1. Routine Immunization System during an M/R SIA?
Can House to House Social Mobilization Support Identification of Missed Children for the
Routine Immunization System during an M/R SIA?
Amina Ismail, MSc & Mary Agόcs, MD, MSc
Health Advisor, Measles & Rubella Initiative, American Red Cross
8th September 2017

2. Presentation & Discussion
Presentation: Overview of:
Red Cross house to house social mobilization for an SIA
Red Cross experience with collecting RI data (MCV1 status) during soc mob for an SIA
Discussion
If Red Cross line lists age eligible children missing MCV1, by name, address, caretaker cell phone (if available), how can that be used?

3. House to House Social Mobilization
Long history: polio, measles, recommendation of AFRO Measles Technical Advisory Group, etc.
Since helping found the Measles & Rubella Initiative, the American Red Cross has:
Supported social mobilization in 110 vaccination campaigns in 46 countries
In the past 5 years alone:
Trained and mobilized over 55,896 volunteers
Visited over 11.6 million households to encourage vaccination

4. House to House Social Mobilization Data Collection

5. Million Dollar Question Raised during UNICEF, IFRC, CDC, and AmRC Coordination Meeting?
Why not also collect information to determine which children have been missed by routine immunization?

6. AmRC Experience: Integration of RI into House to House Soc Mobilization
Purpose: identify missed children
MCV1 selected as indicator antigen
Discuss new strategy with MoH and in-country partners
Collect information, as usual, on name of parent, contact details – ability to identify specific children
Post SIA: share information with MoH and in-country partners
Pilot countries: Kenya (May ‘16), Namibia (July ‘16)
Zambia results

7. Zambia
Children’s Clinic Card, with measles (MCV1 and MCV2) vaccination

8. Data Form with RI, Zambia, September 2016

9. Total No. of children 12 months -23 months in HH with vaccination card
Identification of Missed Children Via House to House Activities, Zambia Example
Total No. of children 12 months -23 months in HH with vaccination card
Total No. of children 12months to 23 months with vaccination against measles marked on card
% vxed
Chawama
19,314
16,274 84
Kanyama
28,609
24,184 85
Chaisa
19,397
16,124 83
George
40,688
37,403 92
Mandevu
13,063
10,606 81
Chipata
40,014
28,489 71
ALL COMPOUNDS
161,085
133,080
Children identified by name & location known by volunteer.
If had a cell, also cell phone number of caretaker

10. Lessons Learned
RI is new set of data; more time required in training and supervision
Because additional information was collected, volunteers reached fewer HHs
Work ongoing to quantify reduction… up to half? Malawi pilot to quantify
Information shared with MoH & partners, but to AmRC knowledge, no follow-up activities
Are children missing receipt of other antigens?
Validation & follow-up?
Detracts from our primary mission during an SIA… raising awareness in the community
Conclusion: Do not integrate collection of data on missed children during SIA social mobilization

11. Summary
Do we agree that we need to reach the 10-15% of children missed by the routine system?
Is it feasible to collect data to identify children missed by routine immunization by Red Cross volunteers going house to house?
Can MoH and partners ensure follow-up & vaccinate these children?
Should Red Cross collect this information during an SIA?
If monies were available, should Red Cross collect this information outside an SIA?
If volunteers direct families with missed children to the health clinic, but there is no vaccine… will we do more harm than good?
Yes
Yes ?? No
RC could, if follow up (& $)
Yes