COVID-19 vaccine express strategy in Malawi: An effort to reach the un-reach

Sethy, Ghanashyam; Chisema, Mike; Sharma, Lokesh; Joshi, Krupal; Singhal, Sanjay; Nicks, Patrick Omar; Macheso, Steve; Damte, Tedla; Ba, Antoinette Eleonore; Mitambo, Collins; Thomas, Mavuto; Laher, Beverly; Phuka, John

doi:10.1016/j.vaccine.2022.07.014

Cited by 4 publications

(1 citation statement)

References 18 publications

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“…In the initial phases of vaccination, the government prioritized healthcare workers, the elderly, and other high-risk groups. By the end of 2021, the vaccine was available for everyone in the population, and the government has implemented several programs for increased COVID-19 vaccination uptake including “COVID-19 Vaccine Express” and “Vaccinate my Village” campaigns ( 45 , 46 ), which increased vaccine access in hard-to-reach communities via the use of mobile vaccination vans. The national vaccination rate (receiving at least one dose) is 26.3% for the total population as of July 2023, while the vaccination rate for the MLSFH sample used in this analysis, which focuses on older Malawians, is 46%.…”

Section: Context: Rural Malawi and Covid-19mentioning

confidence: 99%

Mortality risk information and health-seeking behavior during an epidemic

Purcell,

Kohler,

Ciancio

et al. 2024

Proc. Natl. Acad. Sci. U.S.A.

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In a context where pessimistic survival perceptions have been widespread as a result of the HIV/AIDS epidemic ( Fig. 1 A ), we study vaccine uptake and other health behaviors during the recent COVID-19 pandemic. Leveraging a longitudinal cohort study in rural Malawi that has been followed for up to 25 y, we document that a 2017 mortality risk information intervention designed to reduce pessimistic mortality perceptions ( Fig. 1 B ) resulted in improved health behavior, including COVID-19 vaccine uptake ( Fig. 1 C ). We also report indirect effects for siblings and household members. This was likely the result of a reinforcing process where the intervention triggered engagement with the healthcare system and stronger beliefs in the efficacy of modern biomedical treatments, which led to the adoption of health risk reduction behavior, including vaccine uptake. Our findings suggest that health information interventions focused on survival perceptions can be useful in promoting health behavior and participation in the formal healthcare system, even during health crises—such as the COVID-19 pandemic—that are unanticipated at the time of the intervention. We also note the importance of the intervention design, where establishing rapport, tailoring the content to the local context, and spending time with respondents to convey the information contributed to the salience of the message.

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Section: Context: Rural Malawi and Covid-19mentioning

confidence: 99%

Mortality risk information and health-seeking behavior during an epidemic

Purcell,

Kohler,

Ciancio

et al. 2024

Proc. Natl. Acad. Sci. U.S.A.

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Knowledge, attitudes and demographic drivers for COVID-19 vaccine hesitancy in Malawi

Ndasauka,

Twabi,

Kainja

et al. 2024

Sci Rep

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This study assessed the association among knowledge, attitudes and uptake of COVID-19 vaccine in Malawi, examining demographic factors influencing these variables. The study employed a quantitative research design. It thus sampled 394 participants from Malawi’s three districts of Zomba, Dowa and Nkhatabay. Results showed that 163 (41.4%) participants had low levels of knowledge of COVID-19 vaccine, 231 (58.6%) had high levels of knowledge, 237 (60.2%) had a positive attitude, and 156 (39.8%) had a negative attitude towards the COVID-19 vaccine. On vaccine uptake, the study found that only 29 (17%) male and 52 (23%) female participants had received the vaccine. Further, participants with low levels of knowledge and a positive attitude towards the vaccine were 5.9 times more likely (p-value = 0.001) to be vaccinated than those with low levels of knowledge and negative attitudes towards the vaccine. On the other hand, those with high knowledge and a positive attitude towards the vaccine were 8.2 times more likely (p-value < 0.001) to be vaccinated compared to those with low knowledge and negative attitudes towards the vaccine. The findings highlight the importance of vaccine-related knowledge and attitudes in shaping uptake and reveal disparities across demographic groups. To improve vaccination coverage in Malawi, targeted interventions focusing on enhancing COVID-19 vaccine knowledge, addressing attitudinal barriers, and countering misinformation are needed. Strategies should be tailored to reach populations with lower uptake, such as males, younger adults, and those with lower education levels. Strengthening public health messaging, engaging community leaders, and building trust in healthcare systems are crucial for promoting widespread acceptance and uptake of COVID-19 vaccines in Malawi.

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