September 2022 — Since the COVID-19 crisis, UNICEF Eswatini has been working with multisectoral partners to improve vaccine uptake. As of January 2022, only 38.8% of the total eligible population in Eswatini was fully vaccinated. As part of a quick re-assessment of the current situation to drive implementation recommendations, the UNICEF Eswatini RCCE team identified its priority groups as vulnerable elderly, healthcare workers and youth to move towards the goal of reaching a vaccination rate of 70% by June 2022.

UNICEF Eswatini entered into its first-ever partnership with GOARN (Global Outbreak Alert Response Network) at WHO and NUSYLLSOM (National University of Singapore Yong Loo Lin School of Medicine) for a RCCE consultant to be deployed to Eswatini on surge mission. The team embarked on a mixed methods assessment, using U-report and a series of focus group discussions to identify the knowledge, attitudes and perceptions of people using the BeSD (Behavior and Social Drivers) framework. With the guidance of the UNICEF ESARO SBC, a social and behavioural assessment was designed and contextualized for Eswatini’s context to identify barriers and inform the vaccine uptake in liaison with ESACREDT WG. The evidence generated from the assessments resulted in data-driven programmatic and policy recommendations for specific target groups, which were shared across RCCE TWGs, senior management of MOH and other stakeholders.

A RCCE training was also developed to enhance the capacity of Rural Health Motivators, Red Cross Volunteers, Faith Leaders and other community mobilizers and influencers to collect feedback and promote confidence and adherence to the vaccination programme. Piloted by a group of Rural Health Motivators and youth facilitators, the training was further refined and contextualized for the local context. A youth facilitator from Super Buddies said: “This training taught me the importance of empathy and active listening. It helped me to realize I have the responsibility to engage my peers.”

To strengthen coordination between national, regional and subregional levels, UNICEF Eswatini, in coordination with the regional ESACREDT, supported the national RCCE TWG to convene, conduct a mapping, and mobilize the participation of strategic partners to support the promotion of the COVID-19 vaccination plan and strengthen linkages with the subnational structures. In particular, the first-ever youth stakeholder meeting comprised 13 different youth organizations.

Lessons Learnt and Way Forward:

• The approach to assessing multiple stakeholders and priority groups overcame barriers of working in silos, bringing together diverse partners to improve coordination and solve complex problems in service delivery. It is hoped that by using evidence generated through qualitative research, analyzing data and translating it into actionable recommendations to various stakeholders, these efforts will help to improve coordination, remove barriers to vaccines and improve service delivery.

• Leveraging these opportunities could be made possible by engaging diverse multisectoral responses at all levels. This reminds us of the central role of communication at all levels of society and the critical role UNICEF plays in engaging policymakers, donors, governments and other decision-makers to better integrate and scale SBCC approaches into programmatic and policy decisions.

• To foster greater accountability and impact, coordination at national, regional and subregional levels must be strengthened, with government authorities taking the lead forward.