Philippines: Local health workers champion COVID-19 safety on remote islands

Once on Manicani Island, the team visited people at home to build trust and understand how to work together to improve their protection against COVID-19.

The first step in understanding people’s reluctance to be vaccinated against COVID-19 was listening. The team went house-to-house in Manicani’s four barangays (villages) –Banaag, Buenavista, Hamorawon and San Jose – to understand people’s knowledge, perceptions, concerns and fears.  

Many people hesitated to be vaccinated because they were sick, undergoing treatment or had just undergone surgery. Some older adults did not see the point, since they rarely left their homes.  

People were also reluctant to spend the time and money travelling to vaccination centres, especially if they were older or unwell. People preferred to spend the boat fare from Manicani Island to Guiuan town, the nearest vaccination centre, to meet their family’s daily needs. Buying food while travelling for vaccination was also a barrier.  

Involving existing community networks in reaching people on Manicani was crucial, said Benilda Codoy, the barangay captain in Hamorawon village. 

“We had meetings with the barangay health workers and the barangay health emergency response teams on how we can convince people to get vaccinated.” 

Tailored information, education and communication materials, translated into the local language helped fill gaps in people’s knowledge, address rumours and provide science-based messaging.  

Before the project, people on Manicani and other small islands in Eastern Samar had no COVID-19 communication materials, such as posters or leaflets.  

Although social media was used extensively nationwide during the pandemic, the project found that far-flung communities like Manicani’s, with limited information sources, appreciated printed communication materials with clear messages and in local languages.  

An important element of the project was developing visual materials, displaying them in public areas and distributing them to households.  

The team encouraged people to place the printed materials strategically, to maximize chances they would nudge behaviour change. For example, posters were pasted on people’s doors for reference on what to do to avoid COVID-19 before leaving the house, when outside and after coming home. 

The materials were especially effective when they were used as part of a face-to-face approach by trained barangay health workers or community health workers, who both listened and educated. 

The individual approach was supported by community and household contests, dissemination of local-dialect communication materials, community meetings, radio advertisements and community bandilyo announcements. The whole approach drew on lessons from the initial rapid rural appraisal and behaviour change assessment. 

Manicani residents said they appreciated the team’s efforts to reach them, which motivated them to get vaccinated and follow prevention protocols. 

Results were impressive. Every resident on Manicani island was reached with information. Vaccination rates almost tripled, with 79% of people on the island being vaccinated. In barangay Banaag, 100% of eligible adults were vaccinated by March 2022. 

Trust in health workers was crucial in keeping people safe, said Banaag barangay health worker Lorena Ida, centre.  

“We were the first to get vaccinated because we are the frontliners so we served as examples to other people in our barangay that nothing bad will happen if you will get vaccinated.  

“I am proud to be a health worker because I was part of the efforts to achieve a 100% vaccination rate in our barangay. 

“We are the frontliners, we were the first to convince the people with the help of the People In Need.  

“For me, what other people and other communities can learn from our barangay is unity.”