Delivery
The gender gap in COVID-19 vaccination and what to do about it
By Maria Antonieta Alva Luperdi & Jonny Barty
Acknowledging the problem and implementing service delivery modalities customized for women are short-term actions governments can take to improve access to COVID-19 vaccinations. Placing more women in leadership positions is critical in the longer term.

A few weeks ago, Taimur Khan Jhagra, Health Minister and Finance Minister in Khyber Pakhtunkhwa, Pakistan, used his Twitter account to highlight gender gaps in COVID-19 vaccine uptake, noting that the uptake among women was less than half that of men. 

 

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As countries continue to roll out COVID-19 vaccines, gender barriers are becoming larger and more obvious. Based on our experience supporting governments, many urgently need to pursue two lines of action.

 

First, acknowledge and understand the problem. 

As part of our efforts to better understand the challenges of reaching women with COVID-19 vaccines, our team carried out in-depth interviews with health workers at the vaccination sites. 

Interviews revealed a range of issues, both on the demand side - for instance, concerns about the impact of vaccines on fertility and pregnancy - and on the supply side - for instance, a lack of female vaccinators, or vaccination sites that did not sufficiently address issues around privacy or comfort. A first step for governments is understanding exactly what is happening on the frontline.

 

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In-depths interviews to understand challenges women face accessing COVID-19 vaccines

 

Second, implement service delivery modalities designed to ensure access for women. 

 

Make women feel safe

It is vital that women feel comfortable during their time at the vaccination site. In many places, the presence of female vaccinators appears to be a key lever for increasing female intake, and important difference from childhood vaccination campaigns where this tends not to be an issue. Government efforts in the short term may need to focus on resolving bottlenecks for recruiting and hiring female vaccinators.

 

In places where security is a major issue, the location of the vaccination sites is also critical. In some countries, women feel more comfortable going to vaccination sites located in busy areas. In conservative areas, waiting times at the vaccination sites can be a major obstacle and deterrent.

 

One example of an innovation in this space comes from Hirat, Afghanistan, where officials opened a mass vaccination center for females: run by women for vaccinating women.

 

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COVID-19 Mass Centers for women in Hirat, Afghanistan

Make women feel comfortable

 In some countries, rumours that COVID-19 vaccines might cause infertility have spread quickly through social media without strong efforts to counter them. 

In many cases, governments need to make greater efforts to make information available and equip healthcare professionals to have informed conversations.  

 

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UK government has built a network of stakeholders to address hesitancy and misinformation among women

 

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CDC in the US provides information for women regarding pregnancy and breastfeeding

 

Finally, when thinking about sustainable and quality services for women it is important to  consider the need for more women in leadership positions. According to the World Health Organisation, women comprise 70% of the global health workforce but hold only 25% of the leadership positions. More women leading action for other women may be the best long-term solution to prevent gender gaps in health service access from emerging.

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