Research Project

A Study on Immunization-Related Campaign Integration in Bangladesh

Summary

A mixed-methods study to identify best practices from previous integrated health campaigns in Bangladesh.

Bangladesh

Immunization

Polio vaccination, Vitamin A supplementation, deworming

  • Raise community awareness of integrated health campaigns
  • Plan for how the campaigns will reach children who missed vaccination events
  • Provide sufficient staffing and training to support integrated campaigns
  • See all promising practices

Key Messages

The Bangladesh government’s integration of polio immunization, vitamin A supplementation, and deworming campaigns achieved remarkable success. As a result, the number of polio cases in Bangladesh dropped to zero. This integrated campaign is no longer active, but it offers a wealth of insights for future campaigns.

To identify lessons learned from these efforts, the James P. Grant School of Public Health at BRAC University conducted a mixed-methods study that primarily involved gathering input from stakeholders who assisted with the campaign’s delivery.

  • Integrating health campaigns can effectively address multidimensional health issues.
  • Delivery of vaccines as part of integrated health campaigns increases immunization coverage.
  • The potential benefits of integrated mass vaccination campaigns include expanded intervention coverage, cost and time savings, attainment of desired health outcomes, improved access for patients, and increased community trust in the health care system.
  • Multisectoral collaboration, community engagement via local leaders, recruitment of volunteers, campaign-specific training, and microplanning on how to reach all community members are key to the success of integrated mass vaccination campaigns.
  • Integrated mass vaccination campaigns are cost-effective, efficient, and convenient for patients. They also promote health-related knowledge among community members and enhance access to services for patients.

Background

Context

In Bangladesh, the integration of polio immunization with vitamin A supplementation and deworming campaigns was so successful that the country eliminated polio among residents. In collaboration with partners, the Bangladesh government delivered these interventions through national immunization day events, which took place in school settings.

Problems or Gap

With the attainment of a polio-free population, Bangladesh discontinued the National Immunization Days in 2014. Vitamin A supplementation and deworming treatment are now delivered as separate campaigns. While the co-delivery of these interventions is no longer necessary, it is important to capture promising practices and lessons learned through the integrated campaign, as this knowledge will inform future campaigns.

Study Objectives

The objectives of this study were to:

  • Identify the contexts that led vaccination campaigns to be integrated with other health campaigns.
  • Articulate the facilitating and hindering factors of health campaign integration.
  • Explore the negative and positive effects of integrated health campaigns on service delivery outcomes.
  • Identify the components of integrated health campaigns that can strengthen future health programs in Bangladesh.

View the slides for detail on the research methods.

Integrated campaigns took place in these areas of Bangladesh in 2014.

Results

Summary

To document best practices that emerged from the integration of polio vaccination, vitamin A supplementation, and deworming campaigns in Bangladesh, researchers gathered stakeholder feedback on the components and impacts of this integrated campaign. The findings illustrate that with proper planning and implementation, integrated mass vaccination campaigns can expand the reach of all the interventions involved.

Scroll down for more key findings. 

Key Findings

  • In Bangladesh, the integrated polio vaccine, vitamin A supplementation, and deworming campaign reached the intended population and increased the coverage of all three interventions.
  • The integrated campaign was cost-effective, efficient, and convenient for patients. Further, the campaign integration improved health-related knowledge among community members and promoted access to services for children and their caregivers.
  • Reasons for discontinuation of the campaign included the achievement of a polio-free status, the improvement of routine immunization campaigns, insufficient collaboration across government ministries, and misconceptions about vaccine side effects.
  • The primary challenges to the campaign pertained to funding, staff capacity and training, and the logistics of simultaneously delivering multiple interventions.
  • Recruitment of volunteers, campaign-specific training for volunteers and staff, and microplanning on how to reach all communities were essential to overcoming these challenges.
  • Some children who resided in hard-to-reach areas remained unvaccinated after the initial campaigns. Misconceptions about the vaccine were another common reason for missed vaccinations. To reach these children, the Bangladesh government canvassed households.
  • The Bangladesh government led the implementation of the integrated campaign with support from several external partners, including the World Health Organization, the United Nations Children’s Fund, Gavi the Vaccine Alliance, and BRAC University.
  • To help coordinate implementation efforts, stakeholders formed committees, each of which focused on a particular aspect of implementation.
  • Study participants perceived future campaign integration as cost-effective and beneficial for increasing intervention coverage.

“This integration was successful, as now polio has been eradicated completely; [the] campaign increased the vaccination coverage.” — Study Participant

  • Early in the process, secure governmental commitment to and ownership of the integrated campaign.
  • Raise community and implementer awareness of the campaign and encourage religious and community leaders to promote community participation in the interventions.
  • Conduct thorough microplanning on how to reach unvaccinated community members.
  • Engage in strategic planning regarding community engagement, logistics, government involvement, and collaboration with partners.
  • Embed the campaign within a trusted platform, like the national Expanded Programme on Immunization in Bangladesh.
  • Consider the local context and ensure that sufficient workforce, training, incentives, and monitoring tools are in place.