A COVID-19 Tipping Point in Tanzania
More vaccinations, less hesitation
With the dark gray shadow of Mount Kilimanjaro looming overhead and sun on their faces, determined community health workers walk the dusty roads of their communities day after day, vaccinating scores of people to help protect them from COVID-19.
In Arusha, a northern region of Tanzania close to Africa’s tallest peak and the border of Kenya, COVID-19 vaccinations are accelerating, and with time, resistance to getting vaccinated is gradually falling.
With support from the U.S. Government’s Initiative for Global Vaccine Access, or Global VAX, USAID has been working with the Government of Tanzania and other partners to increase vaccination rates in the country. Through targeted strategies, we have worked to increase access to the vaccine and combat misinformation about it, so more Tanzanians are able and willing to get vaccinated.
As a result, the country has more than tripled its COVID-19 vaccination rate in just over two months. As of August 19, 54% of Tanzania’s eligible population has been fully vaccinated.
While attitudes toward the COVID-19 vaccine are changing in Tanzania, it hasn’t always been easy to convince people to accept the shot. Beata Mayok, a community health worker from Moivaro Health Center on the outskirts of Arusha City, described the kind of resistance health workers sometimes face.
“A guy who welcomed us started saying, ‘Imani yetu imeshatuponya, hatuhitaji hizo chanjo zenu,’ meaning ‘in this family, we have been saved by our faith; we don’t need your vaccines,’ ” she said.
“In these kinds of situations, we try hard to educate them as much as we can. They are fed poor information on the vaccines, and what we normally do is to state the facts and sometimes let the community health worker explain more on the importance of getting vaccinated, even by using the local language.” — Beata Mayok, a community health worker
Although Swahili is the national language in Tanzania, 126 languages are spoken in the country, so communicating in the local language is critical for effective vaccine education.
While some have strong beliefs that prevent them from getting vaccinated against COVID-19, an even greater challenge is simply awareness of the vaccine and access to it. People often live tens of miles from the nearest health facility, and for a healthy individual, getting vaccinated against COVID-19 is not top-of-mind.
However, by using a door-to-door approach, Beata says her team can vaccinate up to 200 people a day.
With support from Global VAX, Beata and her colleagues used this door-to-door approach to vaccinate nearly 2,900 people in one month — compared to vaccinating 740 people during the entire six months prior, when vaccines were mainly administered at health clinics.
“We walk house to house, and sometimes we attend village meetings, visit marketplaces and also churches,” Beata said.
Gaining the support of community leaders, especially religious leaders, is key to convincing others. During community meetings, the leader sometimes holds up his vaccination card to prove that he has received the vaccine, said Anneth Meena, a health care provider at Oldonyo Sambu Health Center outside Arusha City. The leader also will remind people of how many lives have been saved by vaccines for other diseases like measles or polio.
This message hit home for Lawrence Laban, a 65-year-old community member who is now fully vaccinated against COVID-19.
“What I believe is the government will never bring a vaccine to kill its own people, so since the doctors came to my house and explained to me that based on my age I am at risk, I decided to get the vaccine,” Lawrence said.
Recalling seeing someone who suffered from COVID-19, Lawrence said: “It’s not a joke when you are in that hospital fighting to breathe.”
As more people are vaccinated and others see limited side effects from the vaccine, people’s willingness to accept it has grown. Anneth noted that people are easily influenced by others; if a neighbor sees someone being vaccinated, he or she will often get the shot, too.
In the Oldonyo Sambu community, Melusori Kibori, an elderly Maasai man, traveled more than 5 miles to a health clinic because of an injured leg, and decided to get vaccinated. As passersby saw his public vaccination, two others followed suit. The Maasai people, an ethnic group common to the northern region of Tanzania, are known to have strong cultural beliefs preferring the use of herbal medicine. Seeing the Maasai people accept the vaccine was a true sign of success.
Community health workers also work with village leaders to target large groups of people at community events and gatherings — even funerals.
In Tanzania, a funeral is typically a large event at which community health workers can vaccinate up to 200 people, according to Anneth. The village leader and community health workers speak to the family of the deceased in advance of the funeral to arrange to bring the vaccines, and the vaccinations take place after the burial.
To encourage vaccinations, the village leader reminds community members attending the funeral that the COVID-19 vaccine can keep them safe and prevent death.
This type of hyperlocal outreach and education — truly bringing the vaccines to the people — is helping change the hearts and minds of Tanzanians.
With Global VAX support, leadership of the Government of Tanzania and other partners, and the strong will and dedication of local community health workers, more Tanzanians are safer and better protected against the COVID-19 virus.
“Little by little, a little becomes a lot.” — Tanzanian Proverb
About the Authors
Megan Bordi is the Development, Outreach, and Communication Specialist for the Global VAX COVID-19 activity at USAID’s Mission in Tanzania. Frank Kimaro is a Communication Specialist/Photojournalist with Jhpiego Tanzania.
