The last year has been one of the most challenging on record for the health field, with the pandemic severely hampering the delivery of health interventions across the globe. Many countries will require innovative delivery approaches to catch up on missed or delayed campaigns and address increasing campaign costs related to COVID-19 prevention. One potential solution is the integration of health campaigns.
To address this, the Health Campaign Effectiveness Coalition, a program of The Task Force for Global Health with support from the Bill & Melinda Gates Foundation, has begun building the evidence base for campaign integration across five health domains: malaria, NTDs, polio, vitamin A supplementation, and vaccine-preventable diseases. The Coalition has published five technical briefs and reports that highlight promising practices and identify current knowledge gaps.
What Is Campaign Effectiveness?
Before campaigns can begin, program managers need a common understanding and use of metrics for campaign effectiveness. The Coalition’s report, Defining Health Campaigns and Health Campaign Effectiveness, defines campaigns, when they are used, and how their success is measured. It also highlights several evidence gaps, namely the need for improved data quality, additional measures for a comprehensive assessment of campaign effectiveness beyond coverage (e.g, measurement of campaign equity, efficiency, acceptability) and initial guidance for using these additional measures for given campaigns.
How Are Campaigns Planned?
Microplanning is a critical feature of effective and efficient campaigns, but the lack of cross-platform forums limit sharing of microplanning best practices and learnings across campaigns. To address this, the Coalition’s report, Promising Practices in Health Campaign Microplanning, identifies four key areas where promising practices exist: 1. Cross-campaign sharing and synergies, 2. Data quality and access, 3. Community engagement, and 4. Efficient planning, implementation, and management.
How and Why Should Campaigns Integrate with Other Campaigns?
Campaign integration is a spectrum, ranging from the partial integration of components to full co-delivery of multiple interventions. The Coalition’s November brief, Integration Between Health Campaigns: Intervention Co-Delivery and Collaboration, analyzes levels of integration across seven campaign components: planning, social mobilization, set-up and preparations, management, implementation of interventions, post-campaign activities, and surveillance, monitoring and evaluation.
“Most recent global strategies focus on integration of interventions with routine health services rather than campaigns,” said Barkha Bhatnagar, Health Systems Research Associate, “but integrating with other campaigns, partially or fully is also a viable way to improve health campaign effectiveness. We need more evidence from field experience to guide the choice of interventions for integration.”
“Campaign integration can be successful depending on the country setting and choice of interventions to combine. It is not a panacea for ensuring effective health campaigns everywhere. Generating an evidence base and key criteria will greatly help countries and their partners identify the most promising integration approaches to test,” said David Gittelman, Advisor and IFRC/Alliance for Malaria Prevention representative.
What Can We Learn from Prior Integrated Campaigns?
The Coalition partnered with Johns Hopkins University’s Synthesis and Translation of Research and Innovations from Polio Eradication (STRIPE) project team to determine the impact of integrating campaigns on health service coverage and community acceptance. T STRIPE drew from hundreds of key informant interviews conducted with individuals at the frontline, sub-national, and national levels in Ethiopia, Nigeria and India.
In the brief, Public Health Campaigns: Lessons Learned from 30 Years of Polio Campaigns in Ethiopia, India and Nigeria, policymakers suggest three methods for improving planning and implementation: investing in long-term contracts and campaign worker training, using co-delivery to reach hard-to-reach populations, and engaging in coordinated cross-program social mobilization.
How Can Campaigns Transition the Delivery of Interventions into Primary Health Care?
Health intervention delivery can be transferred from campaigns to primary health care systems. This is sometimes the case with countries that are entering middle-income status, witnessing donor funding shifts, experiencing positive changes in epidemiological trends, or aiming for universal health coverage. The fourth brief, Transitioning Service Delivery of Health Campaign Interventions to the Primary Health Care System: A Strategic Balance of Independent and Integrated Delivery of Interventions, focuses on transitioning independent delivery of donor and/or government-funded campaign interventions to integrated delivery through the PHC system.
“Campaign integration and linkages with the primary health care system is increasingly fostering higher levels of interest among program planners, implementing partners, donors, and researchers, and collaborative planning is key,” said Dr. Eva Bazant, Senior Associate Director of Implementation Research.
These documents serve as the foundation of the Coalition’s cross-campaign forum to foster learning and systems change. This year, the Coalition is supporting countries with awards to develop case studies on the collaborative planning of campaigns and to conduct and implementation research on campaign integration. It also hosts monthly interactive learning events for campaign managers and health services actors from across all five disease domains. Learn more about the Coalition’s publications on the website.