Strengthening Immunization Programs

Published by the Basic Support for Institutionalizing Child Survival Project (BASICS II) for the United States Agency for International Development (USAID), this document describes and endorses the use of communication for immunisation programmes. The paper is intended to serve as a tool for programme planning and management.

Speaking to immunisation technical experts and communications specialists working at global, regional, national, and sub-national levels, Lora Shimp argues here that "Advocacy, social mobilization, and program communication should be an inherent part of immunization programs. Communication activities complement other immunization technical components, such as quality of service; cold chain and logistics; surveillance, reporting, and data management; and training, supervision, and monitoring. This report provides an overview of immunization communication and describes how to maximize its contribution to immunization programs in developing countries. The discussion and examples focus on communication's place within immunization planning, activities, and partnerships, based on lessons learned from behavior-centered analyses and programming. A detailed case study of Madagascar's immunization communication activities is provided as an example of country implementation."

To highlight two sections that provide context for the paper, Shimp begins by orienting the reader as to the specific ways in which communication can support immunisation programming - while also examining barriers to communication strategies. First, she clarifies the scope of the paper, defining an immunisation communication programme as one that includes advocacy, social mobilisation, and programme communication (including behaviour change activities). The goal of this type of programming, she explains, is to increase and sustain demand, acceptance, and use of immunisation services. Examples of these communication activities are: advocating to make immunisation a priority of decision-makers, mobilising communities to participate in immunisation services, and educating caregivers about the importance of immunisation (hopefully in the process motivating them to vaccinate themselves and their children completely and according to schedule).

Shimp explains that "Communication activities that are sufficiently planned, funded, and integrated with service delivery can help Expanded Program on Immunization (EPI) programs:

• Achieve higher coverage rates for all antigens and reductions in missed opportunities, unreached children, and drop-out rates by mobilizing sectors and resources from national to community levels to support immunization;
• Reduce morbidity and mortality due to vaccine-preventable diseases by facilitating community awareness of immunization as a public health priority and by ensuring commitment and participation in immunization services and disease detection and reporting;
• Implement immunization policies and action plans through effective communication of facts and figures on vaccine-preventable diseases, as well as through intensive advocacy to ensure participation of leaders and communities;
• Mobilize financial resources and lobby other donors and organizations from various sectors and the community to support immunization;
• Strengthen understanding between the Ministry of Health (MOH) and EPI staff and other government agencies, the Inter-agency Coordinating Committee (ICC), non-governmental organizations (NGOs), the community of financial backers and donors, and provincial or district officers;
• Improve quality of services to meet demand, improve interaction between health workers and communities, and improve safety of injections and safe handling of vaccines; and
• Prevent or dispel misinformation and doubts related to immunization through the use of multiple channels, information sources, and media that influence the population and public opinion."

Despite the rich potential that communication has to support increased use of immunisation for better health in those and other ways, Shimp acknowledges that barriers to communication exist. She explores some of these barriers, which can relate to service delivery, interaction with communities, channels of communication, or content or clarity of the messages themselves. These communication barriers can occur at national, provincial, district, and even institutional levels. The remainder of the document is dedicated to detailed discussion of approaches for addressing these kinds of barriers.

Click here to download the document in PDF format - English language.
Click here to download the document in PDF format - French language.