Implementing national COVID-19 vaccination programmes in sub-Saharan Africa- early lessons from Zimbabwe: a descriptive cross-sectional study.

INTRODUCTION: Zimbabwe was one of the first countries to run a national COVID-19 vaccination programme in Africa. Lessons learnt could inform the roll-out of similar programmes in sub-Saharan Africa. To describe the trends of uptake of the COVID-19 vaccines in the first three months (February - May 2021) of the Zimbabwe vaccination programme and the lessons learnt. METHODS: a secondary descriptive analysis of routinely available COVID-19 vaccination data extracted from the daily situation reports published by the Ministry of Health and Child Care. RESULTS: in the first three months of the programme, 1 020 078 doses were administered, with 675 678 being first doses and 344 400 were second doses. Using population estimates, at three months, 5.2% of the population had received at least one dose and 2.6% had received the full two doses. Uptake was initially slow, followed by a gradual, and subsequently an exponential increase. CONCLUSION: by the end of May 2021, Zimbabwe had rolled out one of the largest COVID-19 vaccination programme in sub-Saharan Africa. The uptake followed a pattern and trend that is consistent with vaccine hesitancy reported in the literature, driven by a combination of confidence, complacency and convenience factors. The gradual increase in uptake followed a series of national and local community engagement programmes. The roll-out of similar programmes must recognise likely patterns of uptake across the population and ensure plans are in place to address vaccine hesitancy. The available data did not allow granular analysis to understand the demographics of people who participated in the programme, which is important for surveillance, targeted action, preventing inequalities and ensuring adequate and proportionate protection of residents prioritising the most vulnerable. Further analysis of the process, outcomes and impact of the programme will be helpful in informing the roll-out of similar programmes across Africa.

At the deep end: COVID-19 experiences of Zimbabwean health and care workers in the United Kingdom.

BACKGROUND AND OBJECTIVES: Black, Asian and Minority Ethnic groups (BAME) in the UK were disproportionately affected by the first phase of COVID-19 in terms of exposure, negative health and socio-economic impacts and consequences including recorded deaths. However, aggregate categories like BAME mask internal diversities and differences and limit the scope for understanding why disproportionalities occur and appropriate interventions. This paper responds to calls for disaggregated and in-depth participatory community based research to improve culturally nuanced understanding of health inequalities and COVID-19 impacts. METHODS: The paper draws from weekly zoom discussions and data from a google-forms on-line survey (n = 103) that the Zimbabwean community conducted to establish and examine COVID-19 experiences of Zimbabwean health and care workers in the UK. Our interpretive approach used MAXQDA software for qualitative data analysis; to code and categorise responses to open ended survey questions. RESULTS AND DISCUSSIONS: Discursive analysis of this community data shows that health and social care worker experiences included recurrent and widely reported themes such as discrimination in allocation of equipment, moral injury and trauma that may lead to long- term mental health problems. These results confirm diversity of experiences amongst health care professionals when compared to other ethnic groups and by gender. They reinforce the case for monitoring, for after care research and support, including that which draws on community-based capital.