Title : Improving covid-19 vaccination among people living with HIV (PLHIV) in rural areas of Sinda District, Eastern Province, Zambia
Abstract:
Background: COVID-19 has shown to put people living with HIV (PLHIV) at a higher risk of catastrophic consequences and mortality. Research suggests that PLHIV who contract Corona virus (SARS-CoV-2) are more likely to require hospitalization and have poor clinical outcomes than people who do not have HIV/AIDS. World Health Organization (WHO) recommends that all eligible Recipients of care (ROCs) on ART should be vaccinated against Covid 19. Despite this recommendation, Sinda District in Eastern Province of Zambia had a low Covid 19 vaccination coverage among ROCs standing at 38% (2967/7811) in September 2022. It was against this background that the district embarked on a QI project aimed at improving performance to 70% by end of April, 2023.
Method: The district used the Performance Improvement Approach (PIA) in which root causes were identified using the fish bone analysis, which included; ART Staff not oriented in vaccination, high refusals due to myths on Covid 19, no Covid 19 champions, Inadequate standardized Covid 19 registers, lack of transport to follow up ROCs booked for vaccination and incomplete documentation. What was done included orientation of ART staff in covid 19 vaccination (one ART staff from all 29 health facilities), involved key stakeholders in sensitization to dispel myths, Covid 19 champions identified in all facilities, improvised hard cover books and excel sheet registers as covid 19 registers in all facilities with no standardized registers, integrated Covid 19 vaccination activities in other outreach programs, vaccination done within the ART rooms, transport and allowances provided for community vaccination.
Results: The proportion of ROCs on ART who were fully vaccinated improved from 38% (2967/7811) in September 2022 to 85% (6741/7908) by end of April, 2023.
Conclusion: Stakeholder involvement, community vaccination, complete documentation and integration of covid 19 vaccination activities in other outreach programs and within ART clinics proved effective in improving the vaccination rates among PLHIV in Sinda district.
Recommendations
- Engage community stakeholders in public health awareness of already existing and emerging diseases of public health significance.
- To vaccinate clients within the ART clinic instead of referring ROCs to other vaccinating sites for proper monitoring and evaluation.
- Integration of Covid 19 vaccination in other outreach programs.
- Routine documentation of covid 19 vaccination data for all eligible ROCs vaccinated in relevant registers.
