Report Open Access

Overcoming barriers to vaccine acceptance in the community: Key learning from the experiences of 734 frontline health workers

Moore, Katie; Muzzulini, Barbara; Roldán, Tamara; Bedford, Juliet; Larson, Heidi J.

Data manager(s)
Kovanovic, Vitomir
Project leader(s)
Sadki, Reda
Mbuh, Charlotte; Steed, Ian Oliver

The report analyses 734 case studies developed by frontline health workers in November 2020 as part of the COVID-19 Peer Hub, a peer learning programme led by the Geneva Learning Foundation (LinkedIn | YouTube | Twitter |  Podcast). Learn more about this report

734 health professionals from all levels of the health system took time out from their demanding daily duties to reflect on their practice, describing and then analyzing a situation in which they successfully helped an individual or a group accept or gain confidence that taking vaccines would protect them from disease. Furthermore, they did this during four weeks of remote collaboration at a very crucial historical moment, months before the first doses of COVID-19 vaccine were to arrive in Ghana and Côte d’Ivoire.

“Reading this report, I experienced a sense of discovery. The stories shared reminded me of my early work with colleagues working at the local levels, and gave me renewed appreciation of these health professionals who faced even greater challenges in the face of a deadly pandemic. I could feel how hard it is to remain that ‘most trusted adviser’ to communities, and how so much remains determined by the capacity of people on the frontlines to explain, advocate, and respond in ways that are almost entirely dictated by context, in this case a highly uncertain and evolving pandemic.” – From the preface by Heidi Larson, PhD, Professor of Anthropology, Risk and Decision Science and Founding Director of the Vaccine Confidence Project at the London School of Hygiene & Tropical Medicine.

Methodology: A mixed methods approach was adopted. The primary focus was the qualitative analysis of the case study narratives, underpinned by the quantitative analysis of demographic information about the scholars who produced the case studies. A matrix was developed to guide the coding of data presented in the case study narratives. The approach used a balance of deductive coding (using pre-defined codes derived from the research questions) and inductive coding (adding new codes in response to themes emerging in the narratives.

A total of 734 Scholars (case study authors) took part in the exercise: 81% (n=591) in West and Central Africa; 11% (n=80) in Eastern and Southern Africa; 6% (n=43) in South Asia. Scholars were engaged at different levels of the health system: 18% (n=131) at the national level; 29% (n=213) at a sub-national level; 29% (n=214) at the district level; 20% (n=144) in health facilities.

The COVID-19 Scholar Peer Hub is a digital network hosted by The Geneva Learning Foundation (TGLF). During the COVID-19 outbreak, the network convened members working in the area of immunisation whose activities had been affected by the pandemic. TGLF supported network members to generate and share ideas and practices for supporting immunisation work across health system levels, organisational boundaries and country borders. TGLF identified COVID-19 vaccine introduction as a crucial focus of action for the network and implemented a peer review exercise based on network members’ experiences of overcoming barriers to vaccine acceptance.

The study was funded by the Bill and Melinda Gates Foundation.


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