The power of geospatial mapping to increase COVID-19 vaccinations

COVID-19 vaccine hesitancy remains an issue in Nigeria, despite the accessibility and availability of vaccines. As part of nationwide support to the Government of Nigeria’s efforts to increase COVID-19 vaccine uptake, Breakthrough ACTION contributed to a 62% increase in vaccination rates in Kebbi State, Nigeria, between August and December 2022 by using geospatial mapping to guide program decision making.

To contribute to this remarkable result, Breakthrough ACTION-Nigeria, collaborated with the Kebbi State Government to use the dataFraym dashboard, a geospatial tool, populated with data on demographics, segments, media consumption, and health facilities collected by Johnson & Johnson Global Public Health. The tool aligns health behaviors and place-based information on COVID-19 vaccine attitudes in Nigeria and dashboard displays data on audiences into five segments based on vaccine attitudes (defined by Johnson & Johnson):

Confident Enthusiasts: People convinced of the COVID-19 threat and vaccination benefits. They are likely to get vaccinated as soon as possible.
Enthusiastic Pragmatics: People aware of COVID-19 threat and the merits of a vaccine, but who are inhibited by practical barriers. This audience is also likely to get vaccinated as soon as possible.
Vaccine Ambivalents: People who are not convinced of the threat of COVID-19 as a disease and lack motivation to get vaccinated but have few barriers to uptake. They are likely to wait at least 6–12 months before getting vaccinated.
Vaccine Skeptics: People who are aware of COVID-19’s impact but skeptical around vaccine safety and efficacy. They are likely to wait at least 6–12 months before getting vaccinated.
COVID Cynics: Those who are strongly hesitant of the COVID-19 pandemic and receiving the COVID-19 vaccine. They are likely to never get vaccinated.

National call-in center data showed only 13% of the eligible population in Kebbi State was fully vaccinated as of August 18, 2022. But as of December 17, 2022, that number increased to 75% after use of the dataFraym tool to guide the teams in their efforts.

Structural Considerations for Selecting Audience Segments

Breakthrough ACTION used the dataFraym dashboard to select the local government areas where the project would concentrate its efforts taking into account the following factors:

Audience segments most likely to accept vaccination: The dataFraym dashboard helped Breakthrough ACTION select local government areas where Confident Enthusiasts and Enthusiastic Pragmatics resided. Messages and interventions for these audiences were developed to eliminate concerns around cost and whether people could access a clinic.
Structural issues that would enable people to get vaccinated: Breakthrough ACTION accounted for enabling environments, security issues in Nigeria, and cultural norms among others when selecting the intervention areas.
Alignment with the government’s selection process: To ensure impact and efficiency, Breakthrough ACTION and the Kebbi State Government used the dataFraym dashboard to identify vaccine-eligible populations across the continuum of vaccine administration. The state government provided technical support to the local government areas, coordinated vaccination logistics, and ensured Breakthrough ACTION was able to share updates and challenges related to COVID-19 vaccination.

After careful deliberation, Breakthrough ACTION ultimately chose 10 local government areas in Kebbi State to focus their vaccination uptake messaging activities.

In Fakai, one of the selected local government areas, the dashboard indicated 50% of the population were Enthusiasts and showed approximately where they were. Breakthrough ACTION worked with State and partner mobile vaccination teams, carrying out community sensitization in preparation for and during the vaccination teams’ efforts. This resulted in over 27,700 people being vaccinated, as compared to the 1,048 people vaccinated before the project used the dataFraym dashboard.

The dataFraym dashboard was a game-changer for COVID-19 vaccinations in Kebbi State. Breakthrough ACTION used hard evidence, geography, and behavioral norms from the dashboard to inform its social and behavior change intervention. As a result, COVID-19 vaccination rates in Kebbi State grew exponentially.