Rwanda Integrated Campaign Catch up campaign - February 2003 Nationwide follow up campaign - September 5 - 9, 2006 Target Population for measles: 9 to 59 months - 1,236,005 children. Routine measles coverage by 12 months – 79.4% (DHS) Observed: 7 Health Centers - 7 outreach sites Rubavu District Preliminary results: National unavailable; Rubavu District >107% coverage

Rwanda Integrated Campaign Vitamin A 100,000 UI; 6 to 11 months - 181,511 children 200,000 UI; 12 to 59 months - 1,054,494 children Mebendazole: 12 to 59 months - 1,054,494 children Measles vaccine: 9 to 59 months - 1,236,005 children ITN: 6 to 59 months - 1,248,970 children

Integrated campaign – triaging system

Mebendazole Children: 12 to 59 months Discussion / challenges Assessment by WHO regarding targeting at 12 months versus 2 years of age Stock outs observed after day 2 and 3. Discussion / challenges Stock out: high market value and/or underestimation WHO assessment: target age for future campaigns? Need for training: how to deliver

Bundling Bundling of vaccine supplies Discussion Vaccines, vaccine diluents, safety boxes & A-D and mixing syringes Stock out of A-D syringes for vaccines Dilution syringe not distributed per protocol (1 per ampoule) Discussion How to ensure bundling occurs? Should dilution syringes be single use?

ITNs Malaria # 1 cause morbidity ITN household coverage 18% Children: 6 to 59 months Pre campaign distribution by PSI Stock outs after day 2 & 3 Large families - some families received 4 nets Discussion/challenges Stock outs: market value issue or underestimation Policy: need for policy for # of distribution (# per household / per child) Reduced credibility: could stock outs affect future campaigns? Need for Follow up on ITN usage (Red Cross role)?

Conclusion - Integrated campaign a success Measles delivery not compromised High turn out - related to added interventions? Difficulties related to underestimation Next steps?: policy issues - ensuring usage - M & E

Cameroon integrated campaign Vouchers Targeted selected districts Underestimation of population Vouchers distributed late ITN not distributed to sites early