Research Project

Evaluation of the Integrated Measles and Meningitis A Vaccination Campaign in the Meningitis Belt of Guinea in 2022

Summary

A study that examined the effectiveness and challenges of an integrated measles and meningitis A mass vaccination campaign in two high-risk regions of Guinea.

Guinea

Kankan and Siguiri Districts

Immunization. Measles and meningitis A

  • Conduct door-to-door outreach
  • Involve local leadership
  • Address the increased workload of those delivering the interventions
  • See all promising practices

Key Messages

In May 2022, the Ministry of Health and Sanitation (MSHP) of Guinea delivered an integrated measles and meningitis A vaccination campaign. To understand the campaign’s successes and challenges, researchers from The Fondation Santé et Développement Durable (FOSAD) and the Centre d’Excellence de Formation et Recherche sur les Maladies Prioritaires en Guinée (CEFORPAG) conducted an implementation research study to better understand the campaign’s successes and challenges and articulate lessons learned.

Co-designing the campaigns with all stakeholders encourages active participation and ownership.
  • In general, stakeholders viewed the integrated campaign as successful.
  • The campaign enabled the MSHP to increase vaccination coverage and reach previously unvaccinated children.
  • In some cases, increased health care personnel workloads and the difficulty of knowing how to attribute potential side effects led to dissatisfaction with the campaign.
  • Microplans validated at higher levels sometimes failed to provide the resources needed at the community level.
  • Other significant obstacles included logistical challenges and difficulty reaching families residing in mining and agricultural communities.
  • Improved planning, training, supervision, and communication are essential for an integrated campaign that combines vaccinations for different age groups.

Background

Context

In Guinea, measles and meningitis outbreaks often overlap, especially in high-risk areas. To reduce the impacts of these diseases, the World Health Organization recently recommended that all countries at high risk for meningitis launch mass vaccination campaigns to immunize individuals against measles and meningitis A.

In May 2022, the Ministry of Health and Sanitation of Guinea, together with partners, delivered an integrated mass vaccination campaign for measles and meningitis A.

View the slides and report for detail on the research methods.

Problems or Gap

The COVID-19 pandemic disrupted health campaigns around the world. Focus shifted to controlling COVID-19, which led to increased difficulty reaching unvaccinated children through other health campaigns. Subsequently, there is an urgent need to catch these children up on their immunizations.

Study Objectives

The objectives of this study were to:

  • Describe the implementation process of the integrated campaign.
  • Assess the perception of the community, health workers/vaccinators, and managers on the integration of the campaign.
  • Estimate vaccination coverage and identify indications of effectiveness.
  • Identify promising practices and make recommendations to stakeholders to promote the effectiveness of forthcoming campaigns.
The Kankan Region is the largest of the eight regions of Guinea with five districts ⎻ two of which are involved in the study (Kankan and Siguiri). It is located in the meningitis belt.

Results

Summary

To explore the effectiveness and challenges of an integrated measles and meningitis A vaccination campaign in two high-risk districts and extract best practices, researchers conducted a mixed-methods study that involved gathering coverage data and interviewing stakeholders. The findings illustrate that while the campaign was generally successful and well-received, there were challenges around microplanning, as well as campaign personnel workloads.

Scroll down for more key findings. 

Key Findings

  • Vaccination coverage was 82.4% for the Kankan Health District and 54.9% for the Siguiri Health District.
  • The integrated campaign reached 60.9% of the unvaccinated children identified as part of this effort.
  • Most interviewees reported satisfaction with the integrated health campaign in question and expressed support for similar integrations in the future.
  • Social mobilizers, community outreach workers, radio, the media, religious leaders, town criers, and local authorities helped communicate key campaign messages to communities.
  • In the future, refinement of the planning approach for integrated campaigns to better align with the realities in the field will increase campaign effectiveness.
  • Improvement of the working conditions, training, and incentives for those delivering the interventions is another key consideration for future campaigns.
  • Stakeholders identified the following challenges:
    • Increased health care personnel workloads that were not offset by incentives
    • Difficulty identifying which vaccine may have led to potential side effects
    • Microplanning that occurred without considering resource needs at the community level
    • Logistical obstacles, such as challenges with the delivery and storage of vaccines, as well as conflicts with competing government-led activities
    • Community member unavailability due to livelihoods from mining and agricultural work
    • The vastness of some geographic areas served

“It is a very good thing for the population insofar as meningitis is truly a very dangerous disease which ravages rural areas, and the same goes for measles. Measles really tires children, and this campaign is welcome.” –Regional Leader

  • Conduct door-to-door outreach in combination with other communication approaches to raise awareness of integrated campaigns.
  • Meet with elected officials and local leadership to ensure their participation in microplanning, organizing and monitoring the campaign, and encouraging community participation.
  • Promote flexibility for health care workers in how they supply, store, and manage vaccines to help mitigate challenges at the local level.
  • In microplanning, address the increased workload implications of campaign integration.