Mind the Gap: CLA to Encourage COVID-19 Vaccination Among India's Third Gender

Since November 2021, MOMENTUM Routine Immunization Transformation and Equity (the project) has worked in India with local sub-awardees, in coordination with the Ministry of Health and Family Welfare and other development partners, has supported national and local health authorities to introduce COVID-19 vaccine, develop vaccine delivery strategies to outreach hard-to-reach populations, track and follow-up individuals who miss vaccinations and re-establish community trust and demand for vaccination in vaccine hesitant communities.

Applying collaborating, learning, and adapting (CLA) principles was important for the project, given the rapid pace of implementation and for adapting outreach strategies across multiple waves of COVID-19. The project used the CLA framework to improve vaccination coverage among socially marginalized and vulnerable populations, such as the Hijra community, which includes transgender and intersex people. We established partnerships and trusting relationships with community-based organizations within the Hijra community, and local sub-awardees met weekly to discuss its members’ concerns and needs. We analyzed COVID-19 vaccination coverage data to identify people who were missed and adapted outreach strategies to reach them. The CLA approach helped us increase COVID-19 vaccine uptake within the Hijra community and create a culture of learning that helped us respond to evolving challenges.