Abidjan, the VillageReach team was strategic in setting up the vaccinodrome at Yopougon, which is normally a sports center, near a COVID-19 testing site. This strategy considered how the vaccination efforts complement the testing activities in order to increase vaccine uptake. When choosing a location for your site, understand what the target user needs are and preferences, including factors such as ease of accessibility, time of day, and safety. The hours of operation need to be communicated properly, and visitors should find the site to be convenient and safe. In addition, it also has to be able to accommodate a large volume of people especially if high throughput is the goal at hand.
4. It’s all about the people
In planning the site, determine the number of staff personnel you need to manage the volume of visitors. These personnel can be supplied by the Ministry of Health or district health officials in order to ensure that vaccine deployment is aligned with the overall national strategy. Moreover, staff payment should be aligned with the salary scale established at the national level in order to be compliant with the existing system. When staffing, identify the personnel that would be part of the direct operations such as vaccinators, vaccine preparers, on-call physicians, data clerks, greeters – both clinical and non-clinical staff. As the site is getting ready to open to the public, there should be clarity on where some staff would be stationed during peak periods of the supply wave or how to re-route visitors when issues arise.
5. Optimizing the visitor experience
In establishing the Yopougon site, there was heavy emphasis on creating a high quality and optimal visitor experience that can also encourage others (through word of mouth) to get a vaccine. In preparing to set up a vaccinodrome, the design of the visitor flow should take into consideration various factors: how visitors would register, where they would sit, resting areas, after vaccination, and more. Additionally, there is a need to standardize the process, which in turn can lead to a highly efficient site. In standardizing the flow of visitors, there is also a need to ensure that they are educated on what to expect onsite and informed about the privacy provisions that are available.
6. Get the word out there
When setting up vaccination sites, it is critical to pay attention to demand both for planning but more importantly to meet your vaccination goals. That said, driving demand helps inform how the site is staffed and the supply of the vaccines needed in order to avoid wasting resources. In setting up a site, demand can be increased through a plethora of ways: adverts on television and radio, working with community groups, community health worker outreach, local ambassadors, and community sensitization efforts. The launch of the site should include a robust awareness campaign so that those who visit are able to encourage others early on. Similarly, you should invite key members of the community with power and influence to speak at the site and if possible, get a vaccine. This would establish credibility and encourage individuals that are uncertain about being vaccinated. As the site is up and running, outreach activities should be intensified so that there can be more awareness of the site.
We applied these tactics in the opening of the vaccinodrome in Abidjan and another site in Kinshasa, DRC. We are taking the findings from these two sites to better inform the planning of a second site in Kinshasa and in standardizing our COVID-19 vaccine uptake model for future adaptation by partners and governments. In addition, we also suggest that you share your key learnings and insights by being part of a learning collective such as the Global Mass Vaccination Site Collaborative (GMVSC).
This post is the first in a series of blogs covering VillageReach’s collaborative efforts in increasing COVID-19 vaccine uptake. For more information about VillageReach’s COVID-19 Vaccine Delivery work, please contact Vidya Sampath, firstname.lastname@example.org
Photo credits: Conexion Photography