Vaccine hesitancy is the delay in accepting or refusing of vaccines despite the availability of vaccine services. Malawi launched covid 19 vaccination campaign in March 2021. The UN estimates the current Malawi population to be 20, 192,495, out of which, an average mean of  11.8% of  Malawians have been fully vaccinated as at end June 2022  against the 70% target of June 2023, ranking it bottom third in SADC region. Phalombe, Neno and Ntcheu districts have so far only achieved 3.8%, 11.3% and 5.3% of full vaccination coverage against COVID 19 respectively.

In this pandemic, vaccines are the most reliable and cost effective public health intervention and the Malawi government is championing the revised national Covid -19 preparedness and response strategy and plan ( July 2021- June 2022) which includes priotising the vaccination of traditional and religious leaders, increased coverage of vaccination sites and health promotion. However, vaccine hesitancy remains wide spread in Malawi due to fears of vaccine safety and effectiveness coupled with cultural and religious beliefs and abundant misinformation about the vaccination programme. Children remained disadvantaged to access the vaccine until January 2022 when the age band became more  inclusive for those from 12 to 17 years of age who are being administered with Pfizer jabs only for now.

Since evidence points to behaviour change or lack thereof, measures to increase COVID-19 vaccine uptake and acceptance should target fear and misinformation as constraints. Interventions such as individual sensitization and motivational interviewing should be considered for guiding individuals towards considering COVID-19 vaccination. PACHI with funding from UNICEF is therefore implementing a project in the three mentioned districts  through engagement of existing communities using high impact proven approaches for social mobilization and accountability.

There is evidence that health care workers in Malawi have a high motivation to be vaccinated and a high COVID 19 vaccine uptake ( 83%). This is associated with their confidence in vaccine benefits and vaccine safety. PACHI through the project is engaging health care workers as change agents by sharing the right information with service users both at static and mobile clinics on vaccine benefits and safety in order to build confidence of clients to get vaccinated and promote polio and other routinized vaccines.