Results

Improving the Effectiveness of an Integrated Measles and Meningitis A Immunization Campaign

Collaborative planning of an integrated campaign in a context of multiple epidemics

Results

Overall, authorities and stakeholders had a satisfactory assessment of the collaborative planning process. Collective and consensus-oriented decision-making regarding the integrated vaccination campaign proved successful, and communities, local, regional, and national authorities supported the integration of MenA-MEAS2 campaigns. The involvement of community actors and consideration of their perspectives improved local acceptability of the integrated campaign.

View the video on the right to see interviews with district and community leaders, assessing the advantages of an integrated campaign.  Voir la vidéo en français

Scroll down the page for the key findings and challenges.

Key Findings

  • GAVI funded the introduction of MenAfrivac into the routine immunization schedule and the integrated campaign with the measles second dose (MEAS2) for children aged 13 to 24 months. Integration was considered for cost savings and operational requirements. Meetings were organized to mobilize funds for the forecasting and vaccine supply from UNICEF.
  • The commitment of the government to support the collaborative planning process was demonstrated by convening stakeholder meetings; making consultants available to support the work; and providing digital tools, including a planning dashboard and videoconferencing tools.
  • A strategic document for the introduction of MenAfrivac was developed and validated by the EPI and its partners after an assessment of cold chain capacity and vaccine safety. WHO provided guidance for the planning and implementation of the integrated campaign.

Challenges

Ultimately, the COVID-19 pandemic and an Ebola epidemic postponed the introduction of MenAfrivac into the routine EPI and consequently, delayed the occurrence of the integrated campaign. Government priorities shifted to epidemic response. Other challenges emerged during the planning process, and mitigation strategies were identified.

Challenges

  • There were missed opportunities for integration with other health campaigns (i.e., insecticide-treated mosquito net distribution, vitamin A distribution, and seasonal malaria chemoprophylaxis), mainly due to a lack of synchronized planning and funding.
  • New funding and administrative procedures put in place by the newly formed Program Management and Coordination Support Unit (PMCSU) of the Ministry of Health were associated with some delays.
  • Vaccinators had concerns about workload, poor motivation, and cumbersome administrative procedures.
  • Some community members expressed concerns about vaccine safety and side effects.

Mitigation

There is a need to prioritize fully or partially integrated campaigns in the most affected areas of the country, even during epidemics of other diseases. Decentralization of decision-making to regional and district levels would enable high-risk areas to implement integrated campaigns more efficiently, even when national priorities shift.

Vaccinators and communities must be engaged to build buy-in and achieve high coverage. The opportunity to express concerns and ideas should be given to these groups during the pre-planning process. Vaccinators should be guaranteed timely remuneration, sufficient training, and manageable workloads. Community sensitization should take place to mitigate fears of and manage potential adverse events.

“These are issues linked to the programmatic aspects: the support of the population, the motivation of the vaccinators, and the adequacy of the funding." -National EPI Coordinator, Central Level