Access to orthopaedic care in Rwanda

Ottobock and UPHLS training healthcare workers in rural regions

OBJECTIVE:

The East African Health Platform (EAHP), African Afya Initiative (AAI) and the Council Health Management (CHM) Team jointly collaborated and successfully implemented a Vaccination Sensitization Campaign in the rural outskirts of Tanzania. The objective of the campaign was to erase misinformation and disinformation around the COVID-19 pandemic that has affected not only Tanzania but also the world., The partnership sought to debunk the myths connected with the vaccines by providing key information given by the Government of Tanzania as measures for fighting the COVID-19 pandemic as well as educating the population about the importance of the COVID-19 vaccine uptake.

 

METHODOLOGY & STRATEGY:

EAHP and AAI supported the CHM-Team to engage with, sensitize and inform community leaders and health service staff at local dispensaries through on-site meetings, public address (PA) announcements, and radio broadcasts. The information given was to support behavioural change by promoting positive sanitation practices and answering questions regarding concerns surrounding vaccine availability, type and the vaccination processes. To engage the local community and pass the message across,  all of the communication was done in the local Maasai language.

The following methods and strategies were used to raise awareness, eradicate false information and provided science-based facts to the communities:

  1. Mass education by using Public Address (PA) to reach those who were not found during door-to-door visits.
  2. Conducted door-to-door visits with the aim of administering vaccination to the citizens that could not access the same.
  3. Engaging with key Government officials,  local tribe leaders and other influential offices in inform and educate them.
  4. Deploy community leaders (laigwanans) that are trusted within their community to sensitize and inform their community.
  5. Engage Community Health Workers to provide fact-based information and perform the vaccination for those who are interested.

Two specific areas were selected to initiate this five-day campaign, based on the low COVID-19 vaccine uptake. These were:

  • Kemunbeine
  • Gelailumbwa

 

ACHIEVEMENTS:

The communities were sensitized on how to adopt healthy, sanitary measures against the pandemic by adhering to the following:

  1. Washing hands often by using soap and running water
  2. Using alcohol-based hand rub (sanitizers)
  3. Covering the nose and mouth using the elbow when coughing or sneezing
  4. Wearing the mask properly when necessary (e.g. crowded areas such as churches, public transport, etc.)
  5. Practising social distancing if possible, i.e. at least 1-meter distance to the next person
  6. The community gets access to the vaccines against COVID-19 and at the same time gets their vaccine certificates onsite.
  7. Data acquisition was prompt and on-time updating of information to the district and regional level by a well-coordinated CHMT on-site and CHMT at the office.

 

The teams, through and with their local leaders, were able to address the concerns of the communities and gave additional and important information so that more people were willing to get vaccinated.

CHALLENGES:

Through the vaccination process at the two areas, there were some hiccups that were encountered;

  1. How to access the local communities: Due to the difficult geographical locations of houses, which are vastly distributed and difficult to reach by car, access to the locals was an issue.
  2. The CHM Team need to be better supported (e.g. motorcycle, fuel payment, etc.) to reach the remotest areas in order to get in contact with the communities.
  3. Lack of awareness: Some of the people contacted were not aware at all about COVID-19 disease, or if so, have received fake news.
  4. Community leaders are the best channels to disseminate information to the community, despite this information being provided by the PHC. Therefore, community leaders are important to these campaigns.
  5. Gaining trust of community members and trying to clarify the misinformation that they have around the pandemic and the COVID vaccine with the aim of changing their point of view by using science-based facts and information.

 

WAY FORWARD:

In order to ensure that peripheral areas are reached by AAI, EAHP and the CHM Teams to stand a chance to achieve the goal of a 60% vaccination rate in Tanzania,  the below are the recommendations proposed;

  • Engaging with and informing the community leaders and community health care workers to provide the information and to gain the trust of the community members.
  • Supporting the “Word-by-Mouth” approach. Those who were willingly vaccinated are good ambassadors, therefore, motivate them to spread the information to other communities and areas.
  • Providing sufficient finances to the CHM Teams to perform further awareness and sensitization meetings.
  • Ensuring that the CHM Teams will be able to visit the above-mentioned communities in order to provide them with the second vaccine doses.