Do community-led programs have a role in Covid-19 vaccine preparedness? Lessons from Colombia 

Community engagement is widely acknowledged as essential for achieving effective and equitable Covid-19 vaccination to end this pandemic. Yet there is limited understanding of how development activities that are reaching vulnerable populations can support this effort. In many under-resourced settings, large-scale vaccination is just beginning, yet variable vaccine acceptance and politicization of the Covid-19 response threaten to limit uptake.

Early this year, Pact joined efforts to collect and contribute insights into community readiness and preparedness for the Covid-19 vaccine. Our goal was to complement other population-based surveys on intention to receive the vaccine and highlight the views of communities that Pact serves through existing programs as well as opportunities to ready them for the arrival of the vaccine. We recently completed a rapid assessment in Colombia where Pact engages with artisanal and small-scale gold miners (ASM) to improve their working conditions.

ASM and their communities are hidden populations that at a global level are being left behind in wider development efforts, including public health. Pact has worked to improve the ASM sector and the lives of artisanal miners for more than a decade. As highlighted by a recent report from the World Bank and Pact, ASM communities are highly vulnerable to the socio-economic impacts of the Covid-19 crisis.

Colombia received its first batch of Covid-19 vaccines through the World Health Organization (WHO) COVAX mechanism in March 2021. As of August 31, less than 30% of the population was fully immunized. The rapid assessment in Colombia, conducted as part of routine program monitoring and evaluation activities, aimed to obtain contextual information on community capacity needs to promote and deliver the vaccine.

Using qualitative data collection approaches in the form of focus group discussions (FGD), Pact’s local team moderated one FGD in each of these program sites: San Martin de Loba, El Bagre and Zaragoza. The FGD participants were purposely selected ASM community leaders who could provide perspectives on their personal and communities' perceptions of Covid-19 and the vaccine. Questions were semi-structured and based on a community readiness framework that we adapted from GAVI’s 4-point checklist for country readiness for the Covid-19 vaccine and the health belief model.

While awareness of basic information regarding Covid-19 is widespread in these Colombian towns, there was significantly low awareness of the benefits of Covid-19 vaccination. Persistent myths and misinformation pose notable challenges. Barriers to vaccine uptake are largely related to health, socio-political and economic issues, underscoring the need for multi-sectoral solutions to ensure successful vaccine uptake in under-resourced communities, including ASM.

Collaborative partnerships with communities, using trusted civil society organizations as the bridge, can ensure that vaccination efforts are appropriate and culturally attuned. This includes leveraging the strengths and reach of faith-based institutions and leaders as champions to enhance community trust in the vaccine. Locally-led mobile vaccination that brings services to ASM communities could also address very real limitations in accessing vaccines, such as lack of transport and desire to minimize time away from work and lost income.

Our brief report on this Colombia assessment is available here. As we continue learning and adapting to new phases of the Covid-19 pandemic, now with multiple rapid-spreading variants, we look forward to sharing more in the near future on assessments that we are now undertaking in Eswatini and South Africa.

Working in 40 countries to strengthen the capacity of community partners in solving local development challenges through multi-sectoral solutions, we hope to contribute meaningfully to the global roll-out of the Covid-19 vaccine. Our trusted relationships and networks with local governments, civil society organizations and community leaders can be leveraged to promote vaccine acceptance and to link individuals and families to vaccination services.