Leveraging Community Health Workers (CHWs) to administer vaccines

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.

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