COVID-19 Vaccine Uptake in Papua New Guinea: An Uphill Challenge - Exploring Key Options
Papua New Guinea (PNG) has one of the poorest COVID-19 vaccine uptakes, when compared with the global data. It is also deeply rooted in the poor and stagnated performance in the routine immunization of the decades. The country has demonstrated poor uptake despite the efforts of the government and development partners. Complex political and governance issues are intertwined with poor health infrastructure at the national and sub-national levels, thus hindering COVID-response and vaccination. These issues include lack of strategic vision and implementation; prevailing vaccine-hesitancy among communities and health workers; strong belief in conspiracy theories and misinformation; inability to reach-out to the remote ‘media-dark’ areas and communities with unwritten languages. Risk Communication and Community Engagement (RCCE) initiative in PNG remains largely restricted to mass media and social media interventions, which has been able to reach only select linguistic communities, whereas the country has more than 800 languages. Observational visits found that the activities were limited to urban settings mostly as there are huge communications challenges. The relevant messages and materials developed and disseminated were found technically compromised in adhering to the protocols of social and behaviour change (SBC), which ought to be based on the primary logic of multiple conceptual frameworks and theoretical underpinnings (Socio-ecological model, Theory of Diffusion of Innovations; Theory of Planned Behaviour; Stages of Change Theory; Health Belief Model and many others). Therefore, PNG is an ideal setting to examine the issues of vaccine hesitancy in the context of missing response and its linkages with the low social media penetration. This article uses a qualitative observational approach to unearth major issues and discuss possible solutions.