A new survey has identified the factors that contributed to the success of both Covid-19 and routine vaccination programmes in Rwanda, as well as the lessons that could enhance efforts to ensure the vaccination of all children in the country, where the current coverage stands at 96 per cent.

The survey carried out in February, was led by Rinda Ubuzima, a local health NGO, through the Turindane project. It was conducted in partnership with the Rwanda Biomedical Centre (RBC) and UNICEF.

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The study covered five districts across Rwanda, namely Kirehe, Musanze, Gisagara, Gasabo, Nyagatare, and Rubavu. It encompassed a diverse population, including women, men, and youth aged 18 and above in the selected districts, along with programme managers and healthcare providers.

Presenting the survey findings during a dissemination meeting on December 7, Julien Mahoro Niyingabira, the Rwanda Health Communication Centre (RHCC) Division Manager, said that 70.63 per cent of the participants reported they accessed the vaccine-related information through different channels in the community, with 99.89 per cent confirming the information being useful, while 88.91 per cent didn’t get any information on vaccines’ side effects.

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In terms of attitudes, 64.57 per cent of participants reported that both parents decide on vaccine uptake, while 55.66 per cent said that mothers are responsible for vaccination (gender role). Additionally, in terms of preferences, 64.11 per cent of participants reported that vaccine appointments are reminded by vaccination cards, while 22.96 per cent prefer to receive SMS reminders.

In terms of public perception, 95.89 per cent indicated that they believe the community has achieved full vaccination while younger individuals showed the least confidence in routine vaccines, likely stemming from limited knowledge on the subject.

Niyingabira attributed the success of Rwanda’s vaccination efforts to robust capacity-building initiatives for community health workers and their partnership with healthcare providers, as well as the strategic use of Information, Education, and Communication materials (IECs) within health facilities.

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Regarding the recommendations, he pointed out using peer groups to address vaccine hesitancy cases, particularly in situations where relying on leaders has proven ineffective.

"Conducting home visits to follow up with individuals who have defaulted on their vaccination appointments is also important. This facilitates interpersonal information sharing regarding vaccination status,” he added.

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Another problem spotted during the survey is the distance from their residence to vaccination points as well as congestion at vaccination sites.

According to Marie Michele Umulisa, the Executive Director of Rinda Ubuzima, there’s a need to extend vaccine availability to secondary health posts.

"This would facilitate the process for parents, as some have reported difficulties in reaching health centres, resulting in missed vaccinations for their children,” she said.

Umulisa also emphasised the importance of encouraging men to participate in getting their children vaccinated.

"Men’s involvement in taking children to the hospital is currently low, and culturally, this responsibility often falls on women. Increased participation from men could help bridge gaps, particularly when their wives are weak after giving birth or facing other challenges,” she said.

The data by RBC reveals a positive trend, with 96 per cent of Rwandan children receiving all required vaccines, an increase from 76 per cent in 2000.

Dr Hassan Sibomana, the EPI Manager for Rwanda at RBC, highlighted that the remaining 4 per cent comprises parents who refrain from participating due to poor understanding or misinformation, religious beliefs, and carelessness.

"Vaccination services are provided free of charge, regardless of whether one has health insurance. Achieving a 100 per cent vaccination rate requires continued collaboration with individuals, local governments, health providers, and other stakeholders,” he emphasised.