This reference table offers a concise snapshot of key Health Campaign Effectiveness Coalition (HCE) resources that support the Collaborative Action Strategy (CAS). Drawing on five years of HCE Coalition experience and contribution from global partners, it highlights actionable insights, evidence, and guidance to advance more collaborative and integrated campaign delivery. Designed for a range of audiences from decision makers to technical implementers, this table curates relevant resources to inform policy, decision making, programmatic guidance and advocacy.
| Theme | Title, Author/Org (hyperlinked to source document) | Health Program | Geographic Scope | Key Messages around Integration | Supporting Findings | CAS Recommendation |
|---|---|---|---|---|---|---|
| Planning & Implementation | Alliance for Malaria Prevention. (2024). AMP 2024 Campaign Digitalization Meeting: Summary outcomes. RBM Partnership to End Malaria. | Malaria | Angola, Congo, DRC, Kenya, Togo, Uganda, Zambia, Mozambique, Bangladesh |
Digital tools should be implemented to streamline campaign operations like household registration, distribution tracking, and real-time data use. Campaigns should consider leveraging health workers' personal devices to reduce hardware costs and minimize logistics burdens. Digitalization should be integrated into microplanning processes to effectively visualize campaign coverage. |
In Zambia’s 2023 ITN campaign, the use of DHIS2 Tracker enabled community-based volunteers (CBVs) to digitally register households and track distributions, with 93% of records synchronized on the same day of collection. Togo and Uganda effectively used CHWs’ own smartphones for campaign activities by mapping device availability, offering technical support, and providing incentives, which reduced procurement costs and risk of device loss or theft. In Bangladesh, “geo-enabled microplanning” was used to convert hand drawn target distribution maps for an immunization campaign into GIS models. |
1D, 1E |
| Planning & Implementation | Alliance for Malaria Prevention. (2021). The use of digital tools to improve the operational efficiency of ITN campaigns. RBM Partnership to End Malaria. | Malaria | Global |
Digital tools used for ITN net campaigns should be integrated across the entire campaign lifecycle, from planning to post-distribution. Digital tool implementation should be planned with sustainability in mind, including government ownership and integration into national health systems. |
Countries that used tools like Reveal, Red Rose, DHIS2, saw better data quality, quicker registration/distribution and reduced fraud. However, success depended on adaptations around limited internet, charging challenges user training. Countries that involved government stakeholders early and aligned tools with national systems were more likely to sustain digital approaches beyond a single campaign. (e.g. Ghana's National Malaria Control Programme (NMCP) |
1B, 1D |
| Planning & Implementation | A Case Study on the Collaborative Campaign Planning of Vitamin A Supplementation and Elimination of Lymphatic Filariasis in Nepal: Prospects and Challenges of Integration. Kathmandu, Bagmati, Nepal; Decatur, GA, USA. Health Education, Agriculture and Logistics (HEAL) Group; Health Campaign Effectiveness/The Task Force for Global Health, Inc.; 2022. | Nutrition (VAS), NTD (LF) | Nepal |
Integrated campaigns should be planned with stakeholders at all levels, supported by strong leadership from the Ministry of Health. Health workers should receive adequate training and culturally appropriate IEC materials should be developed to address community concerns and enhance campaign effectiveness. Monitoring approaches should be employed to identify and reach individuals missed by initial campaigns. |
A Campaign Integration Working Group (CIWG) was formed to support all phases of integration, with recommended sectors for inclusion at the municipal level including Agriculture, Women & Children, Veterinary and Ayurveda. Sufficient time was allocated to train local health facility staff using an exercise sheet adapted from the HCE decision tool. Communities were sensitized using culturally appropriate information, education, and communication (IEC) materials, addressing specific concerns in the local language (i.e. fears of drug interactions). Health workers used the complementary monitoring and supervision (CMS) approach during home visits. Applying the CMS approach to identified people who missed MDA in the preceding LF campaign. |
1A, 1B, 1C 1D, 1E |
| Planning & Implementation | Catholic Relief Services. (2022). Digitizing health campaigns: What it takes. | Malaria | Benin |
Campaign digitization should be initiated or co-owned by Ministries of Health and aligned with national structures to enhance sustainability and impact. Digital campaigns should include targeted training and account for frontline realities like low connectivity, literacy, and logistical constraints. Digital solutions should also interface with the national health information system (such as DHIS2) to avoid creating parallel health information management tools. |
In Benin’s 2020 digitized mosquito net campaign, strong national leadership ensured data collected was used to inform national malaria planning, demonstrating how ministry-led efforts can drive data use beyond a single campaign. Campaigns across West Africa encountered challenges with poor internet access and limited digital literacy by health workers. CRS posits that where access to power will be a challenge, solar charging stations are likely needed. By integrating with platforms like DHIS2, digital solutions can provide real-time data that supports not only the immediate campaign but also future health system improvements. |
1D, 1E |
| Planning & Implementation | Global strategy on digital health 2020-2025. Geneva: World Health Organization; 2021. License: CC BY-NC-SA 3.0 IGO. | Digital health, capacity building, health systems | Global |
A national digital health strategy should integrate financial, organizational, human, and technological resources to ensure sustainable digitization of campaigns. Digital health tools should be adapted to each country’s context and supported by tailored health workforce training and education programs. Governments should establish strong governance mechanisms to lead digital health integration and ensure alignment with national health priorities. |
Successful digital health initiatives require integrated planning that combines leadership, financial investment and workforce capacity. Fragmented or siloed approaches lead to poor coordination and service delivery. The strategy calls for embedding digital health competencies into national training curricula and ensuring that training is adapted to local capacities and contexts. Governance structures are necessary to set standards, define roles, coordinate stakeholders, and uphold data protection. |
1D |
| Planning & Implementation | A scoping review on integrated health campaigns for immunization in low- and middle-income countries. Health Policy Plan. 2023 Nov 28;38(10):1198-1224. Ahmed ST, Haider SS, Hanif S, Anwar HB, Mehjabeen S, Closser S, Bazant E, Sarker M. | Immunization | Global |
Integrated immunization campaigns should conduct strong engagement with existing community structures, and with trusted leaders. Campaign workforce training should be harmonized to ensure clarity of roles and consistency in delivery. Integrated immunization campaigns should be grounded in early, joint planning among national planners and implementing partners. |
In Tanzania, linking MDA campaigns to popular measles-rubella immunization campaigns increased coverage and trust for the MDA campaign. Several studies cited duplicative or inconsistent training materials as a barrier to successful integration. Harmonized training materials incorporated job specific responsibilities. In Ethiopia, early coordination between measles and VitA campaigns enabled shared training sessions, unified social mobilization strategies, and aligned logistics planning. In Zambia, early planning also facilitated joint budgeting and resource mapping. |
1B, 1D, 1E |
| Planning & Implementation | Stone, EC, McFarland, DA, Rogers, H. Health Campaign Integration: A Scoping Review, Section 1 – Neglected Tropical Diseases. Health Campaign Effectiveness Website. 2022. | NTD | Global |
NTD campaigns (particularly MDA) should be integrated with other health campaigns, or into the country's health system. Programs should incorporate health education into development and delivery. Programs should consider local context when choosing delivery channel. |
The scoping review found strong evidence that integrated NTD campaigns reduce infection rates and are cost-effective compared to standalone efforts. Qualitative evidence shows that fear of adverse effects of taking multiple drugs is high; health education shown to reduce this and improve coverage. Strong evidence supports cost-effectiveness when campaigns use community-based or combined community-and-school delivery, rather than relying solely on schools. |
1B, 1E |
| Planning & Implementation | World Health Organization. (2021). Implementing Integrated Health Campaigns: Working Draft Guide. Geneva: World Health Organization. | Nutrition, Polio, Immunization, NTD | Global |
Countries should follow a structured decision-making process when planning to integrate health campaigns, focusing on key factors that determine the feasibility of integration. Campaign planners should implement comprehensive practices and guidelines across all phases of integration, including planning, coordination, and logistics. Countries should prioritize effective coordination and stakeholder engagement during and after the integration process to ensure long-term sustainability and maximize impact. |
The guide outlines five key steps for deciding when to integrate health campaigns, helping countries assess the timing, resources, and readiness for integration. This includes thorough planning, coordination, and feasibility assessments. The guide provides detailed practices for each phase of campaign integration, covering aspects such as microplanning, social mobilization, training, monitoring, cost-sharing, financing, and logistics, including waste management and safety. The guide stresses the importance of coordination and social mobilization throughout the integration process, including post-campaign follow-ups. This ensures that all stakeholders are engaged, and that integration efforts can be sustained. |
1A, 1B, 1C, 1D, 1E |
| Planning & Implementation | Co-delivery of preventive chemotherapies against onchocerciasis and soil-transmitted helminths along with complementary social and behavioral change communication interventions in Ethiopia. Decatur, GA (USA): Health Campaign Effectiveness Program, The Task Force for Global Health; 2022. Birhanu Z, Sudhakar M, Abraham G, Bulcha G, Shiferaw T, Kebede Y; Jimma University. | NTD | Ethiopia |
Integrated preventive chemotherapy (PCT) campaigns should leverage existing community networks and health extension workers (HEWs) to enhance treatment delivery and trust. Co-delivered campaigns should be complemented with behavioral change interventions that promote awareness and disease prevention. |
In the integrated PCT/STH campaign, volunteers were effectively re-oriented as community mobilizers rather than drug distributors. Post integrated campaign, community knowledge of targeted NTDs (e.g. STH, onchocerciasis) was significantly higher than baseline levels with addition of behavioral change interventions. |
1B, 1D, 1E |
| Planning & Implementation | Explorative Research to Inform a Model for Full Integration of Lymphatic Filariasis and Deworming MDA with Learnings from the Pulse Polio Campaign in India. New Delhi, India; Decatur, GA, USA. PATH and Health Campaign Effectiveness /The Task Force for Global Health, Inc.; 2022. | NTD, Polio | India |
Planners of integrated health campaigns should leverage existing campaign resources, such as experienced front-line workers. Stakeholders at all levels, from the national to the community level, should have a clear understanding of their respective priorities, barriers and enablers. Integrated campaigns should ensure adequate supervision and renumeration structures to reflect the increased workload caused by integration. |
The same field workers implemented both STH and LF interventions, demonstrating their familiarity with shared target populations and geographic areas. Stakeholders initially held differing views on what integration meant, but early engagement through a mapping exercise helped align their priorities and clarify shared objectives. Nurse midwives supervising integrated campaigns were overburdened, leading to reduced supervision quality. CHWs also reported that added responsibilities were not matched by adequate compensation. |
1A, 1B, 1C, 1D, 1E |
| Planning & Implementation | Health Campaign Effectiveness Coalition. (2023). Considerations for integrating health campaigns: A synthesis of findings from implementation research studies in immunization, neglected tropical diseases, malaria, and vitamin A supplementation. The Task Force for Global Health. | NTD, Immunization, Malaria, Nutrition (VAS) | Bangladesh, Colombia, Ethiopia, Guinea, Nigeria, Rwanda |
Integrated campaigns should prioritize clearly defined roles (i.e. SOPs) and consistent communication across all campaigns. Campaign teams should employ a co-design approach to identify and address potential bottlenecks. Integrated campaigns should adopt, when possible, digital tools (i.e. mobile apps, dashboards) for real-time data collection and efficient training. |
In the multi-country survey of campaign managers, “poor communication or coordination between donors, governments, and other partners” was ranked as the top barrier for full or partial integration. Ethiopia and Nigeria demonstrated that co-developed operational timelines and harmonized training reduced campaign overlap and improved worker performance. Partners in Colombia developed digital training/capacity building tools with digital modules on each campaign disease domain for community socialization. |
1B, 1C, 1D, 1E |
| Planning & Implementation | Health Campaign Effectiveness Coalition. (2022, February 7). Improving the effectiveness of an integrated measles and meningitis A immunization campaign in the context of multiple epidemics: A case study in Guinea. | Immunization (Measles/MenA) | Guinea |
Collaborative planning should include assessments of community acceptance. Governments should consider de-centralized decision-making to allow most at risk areas to implement their own campaigns. Administrative procedures should be streamlined to ensure timely remuneration of health workers, utilizing electronic payment systems to reduce delays and paperwork. |
Adverse events following immunization (AEFI) were a major concern for caregivers and required community sensitization for uptake.
Empowering local authorities through decentralized decision-making enabled regions most at risk to implement context-specific strategies.
The creation of The Program Management and Coordination Support Unit (PMCSU) introduced new accountability procedures, but increased paperwork led to delays in health worker remuneration. |
1B, 1D, 1E |
| Planning & Implementation | Integration of Neglected Tropical Disease Control Campaigns in Two Districts of Uttar Pradesh, India. New Delhi, Delhi, India; Decatur, GA, USA. International Institute of Health Management Research, New Delhi and Health Campaign Effectiveness /The Task Force for Global Health, Inc.; 2022. | NTD (LF, STH) | India |
Existing technological platforms should be leveraged for community education, communication, monitoring and reporting. Community health workers (CHWs) should be trained using systematic and consistent training mechanisms. Integrated campaigns should closely involve community leaders and local government to support buy-in. |
The existing disease surveillance system DASTAK (originally created for JE) proved to be a potential system for NTD surveillance but needs further alignment.
The implementation of a single training manual in the local language ensured systematic and consistent training. A dedicated day of recognition for CHWs in Uttar Pradesh also boosted morale and motivation, contributing to campaign success.
Leaders and government officials displayed ‘social modeling’ by consuming antifilarial drugs in public view to dispel concerns of drug safety. |
1A, 1B, 1C 1D, 1E |
| Planning & Implementation | Lessons Learned from the 2019-2020 Implementation of Measles and Meningitis A Integrated Campaigns in the Context of COVID-19: A Retrospective Case Study of Kogi, Niger, and Kwara States in Nigeria. Abuja, FCT, Nigeria; Decatur, GA, USA. Clinton Health Access Initiative (CHAI) Nigeria; Health Campaign Effectiveness/The Task Force for Global Health, Inc.; 2022. | Immunization (Measles/MenA) | Nigeria |
Integrated campaigns should be co-planned through a national coordination platform that includes all key stakeholders, from national leaders to community members. National leadership should guide oversight, readiness assessments, and supply chain planning to ensure operational success. Targeted, culturally appropriate social mobilization should be embedded in campaign design to reach priority populations. |
The National Technical Coordinating Working Group (NTCWG) enabled aligned timelines and joint decision-making, while early engagement of state and local actors clarified roles and strengthened ownership in Kogi, Niger, and Kwara States.
Federal-level coordination enabled streamlined vaccine allocation and technical gap identification. States that conducted early supply chain assessments avoided cold chain disruptions and managed vaccine inflow.
Effective mobilization strategies included local-language materials, trusted influencers, and house-to-house outreach. These methods improved awareness and participation, particularly in hard-to-reach areas. |
1A, 1B, 1C, 1D, 1E |
| Planning & Implementation | Mainstreaming neglected tropical diseases campaign interventions into the primary health care system: Exploratory implementation research in Ethiopia. Eyu-Ethiopia and the Health Campaign Effectiveness Program at The Task Force for Global Health. (2022) Ali, E. H., Gebre, T., Seife, F., Embiale, W., & Gello, B.M. | NTD, PHC Integration | Ethiopia |
Strong coordination and collaboration at national and local levels should be emphasized for successful NTD mainstreaming into Ethiopia's PHC. District and facility-level management systems should be strengthened before integration, and require robust organization and leadership at these levels. |
Limited communication and unclear roles among partners have slowed progress. Strengthening coordination through task forces and better information sharing can help align efforts and improve integration.
Infrastructure limitations, such as inadequate storage and low drug availability (e.g., praziquantel, ivermectin, azithromycin below 50%), hinder the effective implementation of NTD campaigns at PHC facilities |
1B, 1D |
| Planning & Implementation | Mehjabeen S, Anwar HB; BRAC University. Implementation research in health campaign effectiveness: a retrospective study on immunization-related campaign integration in Bangladesh. Dhaka. Decatur, GA (USA): Health Campaign Effectiveness Program, The Task Force for Global Health; 2022. | Polio, Nutrition (VAS), NTD | Bangladesh |
Integrated campaigns should prioritize multisectoral collaboration and strong government ownership.
Integrated health campaigns should be embedded within national programs like the Expanded Programme on Immunization (EPI) and National Immunization Days (NIDs), which hold existing infrastructure and public trust. |
The Government of Bangladesh led the integration process, coordinating multiple sectors and mobilizing millions of community volunteers to support NID delivery. This commitment ensured alignment across programs and improved campaign outcomes.
VAS and deworming were integrated into NIDs using the established EPI platform for training, cold chain logistics, and community mobilization, which streamlined operations and expanded reach by leveraging community trust already associated with polio NIDs. |
1B, 1D, 1E |
| MERLA | Ending the neglect to attain the Sustainable Development Goals: a framework for monitoring and evaluating progress of the road map for neglected tropical diseases 2021−2030. Geneva: World Health Organization; 2021. License: CC BY-NC-SA 3.0 IGO. | NTD | Global |
Countries should align NTD M&E efforts with national health information systems like DHIS2 to promote sustainability and integration. Countries should adopt standardized NTD indicators and consistent M&E terminology, tracked at national and subnational levels, to improve comparability and accountability. |
The WHO urges programs to move away from siloed, disease-specific M&E tools and instead use platforms like DHIS2 for routine, unified data reporting, ensuring better health system integration and more sustainable data practices.
Notable variations existed in the use of terminology on M&E, NTD indicators, and methods of evaluation across NTD programs, with consequent inconsistent interpretation of data. |
2A, 2B, 2C |
| MERLA | Health Campaign Effectiveness Coalition. (2024, August). Integrated campaign digitization monitoring, learning and evaluation framework approach. The Task Force for Global Health. | General M&E guidelines, digitization | Global |
Integrated campaigns should implement a customized MLE framework.
A logic model and indicator bank should guide development of the MLE framework. |
The HCE framework provides practical tools, including examples of user questionnaires, key informant interview guides, and pre-/post-training tests, to facilitate comprehensive evaluation and learning.
The framework includes an extensive indicator bank covering various domains such as governance, sustainability, resource allocation, and cost-effectiveness, providing a robust foundation for M&E activities. |
2A, 2B, 2C |
| MERLA | Improving the effectiveness of mass Long-Lasting Insecticide-treated net distribution campaigns through community-based health planning and services programme in Ghana. MY-CAMP Project, University of Ghana School of Public Health. Phyllis Dako-Gyeke, Franklin N. Glozah, Emmanuel Asampong, Philip T. Tabong, Adanna Nwameme, Ruby Hornuvo, Nana Yaw Peprah, Margaretta Gloria Chandi, Philip B. Adongo. (2022). | Malaria | Ghana |
Long-lasting insecticidal net (LLIN) campaigns should be integrated into existing primary health systems, such as the Community-based Health Planning and Services Programme (CHPS) program, to enhance sustainability and community engagement. Campaign planners hould implement continuous social and behavioral change communication (SBCC) to improve LLIN utilization beyond initial distribution. Monitoring and evaluation of integrated LLIN campaigns should employ mixed-methods approaches to generate comprehensive, context-specific insights. |
The study co-created a Community Health Advocacy Team (CHAT) made up of community actors and health officers to support LLIN distribution and use. After four months, 90% of community members across six districts perceived the CHAT intervention as acceptable, appropriate, and feasible for integrating LLIN campaigns into the CHPS system.
Despite free distribution of LLINs, there remained a need for ongoing SBCC activities to encourage consistent use among beneficiaries.
The study utilized surveys, KIIS, FGDs and participatory workshops across six districts, to gather diverse perspectives on LLIN campaign integration. This comprehensive M&E strategy facilitated the co-creation of context-specific interventions like the CHAT model. |
2B |
| MERLA | Measuring national immunization system performance: a systematic assessment of available resources. Glob Health Sci Pract. 2023;11(3):e220055. Patel C, Rendell N, Sargent GM, et al. | Immunization | Global |
National immunization programs should evaluate system performance across all components, not just vaccination coverage, to gain a comprehensive understanding of program effectiveness.
Policymakers and implementers should prioritize a streamlined, context-specific core set of validated indicators to reduce reporting burdens.
Global and national immunization stakeholders should strengthen validation of newer indicators, particularly for under-measured dimensions. |
The review identified 20 M&E resources encompassing 631 distinct indicators. While vaccination coverage indicators comprised the majority (110 out of 124 outcome indicators), there was considerable variability and gaps in assessing other components such as governance, financing, regulation etc.
The extensive number of indicators has led to substantial data collection and reporting burden, particularly in resource-constrained settings. Streamlining indicators to be most relevant for a country’s priorities and challenges can improve usability.
The review did not identify any metrics examining the burden of well-established diseases affecting older adults, like influenza, pneumococcal disease, and herpes zoster, suggesting a need for validation of indicators with gaps, such as with adult immunization.
|
2B |
| MERLA | Synthesis and translation of research and innovations from polio eradication (STRIPE): initial findings from a global mixed methods study. BMC Public Health 20 (Suppl 2), 1176 (2020). Alonge, O., Neel, A.H., Kalbarczyk, A. et al. | Polio | Global |
Comprehensive readiness assessments should be conducted at multiple levels before implementation of integrated programs to identify potential barriers and facilitators.
Integrated campaigns should include a structured transition plan (ie. labs, surveillance, trained staff) into national systems before donor support ends. |
External factors, including social, political, and economic elements, were the most frequently cited barriers to polio eradication efforts, and should be thoroughly assessed.
Where transition planning was delayed or absent in GPEI, critical surveillance functions and health worker networks collapsed, emphasizing the value of early, intentional integration strategies. |
2B |
| MERLA | UNICEF. (2021). Delivery effectiveness of health campaigns: Final report. Health Campaign Effectiveness Coalition. | Nutrition (VAS) | Global |
VAS programs should prioritize the collection of high-quality, disaggregated data to inform global and national effectiveness assessments.
Additional effectiveness parameters such as service quality, acceptance and sustainability should be integrated into M&E systems for a more comprehensive evaluation. |
The report notes major gaps in globally available data, particularly on community acceptance, which limits the ability to assess delivery effectiveness comprehensively.
Stakeholders in various countries reported access, equity and cost-effectiveness to be the most important indicators for programs, beyond VAS coverage. |
2A, 2B |
| MERLA | The Use of Real Time Monitoring Approaches and Tools for Immunization Campaigns: Good Practices and Lessons Learned New York: United Nations Children’s Fund (UNICEF), 2021. | Immunization | Global (with case studies from Pakistan, Indonesia, Uganda) |
Real-time monitoring (RTM) using digital tools should be integrated into immunization campaigns.
Digital RTM tools should be tailored to local contexts and integrated with existing health systems.
The adoption of digital RTM tools should include capacity building and stakeholder engagement in immunization campaigns. |
In Pakistan's 2018 measles campaign, RTM open-source tools such as RapidPro Surveyor and KoBo Toolbox improved cross-campaign communication and facilitated quick program adjustments.
In Uganda, the MOH integrated Open Data Kit (ODK) with the national DHIS2 dashboard during the 2019 MR and OPV campaigns. This allowed rapid visualization and analysis of campaign data. Staff at all levels were also able to leverage and support the local DHIS2 partner (the Health Information System Program).
In Zambia, multiple campaigns (cholera, MR, polio) used RTM across delivery methods and target groups, with strong success attributed consistent stakeholder engagement and training of health workers. |
2A, 2B, 2C |
| MERLA | United Nations Children’s Fund (UNICEF). Beyond coverage: measuring vitamin A supplementation programme effectiveness in Mauritania and Sierra Leone. Health Campaign Effectiveness Coalition, Task Force for Global Health: Decatur, GA (USA); 2022. | Nutrition (VAS) | Mauritania, Sierra Leone |
During all stakeholder conversations the end-user perspective should be included to achieve community-level representation.
Campaign review sessions should be structured around a clear and well-accepted framework (e.g. UNICEF’s 11-step delivery effectiveness framework) to promote shared understanding and meaningful discussion. |
In Mauritania and Sierra Leone, a participatory strategic review process enabled country stakeholders to deliberate on aspects of program effectiveness in VAS programming, resulting in context-specific recommendations. However, community-level representation was not included in the first two workshops.
In Mauritania and Sierra Leone, structuring the review sessions around the 11 UNICEF delivery effectiveness framework was well-understood, and led to in-depth discussion. |
2A, 2B, 2C |
| MERLA | World Health Organization. (2010). Independent monitoring of polio supplementary immunization activities (SIA): Global guidelines. Global Polio Eradication Initiative. | Polio | Global |
Monitoring systems for integrated campaigns should function independently from implementation teams to ensure impartial and credible data collection.
Independent monitors should use standardized data collection tools at all steps of program monitoring and evaluation to ensure data credibility and consistency.
Monitoring systems should include both in-process and post-campaign monitoring to enable real-time course correction and long-term planning. |
The WHO guide states that independent monitors are critical for collecting unbiased data, as their separation from campaign implementers supports real-time accountability. (ex. Monitors conducted household visits and assessed key indicators such % of children missed)
Monitors must follow standardized protocols and tools at every step to maintain data quality and support actionable insights across sites and over time.
The document outlines in-process monitoring for immediate issue resolution during SIAs, and post-campaign monitoring to assess coverage and improve future campaign strategies. |
2A, 2B, 2C |
| Financing | Cost of integrated immunization campaigns in Nigeria and Sierra Leone: bottom-up costing studies. BMC Health Serv Res 24, 1334 (2024). Boonstoppel, L., Moi, F., Banks, C. et al. | Polio, Immunization | Nigeria, Sierra Leone |
Integrated immunization campaigns should be designed to maximize reach at each site to reduce the average cost per person vaccinated.
Campaign planners should account for both direct and indirect costs—such as staff time and shared resources—to accurately capture the true cost of integration. |
In Anambra State, Nigeria, integrating yellow fever and MenA vaccine delivery resulted in estimated financial savings of at least $1.2M. By increasing the number of vaccinations at each location, expenses from staff time, transportation, and supplies for each individual vaccinated were reduced.
In Sierra Leone, while the direct financial cost per vaccine dose was $0.34, incorporating economic costs such as staff time and logistics raised the total to $0.73 per dose, highlighting the importance of including all cost types to understand full resource implications. |
3A, 3B, 3C, 3D |
| Financing | The effects of integration on financing and coverage of neglected tropical disease programs. The American Journal of Tropical Medicine and Hygiene, 89(3), 407–410. Hooper, P. J., Zoerhoff, K. L., Kyelem, D., Chu, B., Flueckiger, R. M., Bamani, S., Bougma, W. R., Fleming, F., Onapa, A., Paré, A. B., Torres, S., Traore, M. O., Tuinsma, M., Linehan, M., & Baker, M. (2013). | NTD | Global |
Integrated NTD programs should be designed to secure long-term funding commitments to maintain program stability.
Campaign integration should be used as a platform to expand treatment scope and geographic reach across disease areas. |
The review emphasizes that integration, while beneficial in the short term, can risk losing its momentum without sustained donor engagement or increased government investment. Without a clear pathway for long-term government financing, the progress achieved through integration can be jeopardized. In Burkina Faso, Mali, and Uganda, integrating trachoma treatment into NTD campaigns resulted in an expansion of both the number of individuals treated and the geographic scope of the campaigns, reaching previously underserved populations. |
3D |
| Financing | Health Campaign Effectiveness Coalition. (2022). Integrating seasonal malaria chemoprevention and vitamin A supplementation: Lessons learnt from Nigeria. | Nutrition, Malaria | Nigeria |
Integrated campaigns should leverage existing high-coverage platforms—like SMC—to expand reach and reduce operational costs.
Programs should establish clear and coordinated funding mechanisms to prevent inefficiencies and ensure timely implementation.
Stakeholders such as NMEP, NPHCDA, and the Child Health Unit of state governments in Nigeria should conduct joint budget impact analyses to inform strategic financing and support intervention scale-up. |
Using the existing SMC infrastructure allowed the campaign to extend VAS coverage without duplicating logistics, leading to cost efficiencies in delivery, supervision, and personnel mobilization.
Although SMC and VAS were co-delivered, they had separate funding sources and delivery systems. This created parallel activities, which caused program delays.
Integrating VAS with SMC was found to offer the opportunity to improve VAS coverage at a minimal additional cost, but requires further costing research to evaluate resource needs and explore sustainable funding options. |
3B, 3C, 3D |
| Financing | Landscape report on the economics of integration of immunization and primary health care services in low- and middle-income countries [version 1; not peer reviewed]. Gates Open Res 2022, 6:61 Portnoy A, Regan MC, Brenzel L and C Resch S. | Immunization, Malaria, Nutrition (VAS) | Malawi, Togo, Ghana, Uganda |
Future research should focus on generating empirical data to assess the economic impact of integrated immunization programs.
Integrated immunization services should be evaluated using comprehensive economic analyses to inform policy decisions. |
The review found a significant lack of empirical evidence on the economic impact of integrated delivery, with the majority of studies relying on projected rather than observed data.
Few existing studies used economic evaluation methods like cost-effectiveness analysis. This gap limits the ability of decision-makers to decide whether integrated delivery models (e.g., combining immunization with nutrition or maternal health services) are a better use of resources than single-focus programs. |
3B |
| Financing | Ozaltin, A., & Owino, E. (2022). At-a-glance: Primers on campaigns and financing. Health Campaign Effectiveness Coalition. | NTD, Malaria, Nutrition, Immunization, Polio | Global |
Integrated health campaigns should leverage existing financing and infrastructure from well-established vertical campaigns, such as polio, to support multi-intervention delivery.
Integrated campaigns should address fragmented financing mechanisms to improve efficiency and alignment across partners.
Stakeholders should increase transparency and accessibility of campaign financing data to enable better planning and assessment of integrated efforts. |
Between 25–50% of GPEI staff time is spent on non-polio activities (e.g., Vitamin A supplementation, soap, bed nets), demonstrating that polio infrastructure is already used to support other campaigns through initiatives like PolioPlus.
In Tanzania’s 2019 MR-IPV campaign, although centrally budgeted as a single campaign, Gavi funds were split between WHO (for MR) and UNICEF (for IPV), each using different disbursement systems. This fragmentation led to inconsistencies and barriers to full integration.
Campaign financing data are often scarce or difficult to access. Poor transparency in funding flows makes it challenging to distinguish allocations for integrated versus vertical campaigns. |
3A, 3B, 3C, 3D |
| Financing | Polio health economics: assessing the benefits and costs of polio, non-polio, and integrated activities of the Global Polio Eradication Initiative [version 1; peer review: 2 approved]. Gates Open Res 2022, 6:5 Thompson KM, Kalkowska DA and Badizadegan K. | Polio | Global |
Given the variety of funding sources provided for integrated campaigns, every dollar should be linked to a specific activity, the party responsible, and the intended outcome, improving accountability.
Campaign planners should distinguish between polio and non-polio costs when integrating activities, to enable accurate health economic assessments. |
GPEI’s 2018 strategic action plan highlights the integration of non-polio activities (e.g., emergency preparedness, health system strengthening) with polio functions. WHO has moved to integrate polio transition funds into the base WHO budget for clearer reporting and resource allocation.
GPEI monitors both polio-specific (e.g., immunization) and non-polio activities (e.g., health system strengthening) using key performance indicators (KPIs). This requires distinguishing between polio and non-polio costs and tracking shared resources. |
3B, 3C |
| Financing | A scoping review on integrated health campaigns for immunization in low- and middle-income countries. Health Policy Plan. 2023 Nov 28;38(10):1198-1224. Ahmed ST, Haider SS, Hanif S, Anwar HB, Mehjabeen S, Closser S, Bazant E, Sarker M. | Immunization | Global |
Integrated campaigns should address the lack of clear, coordinated funding mechanisms, as this is a significant barrier to effective integration.
Integrated campaigns should adopt flexible, pooled financing mechanisms aligned with joint planning structures to enhance efficiency and coherence. |
Many integrated campaigns relied on fragmented funding sources, with each partner funding its own vertical component, leading to unclear cost accountability, and duplicated expenditures.
Successful case examples (e.g. Zambia’s integrated Child Health Week) benefited from joint funding agreements and planning structures. |
3A, 3B, 3C, 3D |
| Financing | ThinkWell. (2022, March 10). Campaign costing policy brief: Findings from immunization campaign costing studies—Policy and program implications. Linked Immunisation Action Network. | NTD, Immunization, Polio | India, Nigeria, Sierra Leone |
Integration of campaigns should be carefully planned in low disease burden areas, as operational costs per person targeted may be higher.
Health system capacity should be strengthened before implementing integrated campaigns to avoid strain on other essential services.
Campaign planners should prioritize managing per diem and transport costs, as they are significant drivers of overall campaign expenses, especially in co-delivered interventions. |
In sites with a lower disease burden, the operational costs per person targeted were higher. This suggests that integrated campaigns might not always result in cost efficiencies in these areas, as fewer individuals are reached, leading to higher unit costs.
If health systems are already overstretched, integrating additional campaigns can divert valuable resources (e.g. personnel and infrastructure) from other essential health services, thus weakening the overall health system's ability to deliver services.
Per diems and transport costs were the main cost drivers of the delivery of the campaigns across sampled sites, accounting for 64-69% of financial costs across the campaigns. |
3C |
| Financing | World Health Organization. (2024). Lessons learned from joint financing of health systems strengthening in low- and middle-income countries (Sustainable Financing for Health Accelerator, Global Action Plan). | Immunization, Nutrition, Cross-cutting | Global |
Joint projects should establish clear procedures and align partner priorities to avoid delays and strengthen country ownership.
Governments should co-lead financial planning to align joint funding with national systems and fiscal calendars. |
Joint initiatives between Gavi and the World Bank faced delays due to differences in financial reporting processes, budget cycles, and timelines, underscoring the need for harmonized procedures.
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3B, 3D |