• Using a community-born, owned and driven local slogan “Timua vumbi” which literally means “dust off”, Ruvuma region, which is one of the regions in the Southern part of Tanzania, typified the advantages of community-owned and community-driven intervention aimed at scaling up COVID-19 vaccination in the region. Ruvuma challenged its district leaders, both administrative and political ones, religious leaders and its healthcare work force to get dusted if the job demands to ensure that everyone is protected from COVID-19 infection in the whole of the region. In the course of implementing this special campaign, under the leadership of the Ruvuma Regional Commissioner, all District Commissioners were given district targets of vaccination which was translated to individual targets of every member in the task force – from the District commissioner and other district level leader to health care workers, community leaders, community health volunteers as well as religious and civil society leaders. Each of them was supposed to take a stock of a targeted number of people whom they have influenced to accept being vaccinated. This made Ruvuma region to intensify out-reach immunization services characterized by the use of well-publicized slogan, increased advocacy and sensitization activities in schools, prisons, market places, religious gatherings and during village meetings, social community events like traditional dancing competitions, sports events and house-to-house visits led community leaders and community health workers. The district and community leaders were assigned to teams for supportive supervision. In the evening of the day’s work, every leader would render an account of his or her stewardship. As well, each member of the Regional Health Management Team (RHMT) was assigned two councils to supervise, mentor, and ensure timely daily reporting about the number of people vaccinated. The Council Health Management Team (CHMT) was assigned to supervise and mentor health facilities to ensure timely daily reporting.

• Collectively, the district set daily local vaccination target of 1,000 persons vaccinated at council level per day and 20 persons per day at health facilities. A total of 687 community leaders and 732 community health workers (CHW) were engaged in the intervention. Every hamlet/village, therefore, had a village champion, a village executive officer and community health worker assigned to mobilize at least six (6) persons per day to be vaccinated at either the fixed post or outreach sessions. As at the time, Ruvuma region was reaching only 300 persons per day which increased to over 10,600 per day during Season 3. At the end of Season 3 of Timua Vumbi in Ruvuma region, as of 12th March 2022, the region has attained 12% fully vaccination rate, more than twice the national vaccination rate at 5%.

• Although they need championship and commitment, social accountability approaches are well known for their strength for social mobilization in all domains of social development including health. These are cheap interventions that require only strong leadership to implement. Many of the social accountability approaches are sustainable because they are derived from community perspectives and perceived invaluable by the community itself.

Social accountability approaches are appropriate for social mobilization in the context of COVID-19 vaccines and vaccination