Thank you for visiting nature. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser or turn off compatibility mode in Internet Explorer. In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript. Here, motivated by the observation that residents of remote, rural areas of Sierra Leone faced severe access difficulties 2 , we conducted an intervention with last-mile delivery of doses and health professionals to the most inaccessible areas, along with community mobilization.
Moreover, auxiliary populations visited our community vaccination points, which more than doubled the number of inoculations administered. Transportation to reach remote villages accounted for a large share of total intervention costs. Therefore, bundling multiple maternal and child health interventions in the same visit would further reduce costs per person treated.
Current research on vaccine delivery maintains a large focus on individual behavioural issues such as hesitancy. Our study demonstrates that prioritizing mobile services to overcome access difficulties faced by remote populations in developing countries can generate increased returns in terms of uptake of health services 3.
Low rates of vaccination keep many countries in Africa vulnerable to the threat of disease recurrence and a renewed possibility of costly lockdowns capable of undermining employment, income generation and food security 4. Low vaccination coverage also raises the hazard of new subvariants emerging that puts the entire world at risk 5. To understand why vaccination rates remain low, we assembled data on vaccination beliefs, hesitancy and access from several countries in late ref. The primary aim of this intervention was to take vaccine doses and nurses to administer vaccines to remote, rural communities, preceded by seeking permission and community mobilization.
A cluster randomized controlled trial RCT across communities showed that the vaccination rate in treatment villages increased by about 26 percentage points in response to this intervention. In addition, large numbers of people from neighbouring communities showed up to receive vaccines at our temporary clinics. These results suggest that low vaccination rates are related to deficiencies in access and that a cost-effective intervention is capable of overcoming that deficiency.
