Combatting COVID-19 vaccine hesitancy through community mobilisers in the Democratic Republic of the Congo

In a busy marketplace in Goma, capital of the Democratic Republic of the Congo’s North Kivu Province’s, curious children crowd around a man wearing a neon yellow safety vest and cloth mask. He is offering a short lesson on how to prevent the spread of COVID-19.

He’s one of a team of UNICEF-trained community mobilisers who take to the streets every Friday, raising awareness about COVID-19 vaccines. Some of the women on the outskirts of the crowd look sceptical. Misinformation and rumours about vaccines have left many people wary in this Central African nation – and keen for information they can trust.

Even as many countries relax their COVID-19 restrictions measures, the risk remains that more contagious variants may emerge, prolonging the pandemic and potentially altering the effectiveness of the current arsenal of vaccines.

“We’re very afraid. We don’t know what to do,” says Riziki Luanda, a Goma resident.

Vaccination rates in high-income countries are 67 times higher than those of low-income countries, and Africa, in particular, has lagged far behind. Vaccine hesitancy on the continent is said to be one of the factors slowing the region's progress. As of 8 May, records there have been 86,767 cases and 1337 deaths in the country according to the WHO. And by that date, the number of vaccine doses administered was just over 1% (1,017,308) of the population of 93 million.

Raising awareness

Health safety messaging campaigns are a critical part of activities to curb the spread of COVID-19. As a key element of the Access to COVID-19 Tools Accelerator (ACT-A) – a global health partnership established to ensure that vaccines are distributed equitably worldwide – aid and humanitarian agencies are not only coordinating procurement and delivery of vaccine doses through the COVAX Facility, but also paving the way for a successful rollout by increasing vaccine confidence.

The outreach workers in Goma are skilled at earning the community’s trust, encouraging those who are eligible to get vaccinated as soon as supplies become available, and combatting vaccine hesitancy by sharing facts about the safety and efficacy of COVID-19 vaccines.

“We are the bridge between the national health system and the community,” says Deogratis M. Mulahuko, president of Goma’s community health centre. “That’s why we are called community relays. Our strategy ensures that the population is adequately informed. Our families are in this community, and by working within our community where we are known, there’s trust.”

Bulonza Rutangila Noella lost her neighbour to the pandemic. She says, “I have been a community liaison officer here in North Kivu Province for two years now. My neighbour was a community relay. She has already passed away, but because of all the good that she did for us, I decided to become a community relay too.”

For her, educating her neighbours about the importance of being vaccinated is more than just a job. It’s a way to protect her family and honour the local health workers who came before her.

Increasing trust

Even as many countries relax their COVID-19 restriction measures, the risk remains that more contagious variants may emerge, prolonging the pandemic and potentially altering the effectiveness of the current arsenal of vaccines. 

Thus, getting vaccines out to countries like DRC is critical. But people need to want to take them.

“The most important ingredient to any vaccine is trust,” UNICEF Executive Director Henrietta Fore wrote in an open letter to the world’s children. Vaccine hesitancy goes far beyond COVID-19 vaccines, Fore added, noting that in 2019, the World Health Organization cited vaccine hesitancy as one of the top 10 threats to global health. “Without trust, vaccines are just expensive vials in a doctor’s cabinet.”