Impact of the "Salud Sobre Ruedas" strategy on COVID-19 vaccination in Guatemala, 2022

The Guatemalan Ministry of Health (MOH), with support from the Pan American Health Organization and the World Health Organization (PAHO/WHO), developed the"Salud Sobre Ruedas" (SSR) strategy of mobile brigades in 189 rural communities in Alta Verapaz (See: https://bit.ly/42JDDmQ). These communities were selected for their limited access and vaccination coverage below 30% with a single dose of COVID-19 vaccine (See: https://bit.ly/42Za2FI).

Implemented from August 1st to October 31st, 2022, SSR provided primary health care services including vaccination, food/nutritional security, reproductive health, and prevention of food and waterborne diseases. Before the brigades arrived, activities were conducted for promotion, education, health communication, and community management through locally elected community facilitators.

To measure the impact of SSR, the increase in COVID-19 vaccination was compared between the 189 intervened communities and 190 non-intervened communities in the same municipalities.

The increase in COVID-19 vaccination coverage was 19.7% in intervened communities for the first dose, compared to an increase of 8.2% in non-intervened communities during the same period. This increase in COVID-19 vaccination coverage for the first dose was 2.4 times higher in intervened communities compared to non-intervened communities.

In the intervened communities, the increase in COVID-19 vaccination coverage was 1.2 times higher in communities with a history of vaccine hesitancy prior to the implementation of the SSR strategy compared to those without any history.

The SSR strategy, with community management and mobile primary health care services, doubled the COVID-19 vaccination coverage increase in intervened rural communities in Alta Verapaz. The impact was even greater in communities with a history of vaccine rejection prior to SSR intervention. The MOH has institutionalized mobile brigades as a primary health care strategy for the year 2023. 

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Photo: Provision of services on a brigade day in La Tinta, Alta Verapaz, Guatemala 2022 (WHO PAHO)

Authors: Marlon Figueroa(1)Manolo Vicente(1), Sharon Reyes(2), Isolda Fortin(2), Keyla Sum(2), Claudia Jarquín(2), Grethel Alvarado(2), Luis Fernanda Quezada(2), Evelyn Balsells(3), Mirna Montenegro(4), Marc Rondy(2) 

1 - Guatemalan Ministry of Public Health and Social Welfare, 2 - Pan American Health Organization/World Health Organization, Guatemala, 3 - Pan American Health Organization/World Health Organization, Washington, DC, 4 - Observatorio de salud reproductiva OSAR, Guatemala