Adopting gender-based solutions to increase vaccination coverage: spotlight on GRID3 Mapping for Health multi-sectoral roundtable in the Democratic Republic of the Congo

May 31, 2021

In a country where almost half of the population is under the age of 15, the government of the Democratic Republic of the Congo (DRC) is encountering significant challenges in achieving full vaccination coverage of its children. According to the 2017-2018 Multiple Indicator Cluster Surveys (MICS), only 35 percent of DRC’s children aged 12 to 23 months are fully immunised, 45 percent are incompletely immunised, and 20 percent have received no vaccines at all. An estimated 1,224,000 children were unvaccinated or incompletely vaccinated in the provinces of Kinshasa, Kwilu, Kasai, Kasai-Oriental, Sud-Kivu, Ituri, Lomami, Haut-Katanga, and Haut-Lomami. Accordingly, these provinces were prioritised under the Mashako Plan, an ambitious programme launched by the government in 2018 to tackle low immunisation coverage across the country. Socio-economic disparities, conflicts, and gender inequalities are some of the factors contributing to low coverage.

The GRID3 Mapping for Health (M4H) project, delivered under the leadership of DRC’s Ministry of Public Health, Hygiene and Prevention and funded by Gavi, the Vaccine Alliance, extends the work GRID3 has already done around health in the country. This project aims to support the Mashako Plan and strengthen the effectiveness and equity of DRC’s vaccination interventions.

Tackling gender-based obstacles to vaccination

As DRC has one of the highest rates of maternal, child, and infant mortality in sub-Saharan Africa, one aspect of the project focuses on the integration of gender and social inclusion (GESI) into vaccination programmes. This work achieved a milestone in May with the organisation of a roundtable focused on the intersection of gender and vaccination. The event brought together, in-person and online, 50 guests from more than 30 organisations. The group included health and gender experts, members of governmental and international organisations, as well as women’s organisations. Among these were representatives from the Ministry of Gender, Family, and Children; the Expanded Programme on Immunisation (EPI); the School of Public Health at the University of Kinshasa; Gavi, the Vaccine Alliance; Global Affairs Canada; the National Programme for Nutrition; Sanru; UNICEF; and Plateforme des Organisations de la Société Civile pour la Vaccination et l’Immunisation au Togo (POSCVI-TOGO). 

Participants took part in practical workshops on the use of specific tools and participatory methods for implementing gender-sensitive immunisation programmes, such as considering gender-related barriers to immunisation during the production of vaccination microplans. In turn, concrete, realistic actions were identified to promote the integration of specific and inclusive approaches to vaccination and health programmes. For example, participants recommended stronger involvement from men in promoting the use of immunisation services and in understanding the importance of equitable sharing of domestic roles with their wives or female partners (such as decision-making and escorting children to care services). They also identified the need for the population data that are integrated in the microplans to be disaggregated by sex and age, which will better facilitate gender and equity considerations. 

The M4H gender work has been led by the GRID3 team at Flowminder who have built a network of professionals dedicated to implementing these solutions in DRC. Working groups for this network were launched in July 2021, and members have been creating practical, multi-sectoral action plans to reinforce gender and social inclusion practices in various health sectors. As part of these action plans, trainings were implemented in Kinshasa and Kasaï where 25 local GESI ambassadors developed skills to train other health professionals through “sensitisation sessions”. These sessions focused on raising awareness around tools that can be used to address socio-economic disparities and gender inequalities within health interventions. To date, GESI ambassadors have delivered more than 20 sessions to over 300 healthcare and community workers in Kasai and Kinshasa provinces who are now able to better identify gender barriers in immunisation, enabling them to deliver more equity-focussed vaccination programmes. 

To read the observations and recommendations from the roundtable, please click here.

For the French version, please click here.

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