Leveraging Community Health Workers (CHWs) to administer vaccines

Rebecca Alban

Global chronic health worker shortages and stagnating routine immunization rates require new strategies to increase vaccination coverage and equity. Research has demonstrated that task shifting, including the use of community health workers (CHWs) to deliver care, can improve population health. As trained, trusted members of their local communities, community health workers (CHWs)are in a prime position to expand the immunization workforce and increase vaccination coverage in under-reached communities. In many countries, CHWs currently play a key role in demand generation for primary health services, including routine immunization, and could serve as a powerful bridge between remote or under-reached populations and the primary health care system. However, CHWs are rarely enlisted to or legally able to administer vaccines. Malawi is one of only a few countries that relies on CHWs - called Health Surveillance Assistants (HSAs) to administer routine immunizations, and as such offers a unique example of how this can be done.

Leveraging CHWs as vaccinators is a promising yet under-explored task-shifting approach that shows potential to help countries maximize their health workforce, increase vaccination coverage and reach more zero-dose children. However more research is needed to produce evidence on the impact of leveraging CHWs as vaccinators on patient safety, immunization coverage/vaccine equity, and cost-effectiveness as compared to use of other cadres for routine immunization.

Technical publications

TitleAuthorYearTypeLanguage
[pre-print] Leveraging community health workers as vaccinators: a case study exploring the role of Malawi’s Health Surveillance Assistants in delivering routine immunization servicesEmily Gibson, Jenny Payne, Rebecca Alban, Tafwirapo Chihana2023Journal articleEnglish
Community Health Workers as Vaccinators: A Rapid Review of the Global Landscape, 2000–2021Emily Gibson, Luc Mahougbé Kouwanou, Mariam Zameer, Rebecca Alban2023Journal articleEnglish
Community health workers who vaccinate: Improving equity in immunizationEmily Gibson, Luc Mahougbé Kouwanou, Mariam Zameer, Rebecca Alban2022ReportEnglish
Leveraging community health workers to vaccinate in Malawi: A unique health workforce approach to increase routine immunization coverageEmily Gibson, Jenny Payne, Rebecca Alban, Tafwirapo Chihana2023ReportEnglish

Advocacy pieces

TitleAuthorYearTypeLanguage
Community health workers as vaccinators: A pathway to achieving global immunisation goalsRebecca Alban, Tafwirapo Chihana2022Journal articleEnglish
Opinion: Amid labor shortage, let community health workers give vaccinesRebecca Alban2022Journal articleEnglish