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DRAFT COVID-19 VACCINE SOCIAL MOBILISATION AND RISK

COMMUNICATION STRATEGY FOR MALAWI 2021-2023

March 2021.

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Table of Contents

Foreword. .................................................................................................................................. 3

Acknowledgements .................................................................................................................. 1

Executive Summary ................................................................................................................. 1

Abbreviations and Acronyms ................................................................................................. 1

1. BACKGROUND AND INTRODUCTION .................................................................... 3

2. VACCINE TO BE USED IN THE FIRST PHASE. ...................................................... 5

3. SITUATION ANALYSIS. ............................................................................................... 5

4. GUIDING PRINCIPLES. ................................................................................................ 2

5. GOAL. ............................................................................................................................... 4

6. OBJECTIVES. .................................................................................................................. 4

7. THEORETICAL UNDERPINNING THE STRATEGY. ............................................ 5

7.1 Diffusion of Innovation Theory. .................................................................................... 5

................................................................................................................................................ 5

7.2 WHO Strategic Advisory Group of Experts (SAGE) Vaccine Hesitancy model ..... 1

8. COMMUNITY ENGAGEMENT IMPLEMENTATION IN THE COVID-19

VACCINE. .............................................................................................................................. 12

9. PARTICIPANT GROUPS/TARGET AUDIENCE AND CHANNELS OF

COMMUNICATION ............................................................................................................. 13

10. COVID-19 VACCINE KEY MESSAGES. ............................................................... 20

11. COVID-19 VACCINE CRISIS COMMUNICATION SCENARIOS, MESSAGES

AND RESPONSES................................................................................................................. 27

12. PROPOSED CRISIS RESPONSES ON ANTICIPATED ISSUES. ...................... 31

13. MONITORING, EVALUATION AND DOCUMENTATION .............................. 35

14. COORDINATION ...................................................................................................... 12

15. IMPLEMENTATION PLAN & BUDGET ESTIMATES ...................................... 13

16. KEY PRODUCTS TO SUPPORT COMMUNICATION AND SOCIAL

MOBILIZATION FOR COVID-19 VACCINE INTRODUCTION ................................. 16

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17. COMMUNICATION TREE ...................................................................................... 24

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Foreword.

This strategy considers COVID-19 vaccine administration and Social and Behavior Change

Communication in close coordination with communications plans related to national COVID-

19 control and immunization. The strategy aims to promote confidence in COVID-19

vaccination, inform key and secondary audiences of the characteristics and public health value

of the new intervention; address questions, concerns, and gaps in information; reinforce routine

vaccination and continued use of existing COVID-19 control practices; and address

misconceptions, rumours, and issues in a timely and appropriate manner.

The communication strategy targets specific barriers to COVID-19 immunization and early

health seeking behaviour, and aims to overcome these barriers by clear and concise response

to queries on the vaccine, trainings and orientations to media and stakeholders that would result

in the increase of target populations seeking COVID-19 vaccine immunization. It also

promotes the use of already existing COVID-19 control and treatment interventions such as

the correct wearing of masks, frequent hand washing with soap and observing physical

distancing among others.

The strategy primarily targets the health workers and other social workers e.g. soldiers,

immigration officials, those involved in humanitarian work and those displaced including

religious and community leaders. It also seeks to get attention of policy makers, government

agencies, the media and other stakeholders in order to have an effective COVID-19 vaccination

programme resulting from good stakeholder collaboration.

The strategy uses the Diffusion of Innovation Theory that states that innovations, new ideas or

behaviours are spread within a community or from one community to another. In this regard,

the strategy will focus on use of multiple channels and approaches in delivery of messages and

materials for the vaccine. The Ministry of Health through the Expanded Programme on

Immunization is implementing a phased introduction of the COVID-19 vaccine in the country.

This is a new COVID-19 Vaccine Communication strategy for the period 2021 – 2023 and is

a guiding document for all partners to implement a successful COVID-19 vaccine programme

being the first of its kind in the country.

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It is my belief that the strategy will play a critical role in increasing knowledge, attitude and

resulting in more priority groups accessing the COVID-19 vaccine.

Hon. Khumbize Kandodo Chiponda, MP.

Minister of Health

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Acknowledgements

The Ministry of Health is grateful to individuals and partners who contributed towards the

development and completion of the COVID-19 Vaccine Communication Strategy for Malawi.

The process started at the end of December 2021 with desk reviews by Health Education

Services and partners through virtual platforms. The Health Education Services need to be

commended for their tiresome work in coordinating meetings in coming up with this document.

We circulated this strategy widely to implementing partners and participants of the consultative

process and comments received to finalize this communication strategy. As such, we

particularly thank the Health Education Services and Expanded Programme for Immunization

for overseeing and guiding this process of developing the first COVID-19 Vaccine

Communication strategy. Special thanks go to UNICEF and WHO for technical support in

developing this document.

Special thanks to Mavuto Thomas (Ag. Deputy Director of Preventive Health Services-Health

Education Services), Austin Makwakwa (Principal Health Promotion Officer-HES), Tobias

Kunkumbira, Alvin Chidothi Phiri, Ellah Chamanga (Senior Health Promotion Officers-HES),

Dr. Mike Chisema (Programme Manager-EPI), Temwa Mzengeza (Deputy Programme

manager-EPI), Brenda Mhone (Surveillance-EPI), Doreen Ali (Deputy Director-CHS),

Precious Phiri (CHS).

Special recognition also goes to Hudson Kubwalo (Health Promotion-WHO), Parvina

Muhamed Khojaeva (Head of C4D-UNICEF), Chancy Mauluka (C4D Specialist-UNICEF),

Henry Chimbali (Communication-WHO), Joel Suzi (Deputy Chief of Party-HC4L), Rachel

Thomas (CRS), Evin Joyce (Community Engagement-UN Resident Coordinators Office),

Upile Kachila (Program Manager-CCPF), Christel Saussier (EOC Technical Advisor, I-TECH)

and Dr. Bob Alexander (RCCE Specialist).

Dr. Charles Mwansambo

Secretary for Health

Ministry of Health.

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Executive Summary

COVID-19 continues to be a critical public health challenge for the Government and People of

Malawi. While risk perception to COVID-19 among the general population has been

fluctuating and in November 2020 dropped to 33% (31% urban, 34% rural), general awareness

is still high at 99%, with the majority indicating that they heard about it from the radio (87%)

followed by religious leaders and health personnel (37%).

The majority of respondents also indicate that COVID-19 can be transmitted through coughing

and sneezing (76.4%, staying in crowded places (70.8%), and contact with infected surfaces at

54.4%.

The strategy employs a Diffusion of Innovation Theory that recognises that innovations, new

ideas or behaviours are spread within a community or from one community to another.

For this reason, different approaches will be utilised including advocacy to create an enabling

environment for preventive behaviours, community mobilization to increase participation and

community ownership and behaviour change communication (BCC) to promote individual

preventive behaviours and discourage negative community perceptions and reduce vaccine

hesitancy.

Integrating COVID-19 vaccine communication with communication for other COVID-19

interventions will be critical. Just like OCV, this vaccine complements other recommended

interventions to prevent the disease. Audiences should therefore understand the role of the

COVID-19 vaccine in relation to other COVID-19 prevention methods. As such, careful

messaging will need to address the fact that the COVID-19 vaccine reduces deaths, the risk of

hospitalization and severe diseases from COVID-19. Those who receive the vaccine could still

get COVID-19 and should continue to use recommended prevention measures.

This strategy also recognizes the importance of strengthening partnerships at all levels and

building the capacities of all relevant personnel in an ongoing basis. The HES is expected to

determine the SBCC capacity needs of relevant personnel within government and among

community based organizations and work with the relevant development agencies,

government departments and tertiary institutions of learning to provide such capacity. In

promoting uptake of the COVID-19 vaccine, this strategy recommends that other COVID-19

preventive methods be promoted as well to combat the disease.

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Abbreviations and Acronyms

ADC Area Development Committee.

AEFI Adverse Event Following Immunization.

AESI Adverse Event of Special Interest.

CBO Community Based Organisation

CCPF Chipatala cha pa Foni.

CHAGs Community Health Action Groups.

CoM College of Medicine.

COVAX COVID-19 Vaccines Global Access.

CSOs Civil Society Organisation.

DIO Diffusion of Innovation.

EMA European Medicines Agency.

FAQs Frequently Asked Questions.

FBO Faith Based Organisation.

FLWs Frontline Workers.

HC4L Health Communication for Life.

HES Health Education Services.

HCMC Health Centre Management Committee.

HCW Health Care Workers.

HAS Health Surveillance Assistant.

IEC Information, Education, Communication.

iNGO International Non-Governmental Organization.

HPO Health Promotion Officer.

KAP Knowledge, Attitude, Practice.

MEIRU Malawi Epidemiology and Intervention Research Unit.

MoH Ministry of Health.

PA Public Address.

PRO Public Relation Officers.

PSA Public Service Announcement.

PwDs Persons with Disabilities.

PHIM Public Health Institute of Malawi.

OCV Oral Cholera Vaccine.

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RCCE Risk Communication & Community Engagement.

SAGE WHO Strategic Advisory Group of Experts.

SMS Short Message Service.

SOPs Standard Operating Procedures.

UNICEF United Nations International Children's Emergency

Fund.

VDC Village Development Committee.

VHC Village Health Committee.

WHO World Health Organization.

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1. BACKGROUND AND INTRODUCTION

COVID-19 is a respiratory illness that is fast spreading across the world. It is a new strain/type

of coronavirus and was first found in Wuhan, China in December 2019. World Health

Organization (WHO) declared COVID-19 a Public Health Emergency of International Concern

(PHEIC) on 30th January 2020, and a pandemic on 11th March 2020.1

Malawi declared a state of emergency on 20th March 2020. The first COVID-19 case was

recorded on 2nd April 2020 in Malawi. By 7th February 2021 Malawi had registered 27,195

cases, 856 deaths, of the cases 1,984 are imported and 25,211 are locally transmitted. The cases

have substantially increased and the country was experiencing second wave of the pandemic,

also on the increase were the number of admission in the COVID-19 treatment centres and

number of COVID-19 related deaths. The second wave has also been characterized by new

strains of the coronavirus being reported in several countries including Malawi. Risk of

COVID-19 infection is also high among Health Care Workers (HCW) as 1,407 cases have been

reported among health workers with 10 deaths cumulatively as of 7th February 2021.2

Malawi is still a hot spot area for COVID-19. The country has registered high numbers of cases

in most of the areas in wet and hot seasons. Therefore, the introduction of the COVID-19

vaccine to complement the already existing prevention interventions will be essential to control

the pandemic. Vaccination is a safe and effective way of protecting people against harmful

diseases, prior to contact with the causative agent of the disease and it uses the body’s natural

defences to build resistance to specific infections and makes your immune system stronger. It

is one of the most effective and impactful public health measure as it helps to reduce mortality

and morbidity from various disease including COVID-19. To get protected from COVID-19 is

critically important because for some people, it can cause severe illness or death and

vaccination is one of many steps that can protect people from COVID-19. Stopping a pandemic

requires using all the tools available. Vaccines work with your immune system so your body

will be ready to fight the virus if you are exposed while other preventive measures such as

masks, hand wash and social distancing, help reduce your chance of being exposed to the virus

or spreading it to others. When these are combined, they offer the best protection. Widespread

use of vaccine can reduce rate of spread in the community and reduce chances of a new variant.

1 https://www.who.int/emergencies/diseases/novel-coronavirus-2019 2 Public health institute of Malawi epidemiological report

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Introducing of any new vaccine especially with new target populations, through potentially

new delivery strategies is challenging and require a comprehensive communication strategy.

Ensuring acceptance and uptake of COVID-19 vaccination among target groups in Malawi

presents a unique set of difficulties but is key to successful reduction of transmission and

containment of the pandemic.

The COVID-19 Communication Strategy is intended to guide timely dissemination of accurate

information about COVID-19 vaccine, address hesitancy about the vaccine, ensure acceptance

of the vaccine, motivate and encourage its uptake. This strategy will also serve to guide

programme designers and implementers at national and district levels to design communication

interventions for disseminating information about COVID-19 vaccines and vaccination process

across the country.

To ensure acceptance and uptake of COVID-19 vaccination, the country will adopt an

integrated approach that starts with listening to and understanding target populations, to

generate behavioural and social data on the drivers of uptake and to design targeted strategies

to respond.

The Risk Communication and Community Engagement (RCCE) sub-committee on COVID-

19 in Malawi is a sub-committee under health cluster which is responsible for Risk

Communication and Community Engagement. The sub-committee has been vibrant in

mobilising resources and providing technical support in implementing RCCE activities at

national and district level. Despite the social and behaviour change activities that have been

implemented across the country to promote adoption of COVID-19 preventive measures, there

has been little reduction in COVID-19 risk and morbidity. The communities have relaxed in

adhering to COVID-19 prevention measures in all settings despite the cases of COVID-19

fluctuating.3 The COVID-19 pandemic has also brought an infodemic where there is a lot of

information and misinformation circulating on different platforms.

The strategy will ensure it builds a supportive and transparent information environment, and

addresses misinformation through social listening and assessments that inform digital

3 Knowledge Attitude Practice Survey on COVID RCCE response

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engagement initiatives through engagement of communities by civil society organizations,

particularly for vulnerable target populations.

The strategy will also ensure that health workers have requisite knowledge of COVID-19

vaccines as first adopters, trusted influencers and vaccinators, giving them the skills to

communicate effectively and persuasively with target populations and communities.

The strategy will prepare implementers to respond to any reports of adverse events following

immunisation (AEFI) and have planning in place to mitigate any resulting crises of confidence.

2. VACCINE TO BE USED IN THE FIRST PHASE.

In the first phase of the COVID-19 vaccination, the country will use Oxford/AstraZeneca

vaccine. It is also known as AZD1222 or ChAdOx1-S (recombinant). Developed by the Oxford

University, United Kingdom, and Astra Zeneca. The vaccine is a colorless to slightly

opalescent solution provided in a multi-dose vial. This vaccine has acceptable safety profile, it

is efficacious and in terms of cold chain, it is compatible with our current cold chain equipment

and stored in a refrigerator at 2°C – 8°C. The recommended dosage is two doses with an

interval of 8 to 12 weeks and the vaccine is administered through injection. In the initial phase

it will target 20% of the population which include the frontline health workers and other social

workers, the elderly and those with comorbidities e.g. diabetes, High blood pressure and other

heart conditions, asthma.

3. SITUATION ANALYSIS.

Since early 2020, there has been general hesitancy around COVID-19 vaccine on social media.

According to the UNICEF social listening tool (talk Walker)4 has gathered that some of the

reasons cited for denial of the vaccines.

By end December 2020, overall tone of immunization content was trending negative in the

region, including Malawi. Around 40% of content had a negative tone, with only 8% of articles

and posts displaying positive content. Examples included posts encouraging vaccine refusal

4 https://app.talkwalker.com/app/project/c6fd639a-9332-4366-bcde-

d6016fda4c9d/shared_dashboard/export_UNICEFESARO_wGpCxJlD.html#/SHARED_DASHBOARD#co=project&cid=c6fd639a-9332-4366-bcde-d6016fda4c9d&psid=export_UNICEFESARO_wGpCxJlD.html&keyid=undefined&data=eyJyIjp7ImEiOnsiYWN0aXZlUGFnZUlkIjoiODYyMzQ1MmEtOGZhOC00Yzc4LThlNTgtOGU3ODgxYzg3YmVjIn0sImkiOiJTSEFSRURfREFTSEJPQVJEIiwicyI6W119fQ==

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and conspiracy claims that Bill Gates is using the COVID-19 vaccine rollout to control people.

The following narratives were tracked in relation to the COVID-19 vaccines:

3.1 Religious fears.

There were claims that the COVID-19 vaccine carry the mark of the devil that will change

human DNA which revived old and new conspiracies, with claims that it will be used to

implement a de-population agenda. Some posts in the region discussed whether the COVID-

19 vaccines will be regarded as permissible under Islamic law as halal.

3.2 Effectiveness of the vaccine.

The news of a different variant of the virus spreading in South Africa and other countries raised

concerns that the vaccines will not be as effective in preventing infections.

3.3 Safety concerns and misinformation.

Specific adverse effects discussed online included potential strong allergic reactions and a

potential increased risk of HIV infection. There were equally false claims that the vaccine will

cause infertility have been tracked. Other online conversations referred to false claims of side

effects of COVID-19 that affect people’s feet and male genitalia.

The vaccine has been developed over a short period of time. Therefore, its safety has not been

scientifically proven. Some say the vaccine is not for COVID-19 but other infections while

others fear it will cause death.

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3.4 Pandemic Fatigue

Pandemic fatigue is increasing. This is due to the stress caused by uncertainty, lower risk

perceptions and reduced trust in government responses.5

By September 2020, according to rapid assessment activities conducted by UNICEF, HC4L

and MEIRU, knowledge of COVID-19 was over 90% while self-efficacy to practice the

recommended behaviours trailed over 70%. However, risk perception was low at around 40%.

It is imperative to increase risk perception to enable preventive behaviours that include demand

for vaccination.

Findings of KAP survey conducted in November 2020.

The College of Medicine (CoM), Public Health Institute of Malawi (PHIM) and UNICEF also

conducted a KAP survey in November 2020. Preliminary qualitative results indicated that low

risk perception as a result of staunch religious believes. Concerns revolved around loss of

business and decreased economy activities; closure of schools as a critical problem facing the

youth, while others were much concerned with isolation.

Quantitatively the preliminary results indicate that 99% of the population heard of COVID-19,

mostly from radio (87%) followed by religious leaders and health personnel (37%).

In regard to how COVID-19 is transmitted, the majority of respondents mentioned that

COVID-19 can be transmitted through coughing and sneezing (76.4%) and staying in crowded

places (70.8%). Contact with infected surfaces was only mentioned as a potential source of

infection by 54.4% of respondents.

However, risk perception dropped to 33% (31% urban, 34% rural) as less were afraid of the

pandemic at the time of the research. On the positive side, 90.6% were confident they would

prevent the disease.

5 UNICEF Evaluation of Insights Report, 2020

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The table below illustrates confidence levels for some preventive practices:

Table 1

3.5 Sources of Information

Majority of participants indicated that they get information from radio, TV and health workers.

Others reported that they get information from church leaders and at funerals. Participants

reported getting trusted information regarding COVID-19 from health workers. However, it

was also noted that radio, television and social media plays a critical role in informing people

regarding COVID-19.

4. GUIDING PRINCIPLES.

Risk and crisis communication and community engagement will be guided by the following

principles:

o Nationally-led — The responsibility to implement RCCE lies with the government

through Ministry of Health. However, they are supported by other line Ministries i.e.

Ministry of Information, Ministry of Civic Education and National Unity, Ministry of

Local Government and local, national and international civil society and the

communities themselves. Multi-sectoral approach will be utilized.

o Community-centred — Effective RCCE will start with understanding the knowledge,

capacities, concerns, structures and vulnerabilities of different groups in communities

– enabling adaptation of approaches, improving outcomes and impact. It will take a

holistic, humanitarian approach that addresses the risk of COVID-19 and crisis

0102030405060708090

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you go out

Can avoid toucheyes and nose

Can keep 1 meterdistance

Can always covermouth withelbow when

coughing

Can stay at homefor long time

Can put on facemask every time

you go out

Confidence to Prevent COVID-19

Overall Urban Rural

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surrounding vaccines but also include other community needs, including protection,

water and sanitation, economic stability, mental health and psychosocial support and

broader development issues.

o Participatory — Communities (with priority given to at-risk or vulnerable groups) will

be supported to lead in the analysis, planning, design, implementation, and monitoring

and evaluation of RCCE and crisis activities.

o Integrated — RCCE and crisis communication will be integrated and harmonized

within the public health, humanitarian and development responses to COVID-19. At a

programmatic level, RCCE will be mainstreamed across all sectors to ensure

participation and to improve effectiveness.

o Inclusive — Support will be prioritized to the most vulnerable, marginalized or at-risk

groups. RCCE approaches will be made accessible, culturally appropriate youth,

disability and gender-sensitive. Communities in remote areas who don’t always have

access to mainstream and social media will be reached with messages and appropriate

materials.

o Accountable — In responding to COVID-19, public health, humanitarian and

development actors will be accountable and transparent to affected communities.

RCCE approaches will ensure communities can access information about and

participate in decision-making about the response. They will also document and

respond to community feedback on the response.

o Innovative – The communication strategy will embrace innovation to pilot, implement

and scale up new ideas and messaging. The use of new technologies e.g. mobile phones

or smart phones, social messaging platforms and others. The platforms will also enable

implementers to tracks immunization: rollout-uptake-feedback. The systems that utilise

push reminder messages to clients informing them of where and when to access the

vaccine will be used. This will also provide clients an ability to provide feedback on

their experience i.e. if there are some side-effects, hesitancy issues etc. The systems

will be integrated into other existing platforms. Additionally, implementers will be able

to send tips and reminder SMSs to clients informing them of their vaccination schedule,

where and when etc. Anyone with a basic phone will have the chance to access this

information.

As a new vaccine, new additional information that becomes available will be used to

update this document regularly to ensure reliable and up-to-date information reaches

all Malawians, including those living in remote and hard-to-reach areas.

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5. GOAL.

The goal is to ensure that more than 90% of the targeted population accept to get

vaccinated against COVID-19.

6. OBJECTIVES.

i. COVID-19 vaccination. ii. COVID-19 RCCE.

By June 2021: Increase to >95%, knowledge

of COVID-19 vaccine (benefits, schedule, side

effects, place and time of vaccination) among

all individuals in Malawi.

By June 2021: Promote to over 80%, positive

attitudes regarding COVID-19 vaccine (safety,

efficacy, willingness/intention) among eligible

population.

By June 2021: Increase to >80%, public

demand for COVID-19 vaccine uptake among

eligible population.

By December 2021: Increase risk perception

of COVID-19 to 70% by end of 2021.

By June 2021: Promote/maintain preventive

practices (handwashing, distancing, and face-

masking in public) of COVID-19 among

individuals to > 90%).

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7. THEORETICAL UNDERPINNING THE STRATEGY.

7.1 Diffusion of Innovation Theory.

DOI refers to the spread of new ideas and behaviours within a community or from one

community to another. The theory suggests that some individuals and groups are quicker to

pick up new ideas, or “innovations,” than others. It categories the adopters as innovators,

early adopters, early majority, late majority, and laggards. The theory explains that if a

person or organisation wants to promote wide spread adoption of a new behaviour, the person

or organisation should market the new behaviour to each adopter group differently using

distinct communication channels, messages and tactics.

Figure 2: DIO

Community leaders,

Youth leaders,

Mother groups,

Health practitioners,

Community volunteers.

Mar Aug Oct Nov

100

-

90 -

80 -

70 -

60 -

50 -

40 -

30 -

20 -

10 -

0 -

Faith-based leaders,

High-level officials,

Health

practitioners,

Well-known

personalities &

celebrities,

Community

volunteers.

Start.

Innovators

Gate keepers that

will be used to

inform the public

that COVID-19

vaccine is available

Community leaders,

Faith-based leaders,

Youth leaders,

Health practitioners,

Community volunteers.

Gain.

Early Adaptors Influential leaders that

people trust will be

featured in communication

products

Community leaders,

Youth leaders,

Mother groups,

Health practitioners,

Community volunteers.

…

Maintain.

Accelerate.

Early Majority

Peer education and

interpersonal

communication will be

used to get more people to

get the vaccine.

Late Majority

Use local leaders to motivate

communities to get the vaccines;

Form allies with them to be part

of communication team

Applying Diffusion of Innovation to generate demand for COVID-19 vaccine uptake

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7.2 WHO Strategic Advisory Group of Experts (SAGE) Vaccine Hesitancy model

This strategy will use WHO Strategic Advisory Group of Experts (SAGE) Vaccine Hesitancy

model which has been used to explore factors that affect the uptake of vaccine in various

countries. The SAGE model will guide all the communication of COVID-19 vaccine as it

anticipated that people have a lot of misinformation and myths about the vaccines that can

affect uptake of the vaccine.

SAGE model is based on the fact that that attitudes to vaccination is a continuum ranging

from complete acceptance to total refusal. Vaccine hesitancy is defined as a locus within this

continuum and could result in acceptance of some vaccines and refusal of others, delayed

vaccination and tentative acceptance, thereby influencing overall immunization utilization.

The model differentiates between contextual, individual and groups and vaccine or

vaccination-specific factors that influence immunization acceptance and utilization (WHO,

2014).

The three domains of SAGE model will be used to guide the development of all communication

products to promote uptake of COVID-19 vaccine as outlined below:

a. Contextual influence.

This explains factors that people who are supposed to get the vaccine cannot control but affect

their uptake of vaccines. Contextual influence arises due to socio- economic, cultural,

environmental, health system, or political factors. The strategy will consider the following

when developing communication products

i. Communication and media environment: The national and community media will

be briefed of COVID-19 and will be part of the communication team for them to have

up to date COVID-19 vaccine information and issues so that they can publish and

broadcast accurate information that can demystify myths and misinformation.

Information on COVID-19 and updates will be shared on national and community

media platforms.

ii. Use of influential leaders, and anti- or pro-vaccination organizations: The

development of communication products will involve influential persons, religious

organizations mainly who have been involved in mobilizing resources for COVID-19

case management and organizations or people who are anti and pro vaccination in all

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communication meetings and will use such people in print and audio visual products to

promote uptake of COVID-19 vaccine.

b. Vaccine and vaccination-related issue.

These include the risk and benefits of taking the vaccine, the scientific evidence available to

back up the efficacy of the vaccine. The schedule, mode of delivery and the supply of the

vaccine and the knowledge base and attitude of health workers towards the vaccine. The

communication of the vaccine will make sure that all the mentioned issues are incorporated in

the communication to promote up take of vaccine.

The communication team will make sure that the health workers are updated with current

information to develop positive attitude toward COVID-19 vaccine. The communication team

will develop and continuously update communication materials for the health workers to aid

discussions with clients

c. Individual and group influences.

This describes factors that clients and the people around them can motivate or demotivate them

to get the vaccine. These are personal, family and/or community members’ perceptions and

experience with vaccination. The beliefs, attitudes about vaccines, health and prevention, their

knowledge about COVID-19 vaccines, their trust in health system and health providers,

perceived risk and/or benefit of the vaccine and belief that immunisation as a social norm or

not needed or harmful.

The communication will make sure that it builds trust of communities towards the health

systems and health providers by providing platform for dialogue between community members

and health workers.

The communication team will identify the influencers of the clients and will develop

communication products of the influencers to motivate the clients to get the vaccine.

The communication will also engage the communities to make immunization as a social norm

and that it prevents deadly diseases like COVID-19.

Testimonies of individuals will be broadcasted or published and uploaded in all media

platforms to motivate the others to get the vaccine.

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Figure 3: SAGE conceptual model and relationship to vaccine uptake

CONTEXTUAL INFLUENCES

Influences arising

due to historic,

socio-cultural,

environmental,

health

system/institutional,

economic or political

factors.

Communication

and media

environment.

Influential

leaders and

anti- or pro-

vaccination

lobbies.

Religion,

culture, socio-

economic

status.

Uptake of

COVID-19

vaccine

among

targeted

people.

VACCINE/ VACCINATION– SPECIFIC

ISSUES

Directly

related to

vaccine or

vaccination

Risk/ Benefit

(epidemiological and

scientific evidence).

Mode of administration.

Mode of delivery (e.g.,

routine program or mass

vaccination campaign).

Reliability and/or

source of supply of

vaccine.

Vaccination schedule.

Knowledge base and/or

attitude of healthcare

professionals

INDIVIDUAL AND GROUP INFLUENCES

Influences

arising from

personal

perception

of the

vaccine or

influences of

the

social/peer

environment

Personal, family and/or

community members’

experience with

vaccination, including

pain.

Beliefs, attitudes about

vaccines, health and

prevention.

Knowledge of the

vaccines.

Health system and

providers-trust and

personal experience.

Risk/benefit (perceived,

heuristic).

Immunisation as a social

norm vs. not

needed/harmful.

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8. COMMUNITY ENGAGEMENT IMPLEMENTATION IN THE COVID-19

VACCINE.

The International Association for Public Participation (IAP2) has established a Public Participation

Spectrum to determine the possible types of engagement with stakeholders and communities. This

spectrum also illustrates the increasing level of public impact of community engagement from

‘inform as the lowest level’ to ‘empowerment’ as final decision-making placed in the hands of the

public to the matters that affect the public such as COVID-19 Vaccine.

Hence, the implementation of community engagement for COVID-19 Vaccine will be based on

the model which hinges on the spectrum of community engagement. It outlines the dimensions of

Community Engagement as stipulated in the figure 4 below:

Table 4: Levels of Engagement in COVID-19 Vaccine.

12

8.1 Techniques of community engagement in COVID-19 Vaccine

A wide variety of techniques will be used by services to engage with communities and service

users. Before the engagement process starts, it is important to ensure that the purpose of the activity

and the level of engagement available is clear to everyone. Five main techniques of the ‘ladder for

participation’ will help us work better together in the COVID-19 Vaccine. These are:

Ladder for community

participation

Description

1. Keeping community

informed on the COVID-

19 Vaccine

Ensuring that people know what is happening with services

and local events – especially those that that are important to

individuals and communities (newsletters, information on the

council website)

2. Asking community what

they think on COVID-19

Vaccine.

Consultation with people when there are a number of options

for the decision to be made (surveys, focus groups, citizen

panel questionnaires, etc.)

3. Deciding together on

COVID-19 Vaccine.

People will become involved in helping decision making on

things that we are responsible for delivering (tenant groups)

4. Acting together on

COVID-19 Vaccine.

Bringing together community groups and the government and

partners to work together to make things better (Planning for

Real)

5. Supporting independent

community initiatives on

COVID-19 Vaccine

Helping people set up independent community groups to

focus on things that are important to them (Community Asset

Transfer)

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9. PARTICIPANT GROUPS/TARGET AUDIENCE AND CHANNELS OF

COMMUNICATION

a. Participant groups/target audience

Priority audiences addressed in this strategy are based on data from WHO guidelines, national

guidelines and studies which identified the priority and key populations for COVID-19

Vaccination. The target audience are the target population for the vaccination and their influencers.

The primary audience include: Health workers in private and public health care facilities, older

people aged 60 and above, people that have chronic conditions and social workers who interact

with many people on daily basis like teachers, security institutions i.e. Police, Prisons and

immigration staff among others.

The secondary audience include: The leadership of association of medical doctors, nurses,

environmental health, pharmacy, laboratory and other allied health association, associations on

PLHIV, cancer, diabetics and others The nurses’ council and medical council of Malawi, Teachers

association of Malawi. The leadership of elderly people in Malawi, pensioners’ association of

Malawi, religious groupings, Malawi interfaith association, Pentecostal churches of Malawi,

traditional leaders, youth groups, disability organizations and community-based volunteers’ e.g.

CHAGs.

The tertiary audience include: Members of parliament, health right activists, Malawi healthy

equity, MISA Malawi, media fraternity

14

b. Participants Audiences and Channels of Communication

1.0 COVID-19 vaccine Concentration

Primary target

audience

Audience description Proposed Approaches and

Channels

Health workers All people engaged in actions

whose primary intent is to enhance

health in private and government

facilities.

Health workers infected with

COVID-19 may contribute to

health care-associated infection

transmission of infection to their

patients and people they care for,

including those at high risk for

developing severe COVID-19

disease and complications.

Interpersonal

Communication: Face to Face

Orientation, Focus Group

discussions, digital media e.g.

WhatsApp groups, power-point

slide decks.

Mass media: Radio/TV

programs & spots.

Elderly. People aged 60 years and above due

to their age-related lowered

immunity exposing them to higher

risk of many infections including

COVID-19

Interpersonal

Communication: community

dialogues

Community Mobilisation:

Door to Door, Mobile van

announcements, influential

leaders, religious leaders,

community-based volunteers’

e.g. CHAGs.

15

Mass Media: radio and TV

spots/programs.

Print media: Posters, flyers,

leaflets, stickers.

Persons with

underlying

health conditions

People of all ages that are diabetic,

live with HIV, have high blood

pressure, asthma and other chronic

conditions who are at significantly

higher risk of severe disease or

death due to COVID-19.

Interpersonal

Communication: community

dialogues.

Community Mobilisation:

Door to Door, Mobile van

announcements, influential

leaders, religious leaders,

community-based volunteers’

e.g. CHAGs.

Mass Media: radio and TV

spots/programs.

Print media: Posters, flyers,

leaflets, stickers.

16

2.0 COVID-19 RCCE.

Teachers,

security staff,

immigration

staff, MRA staff,

drivers, sex

workers,

hospitality staff.

Due to the nature of their job, these

workers interact with a lot people and

most of the time it can become difficult

to adhere to preventive measures.

Interpersonal

Communication: Face to

Face Orientation, digital

media e.g. WhatsApp

groups, power-point slide

decks.

Mass media: radio/TV

programs & spots.

People around

borders/POEs

(general

populations).

They are at high risk of getting infected

with COVID-19 as they may get exposed

to travelers.

Mass communication:

leaflets, banners, radio

programs/spots.

Community

Mobilisation: community

dialogues, meetings, Door

to Door, Mobile van

announcements, influential

leaders, religious leaders,

community-based

volunteers’ e.g. CHAGs.

Travelers. They are highly exposed to COVID-19

during travel.

Mass communication:

leaflets, banners.

17

General

population.

They may have low risk perception due

to misconceptions and myths.

Interpersonal

Communication:

Community dialogues.

Interpersonal

Communication (for

children and youth):

Creativity Competitions

(art, story, theatre, video)

on themes that promote

vaccine uptake (from T/A-

level).

Community

Mobilisation: Door to

Door, Mobile van

announcements, influential

leaders, religious leaders,

community-based

volunteers’ e.g. CHAGs.

Mass Media: radio and

TV spots/programs.

Print media: Posters,

flyers, leaflets, stickers.

Children &

Young People

Children are particularly vulnerable to

the socio-economic impacts and, in some

cases, by pandemic mitigation measures

e.g. school closures. They may not be

able to access appropriate information or

Interpersonal

Communication:

interactive guides,

sensitization at school by

18

understand the recommended behaviours

and also suffer from the psychosocial

impacts of the pandemic. There may also

be disruptions in care due to the socio-

economic impacts.

On the other hand, children and young

people may be great spreaders of the

word to their families and communities.

School Health Committees

or teachers.

Mass Media: comic

books, animations.

Community

Mobilisation: Door to

Door, Mobile van

announcements, influential

leaders, religious leaders,

community-based

volunteers’ e.g. CHAGs.

The homeless They may live isolated from society and

not have a network of family and friends

to share information.

They may be more focused on surviving

and obtaining food than accessing

official public health information and

may be suspicious or fearful of

government services while being at high-

risk of getting severe COVID-19.

Interpersonal

Communication: Guides

for child protection

frontline workers.

GBV Survivors Gender-based violence (GBV) increases

during every type of emergency,

including disease outbreaks. Care and

support for GBV survivors may be

disrupted, including safety, security and

justice services.

Interpersonal

Communication: Victim

support materials

(integrated with COVID-

19 messages).

19

Print media: Posters,

flyers, leaflets, stickers.

Persons with

disabilities.

Even under normal circumstances,

people with disabilities are less likely to

access health care, education and

employment and to participate in the

community. They are more likely to live

in poverty, experience higher rates of

violence, neglect and abuse, and are

among the most marginalized in any

crisis-affected community. They are

often excluded from decision-making

spaces and have unequal access to

information on outbreaks and availability

of services, especially those who have

specific communication needs.

Interpersonal

Communication: Special

materials for PwDs e.g

Braille, sign language.

Print media: Posters,

flyers, leaflets, stickers.

Youth 15 to 30 year olds, especially school

graduates living at home, and people

already volunteering in community

initiatives, currently unemployed.

Interpersonal

Communication:

Creativity Competitions

(art, story, theatre, video)

on themes that promote

vaccine uptake (from

T/A-level).

Multi-media: WhatsApp

groups, U-Report, Radio.

20

10. COVID-19 VACCINE KEY MESSAGES.

Approaches to messages

Communication to the health workers and community about the vaccine to clarify the intended

role of COVID-19 vaccine in the control and prevention of COVID-19 is very much needed.

The right information on COVID-19 vaccine would be needed to promote acceptance and uptake

of the vaccine, by addressing peoples’ questions, concerns, vaccine’s safety, and demystify myths

and rumours that would circulate. The communication on COVID-19 vaccine would raise

awareness of the safeguards in place to protect public health and safety.

In this context, the strategy would address the following:

● Build on generally positive attitudes toward vaccines: Evidence suggests that childhood

vaccination has high acceptance and uptake because the vaccines have demonstrated to

prevent life threatening diseases like polio and measles. Recently we have also seen no

cases of Cholera outbreaks in hotspots where Oral Cholera Vaccine (OCV) has been

administered successfully. The messages should be framed basing on child immunization

as an intervention that has an impact in reducing life threating diseases.

● Manage expectations about the COVID-19 vaccine: Administration of the COVID-19

vaccine may raise unrealistic expectations about the vaccine’s protective ability. People

may think that the vaccine will eliminate COVID-19 within a short period of time.

Messages should be framed that the vaccine is an additional intervention to already existing

preventive measures of hand washing with soap, physical distancing and wearing of masks

and messages should stress continued use of existing COVID-19 preventive measures.

Explanations on why vaccine alone is not sufficient to protect against and eliminate

COVID-19 will be given to assist with adherence to other preventive measures.

● Emphasize COVID-19 symptoms: Signs and symptoms of COVID-19 may be similar to

other diseases like malaria, pneumonia and cough. This has implications as communities

21

may say that COVID-19 vaccine has no or little effect in reduction of COVID-19 cases.

Messages should promote early health seeking behaviours and testing if people have signs

and symptoms similar to that of COVID-19 to rule out or confirm COVID-19 and act

accordingly.

● Explain who should get the vaccine and why: Messages should describe the priority

beneficiaries of the COVID-19 vaccine and the reasons for targeting them.

● Explain the schedule and delivery mode: Communities should be informed on the

schedule, where the vaccine will be administered and the number of doses to promote

uptake of the vaccine whilst observing COVID-19 preventive measures.

● Phased introduction of the COVID-19 vaccine: The messages should explain why the

phased approach is being used and that people that are at high risk of contracting COVID-

19 or at high risk of having severe form of COVID-19 will receive the vaccine in the first

phase and others will get in the subsequent phases up until 80% of the population is

vaccinated.

● Vaccine safety and efficacy: Messages should provide assurance of the safety of the

vaccine and efficacy in reducing number of COVID-19 cases if herd immunity is reached.

● Communicate the dates and places where the vaccine will be delivered: The messages

should provide information on where and when to get the vaccine to avoid doubts and

confusion thus possible missed opportunities for vaccine administration.

Examples of specific messages about vaccination with the COVID-19 vaccine.

Health workers, community leaders, and other trusted and reliable sources may provide messages

for parents and other caretakers of young children. The messages would need to be audible, easy

to understand, visible in local languages, and directed at both men and women. When possible,

infographics should be used. Messages for parents or caretakers of young children and their trusted

sources may take the following approach:

22

Key messages on COVID-19 vaccine

COVID-19 disease

COVID-19 is infectious and spreads quickly. It can cause serious illness to any person;

some cases have caused death.

COVID-19 attacks everyone but people that have underlying health conditions of diabetes,

blood pressure, HIV, heart condition regardless of age are at high risk.

People that are 60 years and above are more likely to contract COVID-19 infection because

most of them their immunity is lowered due to age

People with COVID-19 have had a wide range of symptoms reported – ranging from mild

symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the

virus. People with these symptoms may have COVID-19:

Most common symptoms:

- Fever.

- Dry cough.

- Tiredness.

Less common symptoms:

- Aches and pains.

- Sore throat.

- Diarrhoea.

- Conjunctivitis.

- Headache.

- Loss of taste or smell.

- A rash on skin, or discolouration of fingers or toes.

Serious symptoms:

- Difficulty breathing or shortness of breath.

- Chest pain or pressure.

- Loss of speech or movement.

23

Please keep in mind that:

COVID-19 symptoms vary significantly from one person to another and while some

people, especially those with underlying medical conditions, can experience severe

symptoms, others can be absolutely asymptomatic.

COVID-19 symptoms can be similar to malaria symptoms!!

The use of mosquito nets significantly reduces the risk of malaria.

There is no proof that anti-malaria drugs help cure COVID-19 and they should be taken

only if you have been tested positive for malaria!! The misuse of anti-malaria drugs or any

other drug can cause serious side effects and illness and even lead to death.

Stay home and self-isolate even if you have minor symptoms such as cough, headache,

mild fever, until you recover. Call your health care provider or hotline for advice. Have

someone bring you supplies. If you need to leave your house or have someone near you,

wear a medical mask to avoid infecting others.

If you have a fever, cough and difficulty breathing, seek medical attention immediately.

Call by telephone first, if you can and follow the directions of your local health authority.

Continue to practice preventive measures of washing hands, properly wearing masks and

ensuring social distance.

COVID-19 Vaccine

The vaccine is an additional intervention to other COVID-19 prevention measures of hand

washing with soap, physical distancing and wearing of masks.

The vaccine will reduce the risk of contracting COVID-19.

The vaccine will reduce the number of cases of COVID-19 if all more people will get the

vaccine.

The vaccine will be administered in a phased approach as there are limited supplies of the

vaccines globally.

24

Who should be vaccinated first?

● While vaccine supplies are limited, it is recommended that priority be given to health

workers at high risk of exposure and older people, including those aged 65 or older.

● Vaccination is recommended for persons with conditions that increase the risk of severe

COVID-19. These include, people with having heart disease, respiratory diseases e.g.

asthma and diabetes regardless of age.

● People living with HIV or those with low immunity are part of a group recommended for

the vaccination, and may be vaccinated after receiving information and counselling.

● Vaccination can be offered to people who have had COVID-19 in the past. But individuals

may wish to defer their own COVID-19 vaccination for up to six months from the time of

infection, to allow others who may need the vaccine more urgently to go first.

● Vaccination can be offered to breastfeeding women if they are part of a group prioritized

for vaccination. The women do not need to discontinue breastfeeding after vaccination.

Should pregnant women be vaccinated?

● While pregnancy puts women at higher risk of severe COVID-19, very little information

is available to know if the vaccine is safe during pregnancy.

● Pregnant women at high risk of exposure to COVID-19 (e.g. health workers) or who have

high risk conditions (e.g. heart disease, asthma e.t.c) may be vaccinated in consultation

with their health care provider.

Who is the vaccine not recommended for?

● People with a history of severe allergies need to consult the health worker to advise them

if they can take the vaccine.

25

● The vaccine is not recommended for persons younger than 18 years until further studies

are conducted.

● It is not recommended for someone who is COVID-19 positive.

What’s the recommended dosage?

● The recommended dosage is two doses with an interval of 8 to 12 weeks.

● At the moment it is not known if people can be protected after taking a single dose.

● The vaccine is administered through injection.

Is the vaccine safe?

● Malawi will be using the Oxford/AstraZeneca vaccine. WHO has approved

Oxford/AstraZeneca for emergency use in all countries. The WHO’s SAGE recommended

the vaccine for all age groups 18 and above.

● The European Medicines Agency EMA has thoroughly assessed quality, safety and

efficacy of the vaccine, approved it and has recommended the vaccination for people aged

18 and above.

● WHO has also approved the vaccine as it complies with all the requirements

of quality, safety and efficacy set out internationally.

● Malawi team of experts on vaccine safety and poison board of Malawi, which both are

independent bodies, have also approved that the vaccine is safe and can be administered to

Malawians.

26

Does the vaccine have any side effects?

Some people might experience some mild side effects that can happen after vaccination

e.g. soreness at the site of injection, fatigue, headache, and muscle pain within 24 to 48

hours after immunization. But these disappear after some time.

Does the vaccine work?

● Oxford/AstraZeneca vaccine has an efficacy rate of more than 60%.

● When you take the Oxford/AstraZeneca vaccine you have a higher chance that if you

contract the virus may not get sick from the disease. However, some people may still suffer

from the disease due to different reasons like immunity.

● Taking 2 doses with an interval of 8 to 12 weeks between the 2 doses increases protection.

Does the vaccine work against new variants of Coronaviruses?

● Oxford/AstraZeneca is still recommended for use even if new Coronavirus types are

present in a country. Countries will assess the risks and benefits of taking the vaccine for

their population.

Does the vaccine prevent infection and transmission?

● The vaccine has efficacy rate of more than 60%.

● We still do not know if someone who has been vaccinated can still carry and transmit the

virus to other people who have not been vaccinated.

27

● It is important to maintain preventive measures e.g. masking, physical distancing, hand

washing, use of elbow when coughing or sneezing, avoiding crowds, and ensuring good

ventilation of rooms.

11. COVID-19 VACCINE CRISIS COMMUNICATION SCENARIOS, MESSAGES

AND RESPONSES

The forecast of scenarios include:

o Side effects: soreness at the site of injection, fatigue, headache, and muscle pain

o Suspicion about poor vaccine quality

o Actual event arising from vaccine: Loss of trust of the current and subsequent vaccines

o Vaccine replacement/recall

o Health workers refusing to get vaccinated, sensitization of health workers might also be

necessary.

o Relaxation of COVID-19 preventive measures once the vaccination process starts

COVID-19 Vaccine

scenario.

Development of side

effects: soreness at the site

of injection, fatigue,

headache, and muscle

pain:

COVID-19 Vaccine

scenario.

Other adverse effects e.g.

fainting or death.

COVID-19 Vaccine scenario.

Developing COVID-19

symptoms after vaccination

Key message:

It is normal to experience

side effects within 24 to 48

hours after immunization

Key message:

There can be other effects not

related to COVID-19 vaccine,

which could have happened if

Key message:

COVID-19 Vaccine reduces

the risk of getting infected.

28

the person had not taken the

vaccine. Always follow

recommendations to avoid

vaccination if you are already

infected.

Supporting message.

Seek prompt medical

attention if side effects

continue or if you are

concerned about their

severity

Supporting message.

COVID-19 Vaccine does not

increase people’s risk to other

life threatening conditions

Supporting message.

After vaccination continue

observing all COVID-19

preventive measures.

COVID-19 Vaccine scenario.

Suspect poor vaccine quality.

COVID-19 Vaccine

scenario.

Actual event arising from

vaccine: Loss of trust of

the current and subsequent

vaccines.

COVID-19 Vaccine

scenario.

Vaccine replacement or

recall: Demand

explanations, apology and

compensations.

Key message:

All vaccines including COVID-

19 Vaccine are tested and found

to be safe for use.

Key message:

Many children in Malawi have

safely received vaccinations

for other diseases.

Key message:

Government can recall or

replace a vaccine if it is

proven that it has

detrimental or potential

29

Oxford/AstraZeneca has been

approved by the WHO.

Vaccination is one of the best

ways to prevent diseases. We

now have vaccines to prevent

more than 20 life-threatening

diseases, helping people of all

ages live longer, healthier

lives. Immunization currently

prevents 2-3 million deaths

every year from diseases like

diphtheria, tetanus, pertussis,

influenza and measles.

The most commonly used

vaccines we have today have

been in use for decades, with

millions of people receiving

them safely every year.

effect to the lives of

people.

Supporting message.

In emergency setting and to

protect lives some vaccines can

be developed quickly e.g. the

Ebola vaccine and COVID-19

Vaccine. These are still tested

for safety.

This is possible because

Regulation Authorities divert

resources to speed up processes

and reduce timelines for the

Supporting message.

COVID-19 Vaccine is safe.

Government can recall/replace

a vaccine if it is proven that it

have detrimental effect to the

lives of people.

Government can recall/replace

a vaccine if it is proven that it

has detrimental or potential

effect to the lives of people.

Supporting message.

When you have issues

with our services seek

advice from the nearest

health facility.

30

evaluation and authorisation of

those vaccines.

Whatever the setting, a vaccine

is authorized if the scientific

evaluation has demonstrated that

their overall benefits outweighs

their risks. A vaccine's benefits

in protecting people against the

disease must be far greater than

any side effect or potential risks.

31

12. PROPOSED CRISIS RESPONSES ON ANTICIPATED ISSUES.

Issue Scenario Seriousn

ess (low,

medium,

high)

Crisis activities Preventive

actions e.g.

training e.t.c

New study New findings

showing that

COVID-19 Vaccine

has lower efficacy

High

Ministerial

statement.

Panel discussion

by experts (live).

Production and

dissemination of

fact sheets.

Health worker

orientations.

Media

orientations.

Community

sensitizations.

Vaccine

reaction

(AEFI,

AESI)

Development of

unlisted side effects

(normal and

abnormal, mild or

serious).

Medium

High

Investigation

(within 24 hours

after an

AEFI/AESI report)

and prompt

feedback.

Follow up/close

supervision of the

cases.

Holding statement

(MoH Hq)

Health worker

orientations.

Community

sensitization.

Surveillance and

supervision.

32

Vaccine

recall or

suspension

Product quality

related issues.

Program related

immunization error.

High Review

communication

materials

(Question and

answers, fact

sheet, press

statement, holding

statement).

Investigation

(within 24 hours

after an

AEFI/AESI

report).

Press statement.

Holding statement.

Community

meeting.

Press briefing

(Question and

answers, fact

sheet).

Training health

workers on

COVID-19

vaccine &

related AESIs.

Community

engagement.

Media briefing.

33

Media

report and

rumour.

AEFIs/AESIs.

Rumours about other

things than AEFIs.

High.

Medium

Media briefing.

Press release.

Public

announcements.

Community

awareness

meetings.

Community

engagement.

Media briefing.

Orientations of

health workers.

Training of

PRO’s.

Press

conference.

Community

awareness

meetings.

Community

engagement.

Vaccine

replaceme

nt

Suspect poor

vaccine quality-

affect uptake.

Loss of trust of the

current and

subsequent vaccines.

Demand

explanations,

apology and

compensations.

High

Media briefing.

Press release.

Public

announcements.

Holding

statements.

Press conference.

Community

awareness

meetings.

Orientation of

health workers,

Media houses &

PRO’s.

Press

conference.

Community

awareness

meetings.

Community

engagement.

34

Community

engagement

35

13. MONITORING, EVALUATION AND DOCUMENTATION

Monitoring tools will be adapted from the HPV monitoring framework and be utilised for data

collection at national, district and community levels. An online dashboard will be created for i)

District health Promotion Officers and ii) national partners (CSOs, iNGOs and government

partners) to fill data on reach and provide insights collected from the field as well as

recommendations that will be discussed in RCCE meetings. To ensure that there is regular situation

analysis, other digital platforms will be utilized e.g. U-report, Chipatala cha pa Foni (CCPF), a

toll-free health hotline. M&E tools will therefore include:

o National-level data collection forms

o District-level data collection forms

o Community-level data collection forms

o Online dashboard (national and district)

o U-report

o CCPF

o Formal Survey by academia

Proposed Set of Core Indicators for Monitoring & Evaluation

Final Outcome (Impact) Indicators.

% of fully immunized eligible individuals in the targeted hotspots.

% of beneficiaries and/or their parents who believe that all eligible individuals

should take the COVID-19 vaccine.

% of beneficiaries and/or their parents who are willing to be vaccinated (or give

consent to be vaccinated).

36

Outputs and Interim Outcomes Indicators.

Knowledge, Awareness, Perception of Risk, Acceptance and Trust.

% of eligible individuals who have heard about the COVID-19 vaccine and know

what it is meant for.

% of eligible individuals who know what measures should be taken if they have been

in contact with someone who has COVID-19.

% of eligible individuals who believe they are at high/low/no risk of getting COVID-

19.

% of eligible individuals old who agree to take the COVID-19 vaccine for preventing

COVID-19.

% of eligible individuals who agree that they would consent to their child/relative

receiving the COVID-19 vaccine.

% of eligible individuals who believe that the COVID-19 vaccines is safe.

% of eligible individuals who believe that the COVID-19 vaccine is effective in

preventing COVID-19.

% of all eligible individuals who gave consent for COVID-19 vaccination.

% of all eligible individuals who intend to give consent for COVID-19 vaccination

(in the future)

Coverage with Equity.

% of eligible individuals who took their first dose/all doses of COVID-19 vaccine.

% of eligible individuals who were fully immunized with 2 doses of COVID-19

vaccine in hard to reach areas.

Vaccination Experience and Frontline Worker Commitment.

% of beneficiaries and/or their parents who reported that the vaccination experience

was positive.

37

% of beneficiaries and/or their parents who had, or agreed to, proactively promote

COVID-19 vaccination in their communities or among their peers.

% of front-liners who ensured that >90% of all eligible individuals in their

designated catchment area were reached with messages/interventions.

Establishing COVID-19 Vaccination as a Norm.

% of beneficiaries and/or their parents who believe that all eligible individuals

should take the COVID-19 vaccination.

% of beneficiaries and/or their parents who believe that their community or peer

group expects all eligible persons to take COVID-19 vaccination.

% of eligible individuals who believe that their friends or family would want them to

self-isolate if they have been in contact with someone who has COVID-19.

Media Support and Commitment.

% of positive and supportive COVID-19 vaccine reports in the media compared to

negative reports.

Input and Process Indicators: Coordination, Planning, and Operations

National Level

# of Communication Sub-committee or Working Group meetings that took

place.

# of communication and social mobilization activities or events planned

compared to # of activities or events actually implemented, at national level.

# of planned communication materials/products produced COVID-19 vaccine.

38

# of planned communication materials/products disseminated on COVID-19

vaccine (distributed or broadcast).

# of parents/guardian of eligible individuals who had been reached by COVID-

19 vaccine key messages (heard on broadcast media or through interpersonal

communication by front-line workers).

# of community leaders (at village/community level) who had been reached by

COVID-19 vaccine key messages (heard on broadcast media or through

interpersonal communication by front-line workers).

District Level

# of districts with communication and community engagement micro-plans

(including specific plans for reaching all eligible individuals in the hotspots).

# of communication and social mobilization activities or events planned

compared to # of activities or events actually implemented, per district.

# of frontline health-workers actually trained or sensitized versus # planned, per

district.

# of planned locations per district that received IEC materials in a timely

manner.

# of districts who reported sufficiency of communication resources (funds, fuel,

IEC materials, front-liners).

# of districts who conducted sensitization and engagement activity in each of the

GHVs.

# of reports of rumours, misinformation, or AEFIs.

# of reports of rumours, misinformation, or AEFIs that were resolved within 72

hours.

12

14. COORDINATION

Coordination mechanisms will be maintained at strengthened at the following levels:

a. National Level:

Chaired by the Deputy Director of Health Education Services (HES), The COVID-19 RCCE

Committee will be maintained and strengthened to increase participation of line Ministries i.e.

Ministry of Information, Ministry of Civic Education and National Unity and Ministry of Local

Government and local and international partners and Civil Society. The committee will be

responsible for

o Mapping interventions

o Monitoring implementation

o Coordinating monitoring and evaluation activities e.g. joint monitoring, coordinating

partners conducting rapid assessment

o Providing guidance for leveraging resources

o Providing guidance for strategic approaches

b. District Level:

Chaired by the District Health promotion Officer, the COVID-19 RCCE Committee will be

maintained and strengthened to increase participation of partners. The committee will be

responsible for:

o Mapping interventions.

o Monitoring implementation.

o Coordinating monitoring and evaluation activities e.g. joint monitoring, coordinating

partners conducting rapid assessment.

o Providing guidance for leveraging resources.

o Providing guidance for strategic approaches.

13

c. Community Level:

Chaired by the Health Promotion Focal person at Health Center level, the COVID-19 RCCE

Committee will be maintained and strengthened to increase participation of partners. The

committee will be responsible for

o Mapping interventions

o Monitoring implementation by community agents

o Coordinating monitoring and evaluation activities e.g. joint monitoring, coordinating

partners, monitoring and reporting AEFIs

15. IMPLEMENTATION PLAN & BUDGET ESTIMATES

Thematic Area

Activities

Y

R

1

Y

R

2

Y

R

3

US $

Materials

development

1

Development of Social

Mobilisation, Risk/Crisis

Communication Strategy and

Vaccine communication materials

34,493

2 Pre-Testing of COVID-19 vaccine

materials

28,699

3 Printing of Publicity materials 43,974

Media

interface and

capacity

building.

4 Conduct Regional Press

Orientations

33,418

5 Conduct Regional Media Tours 215,385

14

6 Media press releases on COVID-19

Vaccine

228,955

Mobile

community

announcements

7 Advance Publicity 157,692

8 Hoisting of banners in strategic

places in cities and districts

1,301,444

Airing of radio

& TV

programs,

PSA's & jingles

in different

languages

9

Production of Radio and TV, Radio

Programs, PSAs and Jingles in

different languages

268,377

10

Airing of Radio and TV, Radio

Programs, PSAs, Jingles and Live

Panel Discussions

251,110

Community

engagement

11 Briefing of local leaders, block

leaders & political leaders.

190,513

12 Briefing of religious leaders 641

13 Conduct Door to Door meetings by

HWs in 29 districts

43,226

14 Engagement with Civil Society 304,487

Conduct orientation meetings with

community groups:

15

Care mother groups, CBOs,

FBOs, CHAG’s, VHCs,

HCMCs, HMCs, VDCs,

ADCs.

Awareness meetings conducted by

community groups:

Care mother groups, CBOs,

FBOs, CHAG’s, VHCs,

HCMCs, HMCs, VDCs,

ADCs.

Monitor vaccine implementation

using the Community Health

Register.

Review meetings with communities

on implementation of vaccine.

Online

presence

15 Strengthen the online presence 28,699

16 Virtual National Launch of COVID-

19 vaccine by H.E.

43,974

M & E

25,564

17

Monitoring of Communication

interventions with district task

teams

33,418

18 Procurement of vehicles and PA

Systems

215,385

Grand Total 3,425,964

16

16. KEY PRODUCTS TO SUPPORT COMMUNICATION AND SOCIAL

MOBILIZATION FOR COVID-19 VACCINE INTRODUCTION

This section gives an overview of key communication products and materials anticipated for 2021.

From 2022 products will need to revised or developed separately, based on the level of

“routinization” achieved for COVAX vaccination services, as well as, the fact that there is

expected to be a much lower level intensity of communication activities.

Key Communication Products and Materials

… (1)

Intended

audience

Purpose

Coordination and Technical Support

1 COVID-19 Vaccine Introduction Strategy,

Communication & Social Mobilization

Strategy, and the Rapid Desk Review

document disseminated.

Key partners,

donor agencies,

and departments

of MOH, MOE

etc.

Ensuring shared

understanding of

goals, objectives,

and approaches.

2 A special consolidated Summary

Document of COVID-19 Vaccine

Introduction, Delivery, and

Communication & Social Mobilization

Strategy document and the Rapid Desk

Review document.

District Level

Offices of all

partners,

Ministries,

Traditional

Authorities,

District

Commissioners,

etc.

Ensuring consensus

and shared

understanding of

goals, objectives,

and approaches.

3 A succinct 4-page Basic Version of the

COVID-19 Vaccine delivery and

communication strategy.

Specifically for all

HSAs, school

Ensuring shared

understanding of

17

teachers, and other

front-liners.

goals, objectives

and approaches.

4 A succinct 4-page Advocacy Brochure of

the COVID-19 Vaccine delivery and

communication strategy.

Political

leadership and

donors.

Timely and

adequate resource

flow.

5 Slide-sets based on the various strategy

documents, desk review and key data.

Implementing

partners/managers.

For use in

workshops,

meetings.

6 A unifying Visual Identity, Logo, and

Tagline for the COVID-19 Vaccine

campaign established.

All audiences and

public.

Visibility and

building brand

affiliation and

loyalty.

7 Set of evidence-based, context-specific

Core Messages and FAQs for media and

high-level advocacy.

Decision-makers

and media-

persons,

gatekeepers.

High-level

advocacy meetings

and media

engagement.

Data, Baselines, and Benchmarks

8 Synthesis of all key research and data into

a common ‘information-for-action’

document.

Program Planners,

managers.

Shared view of

barriers, enablers.

Micro-Planning and Training

9 Guidance note/template for microplanning

community engagement and mobilization

activities.

All district-level

functionaries.

Support

microplanning,

budgeting

18

10 Informational flyer on crisis

communication plan and AEFI

management SOPs.

All district-level

functionaries.

Rapid response to

rumours, AEFIs.

11 Training module with supportive materials

on interpersonal communication +

Crisis/AEFI plan.

All front-liners. Rapid response to

rumours, AEFIs.

12 Orientation/sensitization of all

communication focal persons (through

special radio broadcasts and SMS

Platforms). This is primarily for those who

are not specifically nominated for face-to-

face training.

All

communication

focal persons,

including those

participating in

face-to-face

training.

Cost-effective mass

training using

distance education

methodologies.

13 Revised materials for refresher training of

front-liners if and as necessary (post-

Wave-1/Dose1).

All front-liners. Support community

engagement.

KEY PRODUCTS TO SUPPORT COMMUNICATION AND SOCIAL MOBILIZATION

(Continued)

Key Communication Products and Materials

… (2)

Intended

audience

Purpose

Materials Development and

Dissemination/Deployment

19

14 Creative briefing note describing rationale,

purpose, and target audiences for all

broadcast and non-broadcast

communication products. Including

suggestions for any planned launch events.

Partners and all

designers,

producers.

Shared

understanding

among all partners

about key products.

15 Guidance note/plan for pre-testing of all

broadcast and non-broadcast

communication materials.

Partners and all

designers,

producers.

Rigorous pre-

testing of products.

16 Special guidance note on COVID-19

Vaccine messaging for online and social

media platforms, including tactics for

monitoring and dealing with negative social

media conversations.

Partners and all

designers,

producers.

Strategic and rapid

response to online

and social media

threats.

Non-broadcast materials (English and

Chichewa versions as required)

17 Core set of Key Messages and FAQs and a

short narrative (in print and electronic

form).

All key partners

and broadcasters.

Websites and

internal briefings.

18 Posters/banners/flags for COVID-19

Vaccine vaccination sites.

General public. Identification and

visibility of sites.

19 COVID-19 Vaccine flyers/brochures to

support interpersonal communication (IPC).

All eligible

recipients,

parents, and

community

influencers.

Support mass-scale

community

engagement by

front-liners.

20

20 Three different and specific versions of

COVID-19 Vaccine informational,

mobilization, advocacy communiques (in

the form of letters), signed by Minister (s).

Religious leaders,

district/traditional

authorities.

Targeted

consensus-building

and mobilization of

local leadership.

21 COVID-19 Vaccine media kit for

engaging/sensitization of media-persons.

Besides printed material, kit must also

include memory stick with photographs and

audio-visual materials.

National and

community media

gatekeepers and

journalists.

Media advocacy

and engagement for

supportive media

reporting.

Broadcast materials (English and

Chichewa versions as required)

22 Brand and COVID-19 Vaccine vaccination

promotion (in short audio, video, print

format): 30/60-second jingles and spots

promoting visual identity, logo, and tagline;

venue/time information prior to vaccination

days.

General public.

23 Testimonials (in audio, video, and print

format): 60-second radio and TV spots with

mix of vaccinated COVID-19 survivors,

parents, front-liners, community leaders

endorsing COVID-19 Vaccine vaccination.

Vaccinated

COVID-19

survivors,

parents,

guardians,

community

influencers, as

well as, the

general public.

Enhance value and

image of all girls;

build trust in

vaccine and

delivery system;

generate demand.

21

24 Interviews/Statements (in audio, video, and

print format): 1-3 minute duration on

COVID-19 Vaccine vaccination by

political and religious leadership for use on

national/community broadcast news

programming, workshops/meetings, training

sessions, websites, social media,

community video screenings.

Vaccinated

COVID-19

survivors,

parents/guardians

, community

influencers, as

well as, the

general public.

Build awareness on

COVID-19

Vaccine. Pre-empt

rumours,

misconceptions.

Build trust and

generate demand.

25 Panel discussion programming (in audio

and video formats): 10-30 mins duration for

national and (mainly) community broadcast

programming, and non-broadcast video

screenings.

Vaccinated

COVID-19

survivors,

parents/guardians

, community

influencers, as

well as, the

general public.

Build trust in

vaccine and

delivery system;

generate demand

26 Single or half-page newspaper

advertisement along with a multi-partner

press release: For release during national

COVID-19 Vaccine launch event.

Political and

social leadership.

Public information

and advocacy.

Brand visibility.

22

KEY PRODUCTS TO SUPPORT COMMUNICATION AND SOCIAL MOBILIZATION

(Continued)

Key Communication Products and Materials …

(3)

Intended

audience

Purpose

Development, Piloting, and Implementation of

Innovations

27 Concept note and plan for development,

piloting, and establishment of U-Report

platform for COVID-19 Vaccine introduction

(including identification/training of

district/community-level U-reporters).

Key partners,

government,

donors.

Buy-in for real-

time: monitoring,

opinion polling,

rumour tracking.

28 Guidance note on piloting of U-Report/SMS

platform for COVID-19 Vaccine, with

database of FLWs.

Managers, front-

liners

Real-time

monitoring and

tracking.

29

Guidance note for the creation of WhatsApp

groups to monitor progress on vaccine roll-

out and rumours at TA-levels.

Health

Surveillance

Assistants,

District Health

Education

Officer, local

NGO partners.

Real-time

monitoring and

tracking.

Monitoring & Evaluation

30 Guidance note and tools for monitoring of

communication and community engagement

activities.

Supervisors,

Field monitors,

Planners.

Measuring

implementation

quality.

23

31 Guidance, tools, and indicator set for rapid

assessment and documenting lessons and

good practices.

Supervisors,

Field monitors,

Planners.

Measuring

implementation

quality.

32 Questions bank for ‘real-time’ targeted

opinion polls using U-report system, FLWs

SMS Platforms.

U-Report and

district level

managers.

Tracking trends in

real time.

33 Template for regular feedback and data

specifically for sub-national managers and

front-liners.

District level

program

managers.

Ensure

implementation

quality.

34 Advocacy brochure for resource mobilization

and sustainability, based on actual

expenditure data.

Policy/political

leadership,

donors

Advocacy for

sustainable

resources.

35 Guidance/template for comprehensive

documentation and a summative Case Study

report.

Partners and

district level

managers.

Comprehensive

documentation.

24

17. COMMUNICATION TREE.

List of Spokespersons and their contact details at headquarters and district level.

Seq Name District Contact details

1 Mr Joshua Malango MoH Headquaters 0884495839

2 Mr Masida Nyirongo Chitipa 0995605854

3 Ms Esterly Nyirenda Karonga 0884449600

4 Mr Bwanalori Mwamlima Rumphi 0881035113

5 Mr Lovemore Kawayi Mzimba North 0995305429

6 Mr Ulunji Luhanga Mzimba South 0884320656

7 Mr Christopher Singini Nkhata-bay 0888346227

8 Mrs Catherine Yoweri Kasungu 0888948015

9 Mr Garry Chilinga Nkhotakota 0994324626

10 Mrs Angela Nyongani Sakwata Salima 0888596995

11 Mr Samson Mfuyeni Ntchisi 0999761510

12 Mr Davie Nuka Dowa 0995821078

25

13 Mr Frank Kaphaso Mchinji 0884111300,

0999391381

14 Mr Richard Mvula Lilongwe 0881604733

15 Mr Mwayi Liabunya Dedza 0881612474

16 Mrs Stella Kawalala Ntcheu 0888151764

17 Mrs Mercy Nyirenda Balaka 0999074095

18 Mr Clifton Ngozo Machinga 0999600435

19 Mr Arnold Mndalira Zomba 0999223897

20 Mr Joshua Cosmas Zuze Chiladzulu 0998047410,

0888660779

21 Mr Dan Chilomo Phalombe 0888865801

22 Mr Chipiliro Mjojo Mulanje 0999342484

23 Mr Fanuel Makina Thyolo 0881126712

24 Mrs Chrissy Banda Blantyre 0888382345

25 Mr George Mbotwa Nsanje 0884223970

26 Mr Harlod Kabuluzi Mangochi 0888621644

26

27 Mr Settie Piriminta Chikwawa 0888861766

28 Mr Dikirani Chadza Mwanza 0999527396

29 Ms Caroline Banda Neno 0881684739

30 Mr Stephano Kaunda Likoma 0993422478