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As childhood immunization coverage shows great disparity in many countries, there is a growing need to focus on the most hard-to-reach and marginalized populations. Ethiopia is home to millions of people who live remote, nomadic lifestyles, and who need to be contacted five times with quality vaccine in the first year of life.
JSI works to strengthen the routine immunization (RI) system in Ethiopia. One key component is support for immunization microplanning which builds health workers (HWs) capacity to plan and implement immunization services. JSI implements a bottom-up approach to microplanning, which engages community leaders in mapping their populations and selecting immunization sites, which is critical when providing services to nomadic and hard-to-reach populations. As part of a larger performance review, JSI examined whether microplanning improved immunization services for nomadic populations and overall immunization performance in study regions.
It was found that microplanning built the capacity of HWs in districts with large nomadic populations to identify, plan, and schedule sessions, and budget resources to reach all eligible children. A bottom-up approach which includes community members in the planning of immunization services was critical in the effort to access hard to reach and mobile populations. As self-reported by health workers, improved planning resulted in more children being reached with immunization services.
In addition, many facilities began to identify and track children who had defaulted on their immunizations, increasing the number of fully immunized children. Bottom-up, participatory microplanning which includes community leaders can be used to strengthen planning and improve the reach of services, even in places with weak health infrastructure and large nomadic populations.
This poster was presented by Lisa Oot at the Fifth Global Symposium on Health Systems Research in Liverpool in October.