By Stephanie Schorow for the Global Mass Vaccination Collaborative
When trying to get as many shots in arms as possible, the question of who will do the jab becomes a key consideration. Also important is who will keep records, clean the facilities, organize supplies and even greet patients. Mass vaccination sites are not possible without a host of trained staff. Thus, establishing an effective staffing model is one of the top concerns in launching a vaccination site.
“We have many inputs that we need to take into account,” said Sié Kambire, Digital Solutions Manager for VillageReach, during the April 29 meeting of the Global Mass Vaccination Site Collaboration, an initiative by Ariadne Labs and the Sabin Vaccine Institute’s Boost Community, to support and promote COVID-19 vaccinations worldwide.
VillageReach is currently operating five COVID-19 vaccination sites in Africa including “vaccinodromes” in Abidjan, Côte d’Ivoire, and Kinshasa, Democratic Republic of Congo. To date, more than 40,000 people in both countries have been vaccinated.
The first step in developing a staffing solution is to determine the number of personnel, both essential and non-essential, needed for various tasks. Staff positions may include data clerks, waste managers, drivers, greeters, and cleaners as well as vaccinators and medical and logistical supervisors and others. Staff may be recruited from government health departments as well as hiring from other sources, such as nearby teaching hospitals, medical schools or from groups such as midwives.
In Côte d’Ivoire, shift rotations allowed staff to work at vaccination sites and complete their other government work. Salary is obviously an incentive and it can be structured in a way that takes budgetary constraints in mind. Staffers in Côte d’Ivoire were paid a stipend (or per diem) every two weeks. “We used to pay staff by cash; now we have a mobile money system,” Kambire said.
To reach an initial goal of vaccinating 1,000 people a day in Cote d’Ivoire, about 41 staffers including eight from VillageReach were assembled. The per diem for government staffers, who already received a salary, was $9 a day and the monthly recurring costs for other salaries, per diems and supplies totalled about $70,000, not counting one-time set up costs. Staffing, Kambire said, is the primary cost category so it’s important to leverage cross-sector partnerships and/or network in sharing costs for this.
Kambire also detailed the staffing model at a site in Kinshasa, DRC, aimed at vaccinating 300 to 500 people a day. “We adapted our strategy to the reality,” he said.
Strategies for improving staff operations included:
- Soliciting feedback in exit surveys from site visitors.
- Conducting weekly meetings and staff trainings.
- Emphasizing the importance of robust documentation.
- Creating a strong, reliable system for storing, handling and administering vaccines.
Kambire stressed that sites should be made “comfortable and welcoming” as this encourages staff and patients to become ambassadors for vaccination. Continuous evaluation is important, particularly when determining times of high and low peak visitation. For example, one site found more people coming at the beginning of the week, rather than the end, and changed staffing accordingly. They also found an increase on Sunday after church. When the staff found that many people lacked transportation to the site, mobile teams were organized and dispatched.
Bringing in staff from multiple agencies does, however, require an established “shared vision,” Kambire said. While per diems may be low ($5 in Kinshasa, for example), they are important to create motivation. Another way to ensure adequate staff is to offer training that allows people to work in jobs other than their primary role, said Kanwagi of GAVI. For example, those learning to be midwives could get training in giving injections.
Kambire said that the VillageReach intends to incorporate such learning into a play book that can be shared widely. Even after the COVID-19 pandemic is brought under control, such insights will be valuable to future vaccination efforts.
Other staffing resources from the Global Mass Site Vaccination Collaborative include:
- Staffing roles and responsibilities
- Staffing calculations and training requirements
- Workflows and processes
The Global Mass Vaccination Site Collaborative was launched as a way for stakeholders directing vaccination campaigns around the world to come together and learn from each other’s efforts. This blog series was created to record and share the learning and insights gained from this collaboration. Read blogs from our previous meetings here.