Beyond Coverage: Introducing the Framework for Measuring Health Campaign Effectiveness

Presentation Summary

The presentation was delivered by Dr. Andreas Hasman (Nutrition International / former UNICEF) and Carol McPhillips-Tangum (Lead Author, Public Health Consultant):

• Moving “Beyond Coverage”: While coverage (the proportion of people receiving an intervention) has traditionally been the gold-standard indicator for campaigns, coverage alone compresses an entire system’s performance into a single number. It fails to explain why individuals were missed or whether services were delivered efficiently, accessibly, and equitably.
• Lessons from Country Reviews (Mauritania & Sierra Leone):
  • Initial research evaluated Vitamin A supplementation programs—Mauritania using door-to-door campaigns and Sierra Leone using routine health system delivery.
  • The study evaluated 11 parameters of effectiveness alongside coverage (e.g., access, service quality, equity, sustainability, resilience).
  • Key Insight: Program effectiveness is highly contextual. For example, equity was prioritized more in Sierra Leone (where routine delivery yielded lower coverage) than in Mauritania (where campaigns reached people more equitably).
• The 5-Step Operational Framework: To translate these learnings into a practical tool for country ministries and partners, the new Framework for Measuring Health Campaign Effectiveness outlines a flexible 5-step process:
  • Assess: Review current campaign goals, existing indicators, and available data sources.
  • Identify: Determine what key performance questions remain unanswered by existing data.
  • Select: Choose additional context-appropriate measures beyond basic coverage (such as acceptance, efficiency, or equity).
  • Plan: Establish how data will be collected, leveraging and adapting existing routine systems where possible.
  • Use: Apply data directly to improve real-time campaign delivery and future planning.

Highlights from Conversation with Dr. Stavia Turyahabwe of Ugandan Ministry of Health

The panel discussion featured Dr. Stavia Turyahawwe, Commissioner for Communicable Disease Prevention and Control at the Ministry of Health in Uganda, moderated by Destiny Chukwu:

• Real-World Country Context: Dr. Stavia highlighted the practical challenges of managing multiple, concurrent, or back-to-back health campaigns (e.g., malaria bed nets, polio, yellow fever, neglected tropical diseases) within national health systems.
• Data Integration & Routine Systems: She emphasized that campaign monitoring must not exist in an isolated “silo”. Effective measurement requires integrating campaign metrics into existing national platforms like DHIS2 so that data continues to inform primary healthcare beyond the campaign period.
• Community & Caregiver Voice: A major highlight was her focus on community engagement. Measuring “acceptance” and “access” requires understanding community perceptions, addressable hesitancy, and direct feedback from caregivers.
• Sustainability & Multi-Sector Coordination: Dr. Stavia stressed the importance of institutionalizing campaign evaluations within Ministry of Health governance structures to ensure continuous learning across different disease programs.

Key Takeaways Overall

• Coverage Is Not Enough: Coverage identifies if there is a gap, but broader parameters (access, acceptance, efficiency, equity) are needed to diagnose why gaps exist.
• Context Matters: What is feasible and essential to measure varies depending on whether delivery is campaign-based or integrated into routine healthcare.
• Action-Oriented Data: Measurement should focus on gathering actionable indicators that directly inform campaign mid-course corrections and future strategy, rather than overburdening staff with excessive data collection.
• Country Ownership: Successful measurement frameworks require local deliberation, cross-program collaboration (e.g., immunization, nutrition, NTDs), and institutionalizing feedback into routine systems.