Kenya began rolling out COVID-19 vaccinations to its adult population in March 2021 and its teenage population with Pfizer in November 2021. By the end of 2021, Kenya had administered 10.1 million doses of five types of COVID-19 vaccines, with 4.2 million people being fully vaccinated and 5.9 million partially vaccinated.

To help expand the vaccination coverage in the large Kasarani sub-county of Nairobi, the Ministry of Health partnered with Amref Health Africa, a leading international non-governmental organization, and Project Last Mile, leveraging the organizations’ strategic advisory in demand creation and decentralized vaccine service delivery. This partnership helped to strengthen vaccine planning and the health workforce, create demand for vaccines, and increase vaccine access via decentralized administration points.

Improving access through activating additional vaccination sites

“With a new vaccine, of course, there were several challenges in terms of vaccine delivery to the community because initially, when we started COVID-19 vaccination, we were using only one center as a site of vaccination in the whole of Kasarani,” says Dr Peter Mogoi, sub-county Medical Officer of Health at Kasarani sub-county. “We had long queues because people were eager to get the vaccine.”

Building on its existing in-country networks and infrastructure, Amref led engagements with the Ministry of Health to activate additional vaccination sites and train and equip healthcare workers.

Leveraging funding from The Coca-Cola Foundation’s Stop the Spread funding, Project Last Mile led demand creation and cold chain equipment management strategies to support making vaccines more accessible and increase vaccine demand.

“With the support of AMREF and Project Last Mile, we expanded to 10 vaccination facilities within Kasarani. We were able to deliver vaccines more effectively to the community,” says Dr Mogoi. Later, the program offered doorstep delivery of vaccines through outreach initiatives. “We were able to organize the teams from the facilities to carry the vaccines and go closer to the communities and households to vaccinate people.”

Nineteen outreach sites have been established, with 305 vaccine outreach events taking place across the Kasarani sub-county since the project launched in October 2021. Each site includes eight healthcare workers to administer the vaccines and five community health volunteers who support the social mobilization of community members.

Joan Mashiri, a public health nurse in Kasarani, says support from the two organizations has also assisted in improving cold chain maintenance. “Through Project Last Mile, we’ve been able to install very new solar fridges in one of the facilities, and we’ve been able to install a generator,” she says. “To me, it is an achievement. We are going to give quality services. We can deliver vaccines.”

A cold chain equipment service provider has been identified to undertake a cold chain audit and preventative maintenance at health facilities administering vaccinations across the sub-county to support increased vaccination.

Boosting vaccine demand

Rose Mwikali, a community health volunteer, says that she was part of the workforce tasked with distributing COVID-19 vaccination information, which was critical in addressing vaccine hesitation and increasing demand for vaccines. “The response was overwhelming because we even vaccinated those who were pregnant and breastfeeding, which had been a difficult task before,” she says. “This indicates that the communities received our messages well.”

The community health care workers also helped to inform people of their nearest vaccination facility. “Besides the main vaccination centers, we decided to have mobile vaccination units at bus stations, marketplaces and churches,” says Mwikali. “We, as community health volunteers, were tasked with informing communities that there are other places or units near them, where vaccination services were available, rather than them coming all the way to Kasarani or Maji Mazuri.”

Mashiri says that healthcare worker strengthening is one of the program’s most important aspects.

“The capacity building has come out very loudly because we didn’t have partners to support us for COVID-19 training because it was a new vaccine,” she says. “It needed a lot of techniques. For training, we’ve been supported by Project Last Mile.”

The AMREF / Project Last Mile program aims to create a replicable model for other sub-counties to support increased vaccination rates. By June 2022, the program had supported the administration of over 79,624 vaccines in the Kasarani sub-county of Nairobi.

This initiative is funded and supported by The Coca-Cola Foundation. The content and information provided on this website are the responsibility of Project Last Mile.