Reaching Vaccination Targets in Liberia

From the bustling streets of Liberia to the global stage of immunization advocacy, Amanda Gbarmo Ndorbor’s journey is a testament to the power of passion and commitment. As a registered nurse with extensive qualifications, including a Bachelor of Science in Nursing (BSN), Master of Public Health (MPH), Master of Counseling Health Sciences (MasCoun), and a Social and Behavior Change Specialist (SBC Specialist), Amanda has dedicated over 13 years to improving public health through immunization.

Her story begins in 2007, when she started as a volunteer Immunization Training Officer on the EPI team in the Ministry of Health in Liberia. Her dedication and hard work soon earned her a position as a Supplemental Immunization Activity (SIA) Coordinator. In this role, Amanda planned and executed eight successful mass vaccination campaigns, including a significant yellow fever campaign, showcasing her ability to lead large-scale health initiatives. Amanda learned several key lessons from this activity:

• Important characteristics to have are empathy, commitment, interpersonal communication skills, and passion.
• Stakeholder mapping facilitates engaging the right stakeholders at the right time; stakeholder engagement is dynamic; the context and prevailing circumstances determine who to engage to get the work done.
• Recognize and respect community protocols, every community is unique, and when the members are respected, it facilitates trust, enhances and vaccine acceptance.

“To my fellow Boost members always remember to engage the community in the planning and keep them involved throughout the implementation. These communities have values, perspectives, and lived experiences that can make our campaigns successful,” said Amanda.

In 2012, Amanda traveled to Western Australia for her studies and desire to work in the immunization space. Upon her return in 2015, Liberia was responding to the Ebola outbreak. With a graduate degree in Mental Health Counseling and experience working with torture and trauma survivors as part of her graduate studies, she joined the mental health and psychosocial team. From 2015 to 2017, she conducted community engagements, trained mental health service providers, and provided individual and group counseling services to Ebola survivors and their families, as well as effected families.

In 2018, Amanda transitioned to a pivotal role as an SBC Specialist for Immunization at UNICEF Liberia.  Recognizing the existing barriers such as unsuitable vaccination schedules, she was able to address this challenge with UNICEF. Details about this work were published in From Coverage to Empowerment Integrating Gender in Immunization Demand Report, by UNICEF and Gavi. She leveraged her skills to engage communities, addressing their concerns and encouraging vaccination uptake. Her work involved understanding the motivations and barriers faced by caregivers and community members, ensuring their voices were heard and respected in the process of health promotion. Amanda spearheaded a project with UNICEF to improve vaccination coverage in Montserrado County, focused on integrating gender into vaccine demand. The project addressed the low vaccination rates by offering immunization services on weekends and extending the hours for immunization services on weekdays. Amanda also called caregivers for reminders before their children’s vaccination due dates. This encouraged caregivers to bring their children for vaccination, especially after learning about the weekend and extended-hour services available at various health facilities in Montserrado.

UNICEF 2022- Child Receiving Age-Appropriate Vaccines 

Amanda’s efforts were not without challenges. The rise of misinformation and vaccine hesitancy during the COVID-19 pandemic posed significant obstacles. However, Amanda led a team of volunteers to counter these challenges through dialogue and co-creation of demand generation activities. For example, the volunteers engaged communities to discuss vaccination and their experiences with the health facility they attend. Safety concerns for the COVID-19 vaccine emerged as the main issue. The volunteers and health promotion officers used posters, their personal COVID-19 vaccination cards, and influential personalities within their communities who were vaccinated to share their experiences after receiving their COVID-19 vaccine. In some instances, the volunteers shared details of credible websites for information on COVID-19 in the communities. In addition, volunteers used the Human Center Design (HCD) tool following the training workshop conducted by the Social and Behavioral Change (SBC) unit. The volunteers used the knowledge and tools from the workshop to work with their communities to address practical issues, gathered feedback from the communities about general health services, and shared this information with the health facilities. Amanda’s leadership and the volunteers’ determination to combat misinformation contributed to Liberia achieving its COVID-19 vaccination targets, with increased acceptance and low hesitancy rates.

UNICEF 2022- Children Under 1 year Vaccinated in Montserrado County

Amanda’s involvement with the Boost Community, especially ongoing professional development trainings, has been instrumental in her journey. Joining the COVID-19 Recovery for Routine Immunization Programs Fellowship in 2023, she gained valuable knowledge and formed valuable connections, which have helped her to understand meaningful engagement with the community and design gender-responsive social and behavioral interventions to remove barriers to immunization. These experiences have further fueled her passion for public health and equipped her with the tools to continue making a difference.

Her commitment to public health extends beyond her professional roles. Amanda is in the process of establishing Nurturing Futures, a local organization aimed at empowering communities to overcome barriers to vaccination and access other health services. Nurturing Futures hopes to strengthen community involvement in identifying and solving social and health issues that affect their lives. This initiative reflects her dedication to improving public health from the grassroots level.

Amanda’s story is one of unwavering commitment to the health and well-being of her community. Her journey serves as an inspiration to all, highlighting the profound impact of dedicated public health professionals in building a healthier future.