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When Mozambique became one of the first countries to roll out the R21 malaria vaccine in 2024, it was a moment of hope. But introducing a new vaccine is never just about supply or logistics — it is about ensuring trust, turning evidence into practice and adapting delivery to real-world conditions. That’s why in July 2025, health leaders, vaccinators and partners gathered in Mocuba, Zambézia for a dissemination workshop.
Participants came together to debate, question and prioritize how to act on the findings of the Behavioral and Social Drivers (BeSD) study. The report highlighted community perceptions and service barriers, and the workshop was where those findings were transformed into operational commitments for the next phase of the R21 rollout.
Grounding solutions in frontline experience
The Mocuba workshop was deliberately local in focus. Thirty participants, from provincial and district health managers to community health workers and vaccinators, convened to reflect on what the BeSD findings meant in practice. Instead of a top-down presentation, the workshop was designed as a space for dialogue.
Dr. Marcos Isaías, Zambézia’s Provincial Chief Medical Officer, set the tone by urging participants to treat the data as a springboard for action. He opened the session by underscoring the importance of analyzing the study results and urged EPI managers to translate findings into actionable solutions, particularly around improving vaccination data quality.
Workshop Highlights
The workshop served as a dynamic forum to share and discuss the BeSD results with those most directly involved in vaccinating children, ensuring that conversations were grounded in real-world experience. Insights from provincial, district and partner representatives enriched the dialogue, turning data into practical strategies for action.
Dr. Issa Hibahimo, Zambézia Provincial PAV Manager, outlined the province’s experience with rolling out the malaria vaccine. He detailed the logistical preparations, vaccinator training and social mobilization that supported the campaign. While training began later than planned, all vaccinators were eventually completed Malaria vaccination training, leading to strong participation during vaccination week. However, challenges such as a mismatch between the number of vaccination teams and available recording tools limited optimal data capture.
During the plenary debate, Dr. Arlindo Banze, representing the EPI at the Ministry of Health, observed that the BeSD findings echoed previous studies but emphasized the need for innovative solutions, integrated within the RED/REC strategy, to achieve stronger results. He called on partners to sustain communication efforts and urged districts to enhance interpersonal engagement to counter misinformation and stimulate demand.
District-level experiences added another layer of insight. In Milange and Quelimane, health teams reported challenges such as outdated or missing child health cards and recurring questions from community members, including: “Why doesn’t the malaria vaccine cover adults?” These experiences highlighted the need for clearer messaging around eligibility and target age groups to build understanding and trust.
After the Workshop
The workshop concluded with consensus on several priority actions to strengthen the introduction and expansion of the malaria vaccine in Zambézia and beyond:
Strengthen Training and Capacity Building
- Conduct vaccinator training, including for community health workers, well in advance of rollout.
- Emphasize that the malaria vaccine is fully integrated into the routine immunization schedule.
- Include modules on recognizing and managing side effects, as well as effective community communication.
Enhance Social Mobilization and Advocacy
- Intensify community engagement through targeted messaging for caregivers.
- Engage community leaders and local structures to reinforce demand.
- Strengthen advocacy efforts with district and community authorities.
Improve Logistics and Service Delivery
- Develop and share a clear rollout schedule with all stakeholders.
- Expand cold chain capacity, including the provision of larger refrigerators.
- Ensure sufficient registration and recording tools for all vaccination teams.
Strengthen Data Quality and Monitoring
- Conduct regular performance reviews for district EPI managers.
- Implement routine data audits to address inconsistencies.
- Apply RED/REC strategies to integrate community-driven solutions effectively.
Address District-Level Operational Challenges
- Standardize and update child health cards.
- Communicate clearly the target age groups for malaria vaccination.
Why this matters
The workshop mattered because it moved beyond identifying challenges to collectively owning the response to these barriers. Participants left with clarity on next steps, from building stronger data systems to ensuring community leaders are part of vaccine mobilization. Importantly, the process reinforced local leadership, aligning district-level priorities with national goals for vaccine expansion.
It also underscored a lesson that is relevant well beyond Mozambique: the rollout of a malaria vaccine is not a one-off event, but a long-term process of adaptation. It requires listening to frontline workers, engaging communities, and refining systems so that every dose reaches the children who need it.
Looking ahead
As Dr. Banze from the Ministry of Health reminded the participants, now is the chance to translate lessons into practical, locally owned strategies. With the malaria vaccine increasingly integrated into Mozambique’s routine immunization schedule, the workshop marked a turning point: from piloting to scaling, from data to delivery.
Participants left energized and deeply committed. Their reflections emphasized that expanding malaria vaccination is not only about the vaccine itself, but about building relationships, respect and trust between health workers and caregivers.