Mobile health caravans rally the Western Balkans to COVID-19 vaccination, bringing health advice closer to where people are

Over the course of 2022–2023, 4 mobile health caravans have been touring remote and under-served locations in the Western Balkans to make sure vulnerable people have access to COVID-19 vaccination and the public health advice they need to protect themselves. To bring vaccination, health care and health recommendations to the heart of communities, with the support of WHO and partners, national and equivalent public health authorities have organized health caravans in Albania, Montenegro, North Macedonia, and Kosovo*. In addition to increasing access to various health services, the health caravans provide an opportunity for risk communication and community engagement (RCCE). When they visit, 2-way dialogue between health care providers and community members means that caravan staff can answer questions and better understand the needs of communities and their barriers to accessing health care. 

Experience in the Western Balkans showcases just why health caravans are such an important public health intervention in emergencies.

Health caravans reduce geographical and practical barriers to vaccination

In March 2022, supported by WHO, the United National Children’s Fund (UNICEF) and the United States Agency for International Development (USAID), a caravan travelled to 14 urban and rural communities throughout North Macedonia where COVID-19 vaccination uptake was lower than the national average. Local civil society organizations provided valuable input by going door-to-door to tell people about its arrival. Mobile health caravans can help to increase vaccination rates in communities that have limited access to health care facilities by overcoming barriers to vaccination, such as a lack of transportation, long distances, and time constraints. New analysis by WHO/Europe shows a return on investment in RCCE for health authorities; the North Macedonia mobile vaccination caravan led to a 35% rise in daily vaccination rates in the weeks following the visit compared to pre-intervention vaccination rates.

“With this caravan, we are reaching out to people who live in remote or underserved areas, to ensure that they have access to vaccines,” said Anne Johansen, WHO Representative and Head of Country Office in North Macedonia. 

Mersiha Usein, a grassroots activist with Romalitico, a nongovernmental organization, agreed. “It is really important to meet the needs and priorities of communities at the local level,” she said.

Health caravans build trust

In Albania, throughout the summer and autumn months of 2022, WHO, together with the Albanian Red Cross and funded by USAID, supported a caravan which brought vaccination services closer to where people live and encouraged them to get vaccinated against COVID-19 and keep up protective measures.

RCCE involves listening to and addressing the concerns of community members. Mobile health workers can answer questions, listen to doubts and explain science in simple terms. Demonstrating that health care providers care for and are responsive to the needs and concerns of the community helps to build trust and increase acceptance of vaccination and health measures.

“COVID-19 remains a threat and we all have to act and get vaccinated to protect ourselves against this disease,” said Anila Shameti, a nurse supporting the caravan community events in Albania.

Health caravans provide public health advice

A total of 28 municipalities were targeted by the caravan’s mobile unit throughout Kosovo*, which ran from 22 December 2022 until 26 January 2023. The caravan was organized by WHO in partnership with Kosovo’s Ministry of Health and the Institute of Public Health, with financial support from USAID.

Medical staff and vaccinators engaged with local communities, encouraging COVID-19 vaccination and offering health advice on a range of other topics. During one of the caravan’s stops, the Liaison Officer from the WHO Office, Pristina, took his seasonal flu vaccine in a mobile unit to show to the public that vaccines offered during the caravan are safe and effective. Access to transparent and accurate health advice helps people to make informed decisions about their own health and understand the importance of taking protective measures. It can also promote behaviour change, encouraging people to take up healthier practices, and may help people to appreciate and follow government guidelines. Crucially, it can foster more resilience within communities; communities with more skills and knowledge cope better with crises and tend to have higher levels of community responsibility and support.

“The caravan was instrumental in bringing vaccination teams closer to communities and providing them with an opportunity to learn more on how to protect their health and well-being and receive life-saving vaccines,” said Isme Humolli, National Professional Officer with the WHO Office, Pristina.

Health caravans address disparities in vaccine uptake

WHO, together with Montenegro’s Ministry of Health and Institute of Public Health, and supported by USAID, jointly launched a health caravan, which is running throughout February and March 2023. The focus is on COVID-19 vaccination, but the initiative also expanded to other life-saving vaccines that can protect children and young people from human papillomavirus (HPV) and measles, mumps and rubella (MMR). The caravan visited 4 municipalities where the uptake of COVID-19, HPV and MMR vaccines had been especially low. Targeting communities with lower vaccination rates and higher rates of disease, mobile vaccination caravans can help to reduce health disparities and improve health equity.

“COVID-19 remains a threat, and vaccine uptake is still low in Montenegro,” said Dr Mina Brajović, WHO Representative in Montenegro. “With the Health Caravan, we want to reach as many people as possible and make COVID-19 and other essential vaccines more easily accessible for at-risk groups and people living in remote and/or disadvantaged areas. To increase vaccination uptake, we need collective action, partnerships, strong local community engagement and informed citizens.”

The COVID-19 pandemic has proven that RCCE is at the heart of emergency response. Indeed, delivering services and interventions in emergencies is not enough. People’s behaviours are central to emergency control and, to accelerate recovery, these services and interventions must be accessed. The Western Balkans health caravans demonstrate why engaging directly and transparently with communities bridges service delivery and access and makes such a positive impact when it comes to protecting health. 

 * All references to Kosovo in this document should be understood to be in the context of the United Nations Security Council resolution 1244 (1999).