Why PNG’s fight against COVID-19 starts with health workers

If Papua New Guinea wants to increase its immunization rate, it must first provide consistent education and support to healthcare workers, writes Mikaela Seymour.

Papua New Guinea (PNG) continues to have one of the lowest COVID-19 vaccination rates in the world, with only 3.2% of the population receiving one or more doses.

As usual, over the Christmas period, urban workers returned en masse to their home villages, meaning the country is expected to see an increase in reported COVID-19 cases when the majority return to where they were. work in February.

Vaccination is the obvious safe and effective intervention to mitigate COVID-19 infection and serious illness, but simply procuring more vaccines will not lead to an increase in vaccination rates.

There is a need to better educate PNG citizens about COVID-19 vaccinations, but current awareness campaigns appear to be having little effect. The simple distribution of information brochures on vaccination is insufficient; a relationship-driven, collaborative engagement program is needed.

In this author’s fieldwork with immunization efforts in Western, Central, and Manus provinces, as well as the National Capital District, there have been several barriers to immunizing people, including lack of support for local health workers.

At the start of the pandemic, there seemed to be an assumption that healthcare workers in PNG would inherently understand the importance of the new vaccine and would be strong allies in the public health response. Unfortunately, this has not been the case, with many workers avoiding vaccination, and some even preaching against it.

While UNICEF and the World Health Organization have rolled out the vaccine training package, it alone is not enough to reassure many health workers. This six-hour session, while very comprehensive, created angst among some, whose take-home point was that adverse events from vaccination were evidence that the COVID-19 vaccine was less safe than routine vaccination. .

Recent World Bank research has confirmed that Papua New Guineans trust their local health worker as a source of information on vaccination. Communities are generally much less likely to receive the vaccine if their health worker is not themselves vaccinated, so any approach must focus on them first. Ongoing, deliberate and appropriate staff training is needed to ensure that they feel confident and empowered to discuss the vaccine.

In discussions with nurses at Port Moresby General Hospital, most rolled their eyes at outlandish claims that vaccination was associated with 5G, population control and microchipping. While they were sure to identify the misinformation, many were unsure how vaccines work, what they contain, or their safety profile. Sustained and targeted education would go a long way to alleviating these problems.

PNG’s geography, cost of transport and living expenses make it difficult for health workers to develop professionally across the country. However, many of these workers, even in remote locations, have wallets overflowing with certificates from workshops and training sessions organized by various non-governmental organizations.

Obviously, it is possible to centralize workers to run these sessions. However, as the pandemic drags on, continued educational input, with the ability to ask questions and respond to new information and concerns as they arise, is needed. Some initiatives have experimented with online education on COVID-19, but while the content was excellent, online delivery is difficult with poor network coverage in much of the country.

An example of a successful program can be seen in Western Province, which recorded the second highest vaccination rate outside the National Capital District. Programs such as the Program for Sustainable Development (PSD) Air Health Patrol with the Western Provincial Health Authority used their existing networks and relationships to ensure continued awareness and advocacy for the vaccine long before it was available.

Once the COVID-19 vaccine was available, SDP representatives had long conversations with health workers, community leaders and religious leaders, who accepted the vaccine and set an example for the good of the community. This approach enabled communities to achieve high levels of vaccination through pre-existing relationships, rather than new, unknown teams that showed up once the pandemic had already begun. It also relied on continuous health visits, rather than one-off patrols.

Jhe health workers who delivered these community programs were not automatic proponents of vaccination. Many of them started with doubts, but continued respectful education, with the opportunity for questions and discussions in weekly face-to-face professional development sessions, resulted in a fully immunized workforce that was confident community immunization advocates.

Healthcare workers in PNG are anticipating and clinically preparing for a likely increase in COVID-19 cases in 2022. These tireless and dedicated workers are the lifeblood of community health and no progress in vaccination against COVID-19 will will be carried out without their consent and support. If the government and humanitarian partners fail to engage effectively with them, PNG is on track for another year of crisis.

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