Newsroom & Blog

Mar 8, 2022   |   Blog Post

Launching new vaccinodromes in Kinshasa

By Carla Toko

Manager, Advocacy and Communications

On December 7, 2021, the Democratic Republic of Congo (DRC) government held a national forum to discuss issues around low uptake of COVID-19 vaccinations in the country. At this convening, vaccine delivery stakeholders were encouraged to increase the number of temporary fixed sites and outreach vaccination efforts. Considering this need, VillageReach is working with the provincial government of Kinshasa to establish more vaccinodromes in public spaces of populous areas of Kinshasa.

The next three vaccinodromes will leverage some of the key learnings from the first site. With 0.47% of people fully vaccinated in Kinshasa, these vaccinodromes come in at a critical time when the government is working to ensure that nobody is left behind. As we work collaboratively, VillageReach learned from its experience in launching the first site in Gombe district which revealed the importance of getting government buy-in from the onset. What was especially important for getting buy-in up front included:

  • Getting the provincial government onboard:  The Governor of Kinshasa signed a letter authorizing the setup of a vaccinodrome in Kinshasa, which was then signed by the mayor.
  • Involving multiple stakeholders in the choice of the site. This led to a more coordinated and rapid effort. The stakeholders included the provincial minister of health, the head of the provincial health division, and the Expanded Program on Immunization (EPI).
  • It took a total of two weeks to launch the next three vaccinodromes.
Site accessibility is key

The first vaccinodrome in Gombe is located in a heavily frequented area next to schools, offices, bus stops, and workplaces. In that same vein, we knew that the additional sites would also benefit from more people if it were in a similarly busy location. For example, there are many shops and transportation hubs around the new sites, which also connect the vaccinodromes to various neighborhoods of Kinshasa, businesses, banks, and more. From our first site, we also learnt that accessibility issues were  mostly related to distance, or ability to take time off from work. Therefore, we decided to have the vaccinodromes open for longer hours each day to accommodate diverse schedules. We are also using outreach vaccination to explore ways in which we can accommodate physically-disabled people.

Understand your target demographic

From our initial rollout of the first site, women had a lower uptick in the COVID-19 vaccine (women – 25.4%, men – 74.6%). Demand generation efforts had to be geared towards women in order to increase their uptick. So how did we do this? We focused heavily on combating misinformation and rumors by working with community health workers as well as leveraging technology platforms such as VaccineCheck in order to provide trusted and reliable information about COVID-19 and getting vaccinated, including its safe use by pregnant and lactating women. Additionally, we have encouraged vaccinated women to share their experiences to assure other women about vaccine safety. We built  on the practices from the first vaccinodrome and also leveraged a new modality of vaccine deployment – outreach to women’s association through mobile /pop-up clinics. At the moment, we are also strengthening our communication strategies so that there can be stronger health behavior change messages to girls/women through targeted TV programming like novels and radio stations in public places such as markets where there is an  influx of women (either visiting or working). 

Leveraging the power of community health workers

Community health workers (CHWs) encourage individuals and families to take the vaccine, dispel misinformation, and provide vaccine doses to people. The data from our first site shows that 50% of people came from CHW referrals. Moreover, we learnt that CHWs can be incentivized through a performance bonus system for referring visitors to the site, e.g. if CHWs refer at least 10 people, they could receive a bonus of up to $10 for every 20 people that they bring.  This financial incentive motivates them to go above and beyond. It also fosters healthy competition, which can lead to more visitors through referrals. Building on our learnings, we have identified other key representative groups to work with in the community. For the additional vaccinodromes, we are working with more institutional community health workers that will also be incentivized to bring people.

Vaccinodrome outcomes depend on staffing resources

From our first site, we learnt the importance of well-planned staffing in order for the vaccination  service to be efficient. When people come to a vaccinodrome, it is ideal that they spend under  20-30 minutes in order for processes to run smoothly and to have a good experience. Achieving this is dependent on the staff personnel that are onsite. When staffing is low, it is critical that action is immediately taken to get more health personnel available. At the second site, we now rely heavily on data for staff planning to manage peak times of the day.

As we look back at the launch of the first site, we realize the need to be nimble and also adaptive as things are happening. Inflexibility  can create more challenges, especially when the current on-the-ground situation is suggesting the need to change approach. As we begin the launch of the additional vaccinodromes, we are going to keep gathering evidence that clearly highlight best practices. We also hope that the sites would show how the vaccinodrome model can deliver impactful outcomes that can improve the quality of health for people and also address the gap in current vaccination.

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