Bringing vaccine awareness to communities

In Nepal’s southern plains, female community health volunteers are battling vaccine hesitancy on the ground and working to ensure vulnerable groups receive the COVID-19 vaccine

UNICEF Nepal
This image shows female community health volunteer Lalita Gupta walking across fields in Saptari District
UNICEF Nepal/2021/PShrestha
23 March 2021

Saptari, Nepal:

“I’m not worried. If you communicate properly, people will come.”

That’s the kind of serene confidence that female community health volunteer Lalita Gupta exudes as she walks around her village in Kalyanpur in Saptari District in Nepal’s southern plains, reaching out to elderly people and reminding them to go get vaccinated at the nearest health facility as part of the second phase of Nepal’s COVID-19 vaccination campaign.

Although majority of people in her area are more than willing to get the vaccine, Lalita does come across some who are hesitant and scared. “That is because they don’t have enough information,” she says.

This image shows female community health volunteer Lalita Gupta talking to an elderly woman
UNICEF Nepal/2021/PShrestha
Lalita Gupta (right) talks to an elderly member of her community about when and how to get the COVID-19 vaccine.

“So, I tell them about my own experience taking the vaccine, and explain that it’s nothing to be afraid of.”

Lalita had been among the frontline workers across Nepal who had received the COVID-19 vaccine during the initial roll-out of the campaign in late January 2021. What was it like being part of that first group? “I wanted to take it,” she says. “This past year has been so difficult for all of us.”

“For me, the vaccine arriving in Nepal felt like piece of good news at a time when we have had nothing but bad news for so long.”

This image shows a group of elderly persons walking to the health facility to get the COVID-19 Vaccine
UNICEF Nepal/2021/PShrestha
A group of elderly residents of Kalyanpur in Saptari District walk towards the vaccination site on 7 March to get the COVID-19 vaccine

Since receiving the first dose herself, Lalita has devoted herself to making sure others in the community are informed about the vaccine’s effectiveness, their own eligibility, and when and where to go to actually get the shot. And thanks to her untiring efforts, and those of her fellow volunteers – as well as other awareness initiatives from the local government – the second phase of the campaign has seen a high turn-out in Saptari, as it did in other parts of the country.

This image shows elderly persons walking into the Kalyanpur PHCC for the COVID-19 vaccine
UNICEF Nepal/2021/PShrestha
Elderly people walk into the premises of the Kalyanpur Primary Health Care Center in Saptari District to get vaccinated against COVID-19
This image shows healthworkers registering the details of elderly people who have come to get vaccinated at the Kalyanpur PHCC
UNICEF Nepal/2021/PShrestha
Healthworkers (left) at the Kalyanpur Primary Health Care Centre register the details of elderly people who have come to receive the COVID-19 vaccine

The Kalyanpur Primary Health Care Centre (PHCC), one of the vaccination sites in Saptari, for instance, saw elderly people walking in and lining up around the registration desk as soon as doors opened on 7 March, with Lalita standing by with other volunteers to help.

This image shows female community health volunteer Lalita Gupta helping an elderly woman get vaccinated
UNICEF Nepal/2021/PShrestha
Female community health volunteer Lalita Gupta (left) helps 75-year-old Musini Yadav (centre) as healthworker Raj Kumar Shah (right) prepares to administer the COVID-19 vaccine

“We had been confused about whether we qualified,” said 75-year-old Musini Yadav, after she got the vaccine. “But Lalita had come by the day before and told us what we needed to know, so here we are.”

This image shows a healthworker preparing to administer the COVID-19 vaccine
UNICEF Nepal/2021/PShrestha
Healthworker Raj Kumar Shah prepares to administer the COVID-19 vaccine at the Kalyanpur Primary Health Care Centre.
This image shows 75-year-old Musini Yadav
UNICEF Nepal/2021/PShrestha
Musini Yadav is headed home after receiving the COVID-19 vaccine at the Kalyanpur Primary Health Care Center

A long journey

The COVID-19 vaccines that were administered at the Kalyanpur PHCC had undertaken a long journey through what is called the ‘cold chain’ – first dispatched from the Central Vaccine Store in Kathmandu to the provincial storage facility, then brought to the District Health Office in Rajbiraj in Saptari, before the allocated doses were divided and delivered to the PHCC two days before vaccinations began.

This image shows UNICEF staff and health office staff preparing a vaccine cold box
UNICEF Nepal/2021/PShrestha
UNICEF Cold Chain Consultant Anish Shah (left) helping the staff at the District Health Office in Saptari pack a vaccine cold box with COVID-19 vaccines.
This image shows UNICEF staff in front of a UNICEF-supported refrigerator at the district public health office in Rajbiraj, Saptari
UNICEF Nepal/2021/PShrestha
UNICEF Cold Chain Consultant Anish Shah at the vaccine store room at the District Health Office in Saptari.
This image shows UNICEF Health Officer Lata Bajracharya
UNICEF Nepal/2021/PShrestha
UNICEF Health Officer Lata Bajracharya at the vaccine store room in the District Health Office in Saptari District.

Understanding how important this cold chain system is in making or breaking an immunization campaign, UNICEF has long been working with the Government of Nepal and key global health partners such as Gavi, to assess, expand and strengthen the country’s cold chain capacity.

This encompasses support to improving vaccine storage facilities at the central, provincial, district and local levels, through installation of vaccine refrigerators and freezers, and provision of cold boxes and carriers, as well as technical and logistical assistance for effective vaccine and cold chain management, among other forms of support.

“It’s wonderful to see how all these efforts, although aimed at enabling safe delivery of vaccines during routine immunization programmes targeted at children, are now being used in the COVID-19 vaccination campaign,” says Lata Bajracharya, Health Officer at UNICEF Nepal.

“It really is a testament to the long-term impact of the work we’ve done.”

This image shows the Saptari District Health Office vehicle on the road to the health facility
UNICEF Nepal/2021/MShrestha
The Saptari District Health Office Vehicle on the way to deliver COVID-19 vaccines and syringes to the Kalyanpur Primary Health Care Center
This image shows UNICEF and Health staff at the Kalyanpur Primary Health Care Center
UNICEF Nepal/2021/PShrestha
UNICEF and health staff store COVID-19 vaccines in the refrigeration units installed with UNICEF support at the Kalyanpur Primary Health Care Center

And to further strengthen the COVID-19 vaccination drive, Nepal has also received the first consignment of COVID-19 vaccines shipped through the COVAX Facility - a partnership between CEPI, Gavi, UNICEF and WHO, made possible through generous donor support from governments, international organizations, foundations and the private sector. A total of 348,000 doses were delivered on 7 March with more to come: the COVAX Facility is set to provide 1.92 million vaccine doses to Nepal by the end of May 2021.

In addition, UNICEF has also procured and supplied over 1 million auto-disable syringes – designed for single use and therefore much safer – for the COVID-19 vaccination campaign in Nepal so far, with a further 2 million on the way for upcoming phases.
 

A legacy of helping people

For Lalita, being able to actively contribute to the success of the vaccination campaign has been very rewarding, not just professionally but also on a personal level.

This image shows female community health volunteer Lalita Gupta
UNICEF Nepal/2021/PShrestha
Female community health volunteer Lalita Gupta at the Kalyanpur Primary Health Care Center in Saptari District.

Her mother-in-law Sumitra had been a female community health volunteer as well, until she passed away very recently. “She was how I got inspired to become a volunteer,” Lalita says. “She would be happy to see what I’m doing.”

And now, Lalita herself is inspiring the next generation. Her 16-year-old daughter Khushbu couldn’t be more proud of her mother. “Last year, she was informing people about how to stay safe from the coronavirus, and now she is helping them get the vaccine,” says the 10th grader.

“When I’m older, I want to do something to help people too.”

This image show female community health volunteer lalita with her daughter Khushbu in Saptari District
UNICEF Nepal/2021/PShrestha
Female community health volunteer Lalita Gupta (left) with daughter Khushbu (right) outside their home in Kalyanpur, Saptari District

The mobilization of female community health volunteers like Lalita has been widely regarded as one of the most successful community health volunteer schemes in the world, representing a bridge between communities and health facilities. UNICEF, together with UNFPA and USAID, have been involved in the FCHV programme from its very beginning in 1988, including supporting the Government of Nepal to scale up the programme to all districts across the country.