July 2023 — The COVID-19 pandemic had led to over 760 million confirmed cases and 6.9 million deaths worldwide as of June of 2023. The United Nations Children’s Fund (UNICEF) contracted GeoPoll in August 2022 to conduct a Rapid Needs Assessment survey in Angola, Comoros, Ethiopia, Madagascar, Malawi and Tanzania in the Eastern and Southern Africa Region (ESAR) to inform the progression of behavior change programming related to COVID-19 immunization, routine childhood immunization, and maternal newborn child health (MNCH) services in the context of the COVID-19 pandemic.

UNICEF conducts a variety of social and behavior change (SBC) programming in the health sector across East Africa. Rapid assessments of community perceptions and behaviors are essential to tailor local programming after historic disruptions to the health sector and changes in health seeking behavior over the course of the COVID-19 pandemic. According to the African Centers for Disease Control and Prevention, many East African countries still have low COVID-19 vaccination rates. By June of 2023, rates of full vaccination within the eligible population varied across the six countries featured in this report from higher rates of vaccination in Comoros (80%) and Tanzania (89%) to lower rates in Angola (39%) and Ethiopia (55%). The lowest vaccination rates among the six countries were in Malawi (23%) and Madagascar (11%). Data collected in these needs assessments will support programming intended to increase demand for COVID-19 vaccination across all six countries of interest.

Research has highlighted that the effects of the COVID-19 pandemic on MNCH services could lead to as much as 30% more maternal and newborn child deaths in some low-middle-income country (LMIC) settings. This is due to the combined effects of lockdowns meant to reduce COVID-19 transmission, a diversion of resources and a reduced focus on MNCH services due to prioritization of COVID-19, and amplified economic constraints. Moreover, research demonstrated the importance of high quality fixed site service, as well as the severe consequences of the COVID-19 pandemic on community outreach activities. Behavior change programming in these six countries of interest aims to address key dimensions of maternal and newborn children mortality including routine immunization coverage, and healthcare utilization during and after pregnancy. According to the Demographic Health Survey (DHS) data collected before the COVID-19 pandemic in 2015, full vaccination coverage for children up to 12 months old varied across the six countries with Angola at 32%, Ethiopia at 38% in 2016, Malawi at 75% in 2015, and Tanzania at 75% at 2015. SBC interventions must be customized to country-level circumstances and take the post-COVID-19 public health context into consideration.

To read the full Aggregate Report here, and Methodological Report here.