Improving vaccination rates during a dry season campaign.

by Emily Esworthy/IMA World Health

Have you ever had diphtheria? What about tetanus or measles? If you’re like most people reading this, your answer is no – thanks to the wide availability of vaccines in the developed world.

In 2009, when IMA began working on the SuddHealth project in South Sudan’s Jonglei and Upper Nile states, vaccination rates for these and other major diseases were well below the targets. Since the purpose of World Bank/Multi Donor Trust Fund-supported project was to reinforce the states’ ability to provide basic health care to their populations, increasing vaccine coverage was a major focus.

IMA coordinated an annual “Dry Season Campaign” aimed at increasing vaccination rates while promoting other key public health initiatives like HIV/AIDS, reproductive and women’s health, and family planning.

Vaccination is a critical part of advancing health in a developing setting like South Sudan. According to the WHO and UNICEF’s Immunization Summary(2007), more than 2.5 million deaths a year are prevented globally thanks to vaccination against just four diseases – diphtheria, tetanus, pertussis (DTP) and measles.

But successfully increasing vaccination rates in a place like South Sudan takes more than simply lining people up for shots.

In South Sudan, there is no real network of roads, making the distribution of vaccines challenging. This problem is worsened during the rainy season, when large portions of both Jonglei and Upper Nile States are inaccessible due to flooding. The population has been displaced and fluctuates frequently due to ongoing conflict, making follow up boosters and reporting difficult. The health workers tasked with administering the vaccines are often in need of training, support and the supplies they need to meet the goals.

One of IMA World Health’s major tasks for SuddHealth was to develop a strategy to overcome these and other barriers to widespread vaccination.

Working with the two state Ministries of Health, health authorities in each county, local health workers and other NGOs working in these states, IMA coordinated an annual “Dry Season Campaign” aimed at increasing vaccination rates while promoting other key public health initiatives like HIV/AIDS, reproductive and women’s health, and family planning.

In addition to public rallies and awareness campaigns on the importance of vaccinating against common diseases, IMA coordinated many behind-the-scenes activities to ensure the health system could successfully manage the task at hand, whether at established clinics or in mobile teams assembled to reach remote areas.

For example, IMA reinforced the existing “cold chain” – a temperature-controlled supply chain – throughout all the counties in each state, allowing vaccines to be distributed to clinics and kept cold for preservation. Since there is no electrical grid in South Sudan, IMA installed solar panels to power the refrigerators. IMA also provided boats, vehicles and four-wheelers where needed to overcome transportation challenges, and worked with health workers to build knowledge of and ownership of the importance of vaccination.

Through these efforts, the SuddHealth project administered over 400,000 vaccinesthrough the Dry Season Campaigns from 2010 to 2012 – a huge step in toward controlling the spread of deadly disease and creating widespread local buy-in on the need to vaccinate.

The SuddHealth project closed in December 2012, and the new World Bank-funded Rapid Results Health Project kicked off on January 1, 2013 to continue the momentum. IMA and their partners are hoping to administer 600,000 vaccines in all 24 counties in Upper Nile and Jonglei States during the next Dry Season Campaign which starts in February 2013.