Fernanda Mussa, a health professional in Namorroi, Zambézia, was frustrated by the lack of community involvement in how immunization services were provided, feeling like more could be done to reach caregivers with live-saving vaccines.
But now, that has changed.
The Bate-Papo Vacina! (Let’s Talk About Vaccines!) solution introduced in Namorroi and Gile, co-created with local communities, actively involves caregivers of fully- and partially-vaccinated children, health workers community health workers (locally known as agentes polivalentes elementares (APEs)) and community leaders from Gilé and Namarroi to improve immunization access.
In the nine months of implementation, the solution has contributed to fully immunizing 6,989 children, representing 84% of the target for the year. “Bate-Papo achieves its goals of ensuring that children under two years old in the most hard-to-reach communities have access to vaccines,” said Fernanda, who works at the Mudine Namarroi Health Center in Zambézia Province, Mozambique.“Bate-Papo achieves its goals of ensuring that children under two years old in the most hard-to-reach communities have access to vaccines.” - Fernanda Mussa, Mozambique health care worker Click To Tweet
With less than a year since its implementation, it is clear that when communities are involved in developing solutions to local problems, they are brought into the success of those solutions, leading to better outcomes for everyone.
Extensive Reach through Mobile Brigades and Education
According to Fernanda, Bate-Papo has led to many positive changes at the community, health facility and district levels, showing the importance of community involvement.
The Bate-Papo solution in Zambézia has three core components: immunization education, mobile brigade prioritization and collaborative immunization activity. Each component brings together various community members, demonstrating the scope of this collaboration.
“The main lessons learned from implementing Bate-Papo include … the importance of communicating with caregivers when undertaking vaccination; the importance of the involvement of community leaders and APEs in planning and executing mobile brigades, and the importance of educational tools [cards] in the mobilization process.”
According to APEs and Health Workers, the educational component especially has empowered caregivers to share what they’ve learned about the importance of vaccination with others.
VillageReach and provincial health authorities partnered with Stanford’s Digital Medic to create pictorial cards which health care workers (HCWs) and APEs disseminate, delivering three key messages: (1) the routine immunization schedule, (2) vaccine side effects and how to treat them and (3) how to involve other family members in the immunization process.
These pictorial cards are handed out during individual and group education sessions. VillageReach also uses large poster versions of the cards at the health facilities during group education sessions. These cards also link caregivers to the AlôVida hotline for more information.
APEs and HCWs are trained to deliver key messages and provide an interactive and communicative immunization experience for caregivers of children under two years old. This includes explaining the vaccination procedure to caregivers, what to expect, and listening and responding to their concerns.
“Caregivers now know the importance of the vaccine and share it with other mothers,” said Fernanda. “Since the implementation of the Bate-Papo, the mothers have given a lot of importance to vaccinations.”
“Based on the educational cards, they can now share information – from the vaccine calendar to side effects and primary post-vaccine care,” said Faife Aguenta, a community health worker (APE) at Namarroi.Health Workers Celebrate Community Involvement in Mozambique Immunization Initiative Click To Tweet
Additionally, the mobile brigades and focal points, which were a part of the collaborative immunization planning alongside APEs, HCWs and elected community leaders, have also helped expand the reach of vaccination information and immunization access. These mobile brigades prioritize the communities furthest from the health facility and have the highest number of immunization dropouts.
“With the involvement of the community focal points, community leaders, and APES in planning and executing mobile brigades, everything is made easier because the information reaches the community, and with the educational cards, they are able to expand the information,” said Fernanda.
While it is still early days of implementation, health care workers in Namarroi like Fernanda and Faifa agree: by putting people and communities at the center of health care decisions, we are one step closer to transforming health care delivery to reach everyone.
To learn more about how the Bate-Papo community-centered solution is making a difference in people’s lives, you can read the first blog post in this series. We look forward to sharing more about how Bate-Papo drives systems-level change in our final story.
About Bate Papo
From February 2020 to February 2022, VillageReach, funded by the Wellcome Trust, worked collaboratively with the Zambézia Provincial Health Department to understand the barriers that prevent complete vaccination in children under two.
Since September 2022, VillageReach has begun to pilot this co-created solution in 11 health facilities in the Gilé and Namarroi districts, aiming to increase the demand for immunization services and reduce dropout rates in the hardest-to-reach communities with the greatest needs.