The Power of Community-Based Networks
How strategies applied for COVID-19 vaccination in India can improve routine immunization coverage
Women from the Kondh tribe in Odisha, India, after receiving their COVID-19 vaccination. / USAID
Mosli Diggal is an older woman from the tribal area of the remote Phulbani District in Odisha, India. Like many people at the start of the COVID-19 pandemic, Mosli and her family had limited knowledge about COVID-19 and how to protect themselves from it.
“People in my community believed that the virus was a curse from God and it would be destroyed by God. Hence, the vaccines were considered irrelevant,” Mosli said.
Among India’s tribal population, COVID-19 vaccine uptake has been low stemming from misconceptions about the vaccine, geographic barriers to access, and other factors.
Mosli Diggal poses for a photo after receiving her COVID-19 vaccination. USAID provides support for increased community awareness and vaccination efforts in her village.
USAID
With USAID’s support, local NGOs and government officials have helped dispel myths in Mosli’s community and improve access to COVID-19 vaccines by leveraging community networks, a model also being applied to improving routine immunization.
This model leverages community connections and leaders as well as local languages and works with the community to identify barriers and solutions to increase vaccination.
Together, with country leadership and partners, we’ve made significant progress to reach remote, hard-to-reach populations. Nevertheless, the impacts of the pandemic and other simultaneous stressors require urgent efforts to catch up underserved communities.
The COVID-19 pandemic caused the worst continued backslide in global immunization in 30 years, according to the World Health Organization. Reaching the hardest-to-reach places, such as the village where Mosli’s family lives, is critical to closing the vaccination gap for the millions of children who missed essential, lifesaving vaccines in 2020 and 2021.
Community health workers engage in door-to-door COVID-19 prevention and vaccination information discussions.
USAID
"The Big Catch-Up” is the theme for World Immunization Week this year, which highlights the efforts needed to protect people from vaccine-preventable diseases. This theme underscores the need for action to catch up the 67 million children who missed out on vaccines during the COVID-19 pandemic, restore essential immunization coverage, and strengthen primary health care.
As of now, one in five children worldwide have missed out completely or are only partially vaccinated against life-threatening diseases.
The continued effects of ongoing conflicts, crises, the COVID-19 pandemic, climate change, and other stressors have severely impacted maternal and child health. As the world rises to meet these new challenges, USAID’s Preventing Child and Maternal Deaths: A Framework for Action in a Changing World, 2023–2030, will guide the collective action needed to regain momentum and meet the 2030 Sustainable Development Goals.
The new framework outlines strategies to enhance maternal and child survival in the next decade by improving the quality, equity, and coverage of primary health care services–including reaching the hardest-to-reach populations with essential vaccines.
A student from a school for the blind in Maharashtra, India, is vaccinated with support from USAID.
USAID
USAID’s model of bringing NGOs together with state and local health authorities to extend the reach of government health services is now being applied to catch up on routine immunization country-wide. In 2021 alone, 2.5 million children in India were not vaccinated against measles, and 2.1 million children did not receive their first dose of the DTP1 vaccine, which protects against diphtheria, tetanus, and pertussis.
Since August 2021, USAID’s MOMENTUM Routine Immunization Transformation and Equity Project has partnered with the Government of India and a network of local NGOs across 18 states to bring equitable COVID-19 vaccination to underserved populations, including Mosli’s community.
Local NGOs are often better positioned to support these communities and are essential to increase routine immunization because they are already trusted by the community members.
The NGOs worked with faith-based organizations, youth clubs, schools, and community leaders to communicate that COVID-19 vaccines are safe, effective, and necessary to prevent the spread of the virus. By holding community meetings, working through local advocates, and conducting vaccination events, these messages reached people through a variety of familiar and trusted platforms.
Members of a tribal community in Odisha, India, attend an educational community meeting about COVID-19 vaccines.
USAID
USAID-supported efforts have increased demand, access, and uptake of COVID-19 vaccination, directly supporting more than 15.6 million people to receive COVID-19 vaccines and over 55 million people to access reliable information about COVID-19 across India.
When USAID first visited Mosli’s community for regular counseling sessions to address misconceptions around COVID-19 vaccines, she was hesitant to get vaccinated. She and her family had heard rumors about the vaccine and were fearful that it could hurt them.
However, after attending multiple community awareness sessions, Mosli’s mind began to change:
“Once all my queries were answered and I was convinced of the importance of [the] vaccine, I took my first dose.”
USAID plans to work with government agencies and local leaders to create effective communications campaigns tailored to specific communities to successfully increase demand for essential immunizations, including those that protect against life threatening diseases like, measles, polio, diphtheria, tetanus, and pertussis.
A community member in Assam, India, participates in a signature campaign after receiving their first COVID-19 vaccine.
USAID
As India strives to reach the Sustainable Development Goals by 2030, USAID’s new framework and partnerships will be vital for increasing routine immunization coverage across the country to increase maternal and child survival.
Today, vulnerable populations in USAID project-supported states are largely vaccinated against COVID-19, thanks to the diligent efforts of Indian state governments, USAID-supported local NGOs, and countless community collaborators.
Mosli and her family are now among the millions in India that are fully vaccinated against COVID-19, thanks to USAID’s partnership with local vaccine champions. Mosli has since received her COVID-19 booster dose and is confident in the power of vaccines to help her stay healthy and protected from vaccine-preventable diseases in the future.
About the Author
USAID’s Office of Maternal and Child Health and Nutrition works to ensure that all women and children have the same chance of a healthy life, regardless of where they live or are born.