Research Project

Country Campaign Manager Perspectives on Health Campaign Integration

A Snapshot in 2022

Photo: Health campaign in Bangladesh. Credit: Maruf for Children Without Worms, Task Force for Global Health.

Summary

Linksbridge SPC conducted a study on health campaign integration that examined reasons for, characteristics of, and influences on full and partial integration.

Respondents reported on campaigns in 26 countries.

Countries are represented across 4 WHO regions (Africa, Americas, Europe, Southeast Asia)

Immunizations; Malaria; NTDs; Polio; Vitamin A Supplementation

  • Include considerations for health campaign integration within national health policies and strategies.
  • To the greatest extent possible, collect and use campaign data from national-level partners.
  • See more.

Key Messages

To contribute to existing data on partially and fully integrated health campaigns around the world, Linksbridge SPC conducted a mixed-methods study that included participants who reported on campaigns in 26 countries, and across several health domains. The research comprised collection and validation of health campaign integration data with a focus on the geographies with integrated campaigns, as well as levels of, reasons for, and influences on such integration. 

Health campaign managers from Africa, the Americas, Europe, and Southeast Asia participated in the study
  • Integrated campaigns occur across all disease areas at national and subnational levels.
  • Integration is easier for some types of campaigns, such as interventions that do not require additional technical skills to deliver and interventions that serve as an incentive for another intervention.
  • Campaign managers view integration as beneficial but perceive substantial barriers to achieving it.
  • The appropriateness of campaign integration depends on the context. A holistic examination of each campaign’s geographic scope is crucial in determining the feasibility of integration.
  • Top facilitators for integration include (1) government buy-in; (2) donor, partner, and government coordination; and (3) identical target populations. Other facilitators include not requiring additional skills to deliver secondary interventions (e.g., deworming, vitamin A), and one intervention acting as an incentive for another (e.g., vaccination paired with a bed net).
  • Top barriers to integration are different for full and partial integration but include issues related to (1) donor and partner coordination, (2) lack of government buy-in, (3) different target populations, and (4) human resource capacity. 
  • Notably, there are many contexts in which integration is not advised. Examples include emergency or outbreak settings with a short planning timeline, when distrust of one intervention will impact the uptake of another, and when campaign logistics are too dissimilar.

Background

Context

As countries work to recover from the disruption of health campaigns by the COVID-19 pandemic, stakeholders show a renewed interest in health campaign integration. Such integration can occur fully or partially. In full integration models, partners collaborate, share tools and resources, and co-deliver interventions, whereas partial integration involves the former elements without the co-delivery of services.

Problem or Gap

The existing data on integrated campaigns focus on full integration, with minimal data available on partially integrated campaigns. In response to this gap in information, Linksbridge SPC aimed to provide a better understanding of integrated campaigns through the data gathered for this study.

Study Objectives

  1. The objectives of this study were to:

    1. Assess the frequency of facilitators, barriers, and opportunities for full and partial health campaign integration in low- and middle-income countries.
    2. Generate a data set of fully and partially integrated campaigns, identifying and collecting data for additional variables to potentially add to the Campaign Calendar database and improve existing tools.
    3. Explore data from global-level partners and compare it with data from country-level campaign managers, highlighting gaps that could impact future work and increase knowledge-sharing around health campaign integration practices.
 See the slides for detail on the research methods.
 

Results

Summary

The data from this study reflect that campaign integration—especially partial integration—occurs more frequently than previously documented. For the 26 countries represented in this study, partial integration was the most common type of integration. Campaign integration occurred across all disease areas at various geographic levels. The ease of integration varied by the types of campaigns. Campaign managers favored campaign integration under appropriate conditions, with consensus among participants that national health policies and strategies should include integration considerations.

View an interactive visual dashboard of the results. 

Heather Ferguson of Linksbridge SPC walks through the background, methods, results, and lessons learned from the campaign integration study.

Key Findings

  • The most frequently reported reason for integration was to better reach the intended populations. Other common rationales included catching up partially immunized children, serving difficult-to-reach communities, and amplifying intervention impacts, including by leveraging one campaign to increase uptake of another.
  • Integrated campaigns most commonly address polio and measles, frequently including vitamin A supplementation and/or deworming treatment as secondary interventions.
  • Some respondents indicated that integration may be easier at subnational levels.
  • Most study participants (94%) indicated that they would engage in campaign integration if funds and resources were not a concern.
  • Top factors that facilitated integration included government buy-in, coordination among all involved parties, and similar populations served.
  • Restrictive government policies, such as those prohibiting the sharing and use of resources, were a substantial barrier to integration. Other obstacles pertained to limitations in coordination, governmental support, staffing, and funding, as well as disparate populations served.
  • Most integrated campaigns employed a campaign coordinating body, such as a district health team, committee, or workgroup.
  • The highest degree of collaboration among partners, government, and other stakeholders occurred in the training, engagement, and recognition of campaign staff.
  • More than half of the integrated campaigns used digital tools, primarily for data collection and reporting.

See the slides for more characteristics of integrated campaigns

Integration is “not something to be done ad hoc; it needs to be well-planned and well-organized, and if it is done at the last minute then everybody loses.” –Key Informant

  • Include integration considerations within national health policies and strategies.
  • Collect data from national-level partners to understand the integration activities they are planning and implementing.
  • Establish coordinating bodies who can guide integration.
  • Use digital tools for planning, executing, and evaluating campaign integration.
  • Share resources that can serve as common inputs, such as funding or waste management.
  • Align the efforts of key agencies with those of local entities to simplify integration.
  • Leverage services from community health programs and influencers.
  • Build integration efforts around person-centered designs.

Photo Credit: University of the Andes


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