April 2023 — As COVID-19 vaccination programmes enter their third year, existing challenges to programmes combine with new needs, complexities, and hesitancies. Vaccination programmes require innovative solutions to scale up COVID-19 vaccination efforts, from administering booster doses to reaching those who have yet to receive their first COVID-19 vaccination. In addition, COVID-19 is no longer the top priority for many populations or countries. In the second half of 2022, resources have been shifted to new emergencies such as the Ebola and cholera outbreaks in the region. This signals the need to consider innovative ways to integrate COVID-19 programmes into routine services moving forward and to shift from an emergency to a development mentality. 

This Social Science synthesis draws on evidence from academic and grey literature, review of available data, programme documents and rapid consultations with partners working in COVID-19 vaccination programmes. It was developed by Anthrologica for the Collective Service at the request of UNICEF East and Southern Africa Regional Office (ESARO).

This synthesis first presents an overview of the vaccination context in three Eastern and Southern Africa Region countries: Malawi, Kenya, and Uganda. It examines community-side (demand-related) challenges to improving vaccination uptake and discusses challenges from the provider side. The synthesis outlines approaches used to increase vaccine coverage and improve supply and discusses the implementation of these approaches into vaccination programmes in each country. Innovative solutions, related lessons learned and recommendations are highlighted in the end to inform vaccination programmes in Malawi, Kenya, and Uganda and for vaccination efforts going forward. 

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