News on the discovery of COVID-19 vaccine brought with it, a renewed sense of hope and security as had been the expectation. Prior to that, COVID-19 response strategy had mainly been non-pharmaceutical interventions (face masks, physical distancing, hand hygiene) and the vaccines were expected to be an additional preventative measure to the pre-existing protocols.
Ghana recognized very early on that access to COVID-19 vaccines and a successful deployment could potentially reduce COVID-19 morbidity and mortality, disruption of social and economic functions, enhance the mental and psychosocial wellbeing of Ghanaians among others. These motivated authorities to work around the clock to meet the criteria set by COVAX.
The swift and proactive measures put in place made Ghana become the recipient of the historic first shipment of COVAX vaccines on 24 February 2021. Neighboring Côte d’Ivoire was the second country to receive the free vaccines two days after. Both countries launched their vaccination campaigns on 1 March 2021.
A few months down the line, a 5-member delegation from the Ministry of Health of Côte d’Ivoire has paid a study visit to Ghana to learn lessons from its COVID-19 vaccine deployment strategy to enhance their capacity for a successful roll out since the country has so far been able to achieve just 48% vaccination rate.
The Technical Advisor to the Minister for Health and Public Hygiene of Côte d’Ivoire and leader of the delegation, Dr Édith Clarisse Kouassi, disclosed that the country’s new Minister for Health had embarked on an intensive COVID-19 vaccination drive which had resulted in the current rate of 48%. She said the delegation hoped to, among others, learn some lessons on how the entire health system is managed in Ghana.
The Minister for Heath, Dr Kwaku Agyeman-Manu, in welcoming the delegation said he believed that the visit would be mutually beneficial as there were experiences in other health areas to tap from Côte d’Ivoire.
Briefing the delegation on what accounted for the feat, the Director for Technical Coordination at the Ministry of Health Dr Mrs Martha Gyansah-Lutterodt said Ghana developed a National Deployment and Vaccination Plan (NDVP) using the WHO SAGE’s value framework for the allocation and prioritization of COVID-19 vaccination and the prioritization of recommendations from the Immunization Technical Advisory Groups (NITAG)-Ghana in its Policy Guidelines for COVID-19 vaccination which was issued on 18 December 2020.
Key aspects of readiness that formed the basis for the NDVP were Regulatory preparedness and safety monitoring, Planning and coordination, Vaccination strategies, Deployment systems and modalities, Immunization monitoring systems, Operational and surveillance, Communication and Information, Supply chain processes, Waste management, Monitoring and Evaluation.
Population segmentation was informed by risk exposure, disease severity, business continuity, and national security to deploy the vaccines. Persons who made this category were categorized into two groups. The rest of the population above 18 years is expected to form the third group while pregnant women and persons under 18 will be fourth, subject to availability of an approved vaccine.
The delivery strategy was mainly static, outreach, mobile, campout, or a combination. Health centers and hospitals were the primary choice of vaccination sites as well as other potential vaccination sites: outreach points, pharmacies, markets and other public places for specific target groups.
Stakeholder engagement also played a pivotal role in the successful role out of COVID-19 vaccination campaign in Ghana. Health professional bodies such as the Medical, Pharmaceutical, Nurses and Midwifery, Allied Health as well as the Psychology Associations were all brought to the discussion table to have a broader conversation. Others included the Ghana Academy of Arts and Sciences, Leadership of Parliament and Plenary of Parliament, Religious Bodies Associations.
Communication and demand generation strategies were mapped out and fiercely rolled out with key messages on the safety and efficacy of the vaccines. Notable was preparations made towards preventing and responding to misinformation and hesitancy related to the vaccine.
A comprehensive logistics and waste management plan was also developed as part of the NDVP. The EPI Program completed the implementation of the Cold Chain Equipment Optimization Platform (CCEOP) which significantly improved the storage capacity at the district and facility levels. The Ministry of Health partnered waste management companies to ensure effective management of the huge injection waste generated from the exercise.
Virtual and in-person microplanning and training sessions vaccinators and supervisors, additional vaccination sites, structures client flow, safety and social distancing at each site, availability of adequate trained personnel at all sites are some of the measures put in place for effective delivery of vaccines. Additionally, provision was made for people to be observed for 10-15min after receiving their jabs and National IDs were used to confirm the age of persons above 60 years. Proof of having underlining co-morbidities were also requested at vaccination sites.
Robust data and coverage monitoring systems were put in place to ensure effective management of the process. This was done through DHIS2; e-tracker for individual records (this will also send a reminder to clients who are due for subsequent doses) and DHIS2 platform for aggregated data. Every vaccinee was issued a Vaccination Card. All supervisory tools are electronic (ODK) and all monitors and supervisors have been trained to use them. Tablets have also been provided and an APP: VaccineUPP is being used in Phase 2 (health care workers).
According to Dr Mrs Martha Gyansah-Lutterodt, innovation has played a pivotal role in Ghana’s successful rollout. The use of electronic register for all vaccines, virtual platforms for training, various Apps to enhance work, etc. could be credited for the milestone