How digital communication can help drive vaccine demand and healthcare access

What a person’s future looks like depends on their access to universal rights like healthcare. Access Challenge is an organisation transforming communities through digital media. Here is what we can learn from their COVID-19 campaigns in Tanzania and the DRC.

These obstacles are complex and often overlapping – and the stakes couldn’t be higher. Because access to health care affects everything, from the day a baby is born, to the quality of life they will lead and how it will end.

People who can access affordable health care live longer, healthier lives that enable them to go to school, work and raise a family. Access, in other words, empowers people to build a prosperous future.

“We feel every person has a role to play, whether it is the president, a mother in the village, a health care provider, or a student in a school. We brought in the private sector, academics, civil society, journalists and influencers from the music industry to advance our mutual goal of driving up vaccinations.”

– Asad Lilani, Director of Political Strategy, Access Challenge

Two recent initiatives in Tanzania and DRC, led by advocacy organisation Access Challenge, harnessed digital media and community influencers to encourage uptake of COVID-19 vaccines. The outcomes show just how effective digital outreach can be in increasing access, empowering communities and giving people a life to look forward to.

As Redemptus Caesar, a TV and radio presenter who came on board as an influencer and local campaign lead in Tanzania says: “Access means hope!”

What is “access” in health care?

For Access Challenge, it means ensuring the basic, fundamental right of people being able to access essential health care support such as vaccines – and being able to do so even at a time when misinformation is rampant.

On a visit to a market in Dar es Salaam in Tanzania, the Access Challenge team quickly learnt the key to health care access: having the right information. Talking to people there, they found that many were on the fence about getting vaccinated, because they hadn’t yet received information that they trusted. The right information, provided at the right time by someone they trusted, was very important. That could be a sibling, a parent, a faith leader, or someone from their community. That crucial knowledge informed their campaigns – which took place during an unprecedented global health crisis.

A “surround-sound approach” for driving access

The development and roll-out of COVID-19 vaccines to combat the pandemic was the fastest in history, yet low-income countries, including countries in Africa, lagged behind. Less than 15% of the 1.4 billion African population had been fully vaccinated by the end of May 2022, according to the World Health Organization (WHO). In the June 2022 WHO bulletin, Tanzania and the Democratic Republic of the Congo (DRC) still had full vaccination rates below 10%. They were 6.8% and 2.5% respectively.

Access Challenge joined two campaigns to boost COVID-19 vaccination in these two countries. The first, One by One: Target COVID-19 Campaign, was launched in July 2022 in Tanzania, together with the African Union, Africa Centres for Disease Control and Prevention (Africa CDC) and WHO.

It was followed in October 2022 by the launch of a two-phase campaign in the DRC. The first phase involved One by One, while in the second phase, in April 2023, Access Challenge partnered with the African Union and others on the  AU Bingwa Initiative.

The goal in both Tanzania and the DRC was to focus on tackling vaccine hesitancy and driving vaccine uptake, particularly childhood vaccinations, alongside promoting other health behaviours, such as regular TB and HIV testing.

So how does a campaign like this achieve its goals? We spoke to Asad Lilani, Director of Political Strategy at Access Challenge, to understand their process.

Before launching a campaign, Access Challenge carries out a landscape analysis, gathering data to identify regions and cities with low vaccination rates. The data informs their targeted and inclusive communications plan, which operates by including people from all aspects of life.

“We feel every person has a role to play, whether it is the president, a mother in the village, a health care provider, or a student in a school. We brought in the private sector, academics, civil society, journalists and influencers from the music industry to advance our mutual goal of driving up vaccinations,” said Lilani.

For the campaign to be visible, accurate and effective, it must be locally led and driven by the communities it targets, such as hiring a local Tanzanian designer to put together the graphics for the Tanzania social media campaign.

With everyone on board, the campaign can be launched using what Lilani calls a “surround-sound approach”. This involves social media and influencers, but also community-based local concerts, comedy shows, sports games, youth and faith leader engagements, and vaccine-themed road shows.

“Alongside social media, we identify each of the touchpoints a person might have for us to reach them throughout the day. That means we have to use billboards, radio, comedians and musicians. We also place advertisements in taxis and on tuk-tuks because you know that when someone is sitting in traffic, they see hundreds of tuk-tuks go by,” said Lilani.

Boosting vaccine demand and uptake

The campaigns have been transformative. According to Access Challenge, in Tanzania, which has a population of nearly 65 million, they reached 36 million people in just four months and created more than 1 billion impressions, representing the frequency at which the campaign was viewed online – a number Lilani has never seen before in his work. In the DRC, the campaign reached more than 25 million people across both phases out of a population of 95 million.

This helped contribute to an increase in vaccinations. In Tanzania, where Access Challenge was one of the leading partners involved, the vaccination rate jumped from 21% in July 2022 to around 50% by the end of December 2022, based on Tanzania Ministry of Health reporting.

In the DRC, vaccination rates for those having received at least one dose were languishing below 6% in October 2022. The vaccination rates in the regions Access Challenge targeted rose and contributed to an overall increase in the vaccination rate from about 9% when the campaign started to 22%, according to figures from Africa CDC recorded at the end of the campaign.

Elevate health campaigns using digital communication

Digital and social media were critical to reaching a large number of people in a short time, especially during COVID-19, because of movement and lockdown restrictions. They were both fuelled by another factor as well – influencers with cross-border reach and impact, the value of which cannot be underestimated on a continent like Africa.

“We had an influencer in Tanzania who would post a message and when we looked at the metrics, we saw that he had followers from five countries across East Africa. When he was posting his messages, he was reaching more than 5 million people per post, across country borders,” said Lilani.

Digital communication also helps with data-gathering and analysis. It costs much less in money and effort than in-person data collection, and so allows allocation of resources to other areas where they can create more impact.

There are also wider-ranging, long-term implications of these campaigns that could keep improving vaccine demand going forward.

“We were able to change the conversation about vaccines, especially through social media platforms. For instance, in Tanzania, people are now not only discussing vaccines in regard to COVID, but vaccines in general and why they are important,” said Caesar.