Routine childhood immunizations, provided on a set schedule over a child’s first two years of life, are very effective at reducing some of the major causes of death in young children. We estimate that in the provinces where we’ve supported programs in the Democratic Republic of the Congo (DRC), about one in 13 unvaccinated children dies from vaccine-preventable diseases before the age of five, yet only about half of children there receive the vaccinations they need.
Much of our Vaccination research subteam’s work focuses on finding ways to make it easier for caregivers to have their children vaccinated, such as bringing vaccines closer to where parents and infants live. This is especially important in places like DRC, where coverage is low and disease burden is high. Following a request for proposals and a request for information seeking targeted vaccination outreach programs, we funded 11 additional programs, run by distinct organizations—six of which will be implemented in DRC. This portfolio builds on years of investment in our research team, which allowed us to evaluate more than 100 proposals and fund several programs side by side to learn which approaches work best.
In this episode, GiveWell co-founder and CEO Elie Hassenfeld speaks with Senior Program Officer Natalie Crispin, who leads GiveWell’s vaccination grantmaking, about the programs we funded in DRC. They discuss barriers preventing many children in DRC from getting vaccinated, how the programs we’re funding aim to reach them, and what we hope to learn.
Elie and Natalie discuss:
Identifying barriers to full vaccination in DRC: Based on the evidence we’ve reviewed, our past experience funding vaccination programs, and the experts we’ve consulted, we think reliable access to opportunities for children to be vaccinated is a major barrier to coverage. The typical immunization schedule requires eight or nine visits to a health facility over a child’s first 18 months. In DRC, families living within about three miles of a health facility are generally expected to travel there. This can mean walking several miles to the nearest health facility while carrying a small child, with no guarantee that the needed supplies or staff will be available to vaccinate their child when they arrive. Mobile vaccinators travel to reach families living further than three miles from a facility, but there are often insufficient resources to ensure these outreach sessions take place on the needed schedule and in the hardest-to-reach communities.
Funding different strategies for reaching under-vaccinated children: Each of the six outreach programs we are funding in DRC includes two core components: (1) a method for