Sanitation

• In Sierra Leone almost 59% of the population live in remote, rural areas.
• Roads may be non-existent or in bad condition, making it very difficult for rural dwellers to access healthcare.

Why are vaccination rates low in Sierra Leone?

• In stark contrast, only 15% of people had been vaccinated in low-income countries.
• The hardships Sierra Leoneans face are typical of the obstacles people in low-income countries have to overcome to access healthcare.
• In the early days of the COVID-19 vaccination campaign in Sierra Leone, it took the average Sierra Leonean living in a rural community three-and-a-half hours each way to the nearest vaccination centre.

How did this vaccine drive tackle the problem?

• The primary aim of this intervention was to take vaccine doses and nurses to administer vaccines to remote, rural communities, preceded by seeking permission and community mobilisation.
• At the time, only 6% to 9% of the adults who took part in the programme were already immunised.
• The leaders were asked for their cooperation in encouraging eligible community members to take the COVID-19 vaccine.
• Finally, vaccine doses and healthcare workers arrived at the villages to administer the doses.

Looking forward

• This approach proved 76% more cost-effective than other vaccination campaigns.
• Transport accounted for a large share of the costs, so the cost-effectiveness of last mile delivery can be increased by offering a “bundle” of health products.
• Other estimates put the death toll for the same period at 14.83 million, which is 2.74 times higher.
• Developing cost-effective strategies to make vaccines easily accessible to everyone, everywhere, is the most promising solution to prevent future pandemics.

Niccolò Francesco Meriggi receives funding from Weiss Asset Management, UKRI and the International Growth Centre.