Taking Covid-19 vaccines to remote areas
INTRODUCTION
Right to Care is supporting South Africa’s National Department of Health (NDOH) and several regional departments of health with their Covid-19 response and vaccination programmes. Its vaccine support is focused on the largely rural provinces of Eastern Cape, Northern Cape, Free State and Mpumalanga. The organisation is using its large-scale comprehensive HIV care and treatment and disaster medicine experience to roll-out a programme of unprecedented scale and complexity. Right to Care is also supporting the NDOH with its Electronic Vaccination Data System.
USAID is a primary funder of Right to Care’s Covid-19 response and vaccination work.
Right to Care’s vaccine commitment
Right to Care is playing a key role to reach SA’s vaccine target of 70% of the eligible vaccine population – approximately 40 million South Africans – by March 2022.
To reach the national vaccine target:
- No single entity can work alone
- Collaboration across sectors is required.
The ability to access a vaccine centre depends on the:
- Distance to a vaccine site
- Availability of public transport
- Levels of socio-economic vulnerability
- Available public information about the Covid-19 vaccines
- A person’s health status.
The private sector can play a more significant role in major metros and secondary cities. The further away from major urban centres, the greater the need for donor-funded not-for-profit organisations to support the NDOH with vaccine rollout.
Sisonke study informs public vaccine programme in rural areas
In early 2021, Right to Care supported the NDOH with the Sisonke study which saw nearly 500 000 healthcare workers vaccinated with the one-dose Johnson & Johnson vaccine. We also set up a call centre manned by doctors and nurses for queries around any adverse effects.
Right to Care targeted healthcare workers in remote facilities, deploying mobile teams and mobile pharmacies to ensure ‘the last-mile’ was covered.
Many of the facilities in the Eastern Cape were in deep-rural areas. We vaccinated over half of all healthcare workers in this province.
Using the systems developed during the Sisonke study to reach healthcare workers in remote facilities, Right to Care began scaling a remote area public vaccine programme to reach South Africans living in hard-to-reach places across four provinces
Vaccinations at the remote Empilisweni District Hospital near the Lesotho border
Vaccination staff at Empilisweni District Hospital
Right to Care’s vaccination efforts at the remote Empilisweni District Hospital
Remote vaccine programme
Approximately one third of South Africans live in rural areas. Vaccine distribution is complicated outside of major centres. Mobile outreach is a critical part of Right to Care’s vaccine programme in remote areas.
Right to Care’s rural vaccination drive relies on:
- Sophisticated Geographic Information System (GIS) technology to assess routes and plan the transportation of vaccines from central to peripheral distribution sites.
- Experienced pharmacy teams who use these maps to establish the best place to store and distribute the vaccines.
- Information technology experts to ensure that the right infrastructure is in place including security and internet connectivity.
- Cold chain planning to ensure vaccines remain at the right temperature.
Example of a vaccine drive
Lusikisiki is a town in the Eastern Cape. Right to Care set up a vaccination site at the popular Boxer discount store where many pensioners receive their monthly payouts.
Boosting vaccine take up
To make sure we vaccinate as many people as possible at every site, Right to Care:
Vaccine hesitancy is not just an unwillingness to vaccinate. Limited access to vaccination sites is a major challenge.
“No-one should be left out of the vaccine programme, including people living in far flung areas.” – Dr Ntombi Sigwebela, chief of party for vaccinations at Right to Care.
“Our approach is to take people to vaccines in urban areas and to take vaccines to people in rural areas.” – Wendy Ovens, vaccine programme lead in the Eastern Cape.
Our vaccine team
Each vaccine team comprises professional nurses, data capturers, drivers and a pharmacist.
Their work is directed by:
Our Head of Planning and Logistics whose role is to:
- Determine and schedule the human resource requirements of each vaccine site
- Allocate equipment
- Coordinate vaccine teams
- Manage mobile teams
- Allocate and manage vehicles.
Our Stakeholder Management and Liaison Officer whose role is to:
- Coordinate with the health sub-district
- Identify, coordinate and manage stakeholders
- Facilitate weekly debriefing sessions.
Our Clinical Specialist whose role is to:
- Coordinate with the provincial pharmacy team to secure supply of vaccines
- Engage local pharmacists and relevant regional personnel to access vaccines daily, determine the number of vials for each outreach site, ensure the safe transportation of vaccines, ensure effective cold chain management, manage onsite pharmacists, provide pharmacovigilance and clinical oversight.
Our Programme Lead whose role is:
- Project development and strategy
- Spatial planning and site selection
- Project coordination including planning and logistics oversight, risk management and mitigation
- Reporting
- Coordination with Provincial, District and Sub-district Department of Health
- To secure and manage funding
- Monitoring and evaluation.
SA’s Electronic Vaccination Data System (EVDS)
Right to Care also supported the NDOH to develop and ramp up its Electronic Vaccination Data System (EVDS). The EVDS is a centralised web-based solution designed for the capturing of all vaccination events at all sites and is supported by extensive data analytics to monitor, plan and report. It allows every vaccine decision to be informed by real-time data.
Key features of the EVDS include:
• Ensuring that vaccines are distributed and administered fairly across population groups and in rural and urban areas.
• Monitoring every dose all the way through to a patient’s arm.
• Scheduling of vaccine sites to avoid overcrowding.
• Minimising stock wastage.
• Identifying areas where vaccine hesitancy is high and where communication efforts are needed.
To register on the EVDS, select one of these options:
• Online at https://vaccine.enroll.health.gov.za/
• Using the WhatsApp line 0600 123 456.
• Via SMS by dialling *134*832#.
• Call the Covid-19 hotline 0800 029 999.
Right to Care is playing a significant role in taking vaccines to South Africans living in hard-to-reach, remote areas where infrastructure is underdeveloped and connectivity limited. Without our rural vaccine programme, many people would not have been able to receive their Covid-19 vaccinations. While we have made great progress and have been recognised by the department of health and the local media for our achievements in taking vaccines to people in outlying areas, we need more support to expand this important programme. To vaccinate more South Africans in rural areas and achieve the herd immunity our country so desperately needs, we welcome your contribution.
Or your donations can be made to the following details:
Bank name: Standard Bank
Legal entity name: Right To Care NPC
Name of account holder: RTC COVID-19
Account number: 021556024
Account type: Business current account
Branch: Sandton city
Branch code: 018105
Branch code: 051001
Swift address: SBZA ZA JJ
