Red Cross Activities to Strengthen Routine Immunization through 5-POINT PLAN A pilot in Two Sub Counties in Kenya: Bobasi and Starehe Kenya Pediatric Association Meeting Sarova Whitesands Hotel, Mombasa 12th April 2019

Piloting a Red Cross 5-Point Plan to Strengthen Routine Immunization Amina Ismail, MSc. Health Delegate, Measles and Rubella Initiative, American Red Cross

Problems and Opportunities EPI strategies used to date have successfully led to ~85% global coverage. However, coverage has stagnated. Relying on the same strategies is unlikely to reach the 15% of missed children. Lessons learned from smallpox & polio show that closing the final ‘gaps’ needs innovation and new approaches. One possible innovation: Opportunity to use CSOs’ pool of resources & provide them with a major role in supporting the strengthening of routine immunization. The 5 Point Plan brings together national & local CSOs and health partners (MoH, UNICEF, WHO, etc.) to identify and solve local problems. Builds on previous RC work to support routine immunization. Seeks a sustainable outcome.

Piloting a Red Cross 5-Point Plan to Strengthen Routine Immunization Demand Supply Pilot’s Objective: Not to improve RI in only a few geographical areas Assess if this is a feasible method to improve RI in the long-term & assess potential to go to scale

Piloting a Red Cross 5-Point Plan to Strengthen Routine Immunization Step 1. Find missed children, create spot map, identify clusters in relation to health centers Step 2. Collate information on why children are missed Step 3. RC relays collated information to MoH and partners, who act to rectify problems Step 4. Social mobilization to caregivers on vaccination Step 5. Evaluation

Piloting a Red Cross 5-Point Plan to Strengthen Routine Immunization Step 1. Find missed children, create spot map, identify clusters in relation to health centers Urban Africa: Mobile Phone GPS, Residence of Children Missing MCV1, 2017 Red dot: child missing MCV1; Blue dot: child not missing MCV1 Building-level data crowdsourced by volunteers, available through OpenStreetMap (OSM) Overlay with clinic locations to identify clusters of missed children

Piloting a Red Cross 5-Point Plan to Strengthen Routine Immunization Step 2. Collate information on why children are missed 2 perspectives Caretaker Health Facility

MoH, WHO, UNICEF & Partners take ACTION Piloting a Red Cross 5-Point Plan to Strengthen Routine Immunization Step 3. RC relays collated information to MoH and partners, who act to rectify problems ICC Meeting MoH, WHO, UNICEF & Partners take ACTION

Piloting a Red Cross 5-Point Plan to Strengthen Routine Immunization Step 4. Social mobilization to caregivers on vaccination

Piloting a Red Cross 5-Point Plan to Strengthen Routine Immunization Step 5. Evaluation: Volunteers find missed children Short-term impact Previously identified missed children vaccinated? 3 months Long-term impact Next birth cohort vaccinated? Sustainability 12 months

Piloting a Red Cross 5-Point Plan to Strengthen Routine Immunization Goal: Assess if the methodology is feasible & not to improve RI in a few areas; assess ability to go to scale Builds on but differs from previous initiatives All 5 steps must be completed In sequential order Creating demand without supply is detrimental Identified problems must be rectified promptly Evaluation after one-year to assess for longer term impact Utilizes input from volunteers and senior RC staff who are trusted community members Utilizes input from MOH EPI Program- National and County & Partners Relies on ensuring open and non judgmental dialogue Pilot: (1) Sub-region of Nairobi, Kenya & (2) TBD Big 6 country