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Bridging immunization gaps: lessons from Zambia's 2024 measles-rubella supplementary immunisation activity
Moses Mwale1, Penelope Masumbu1, Peter Jay Chipimo1
1World Health Organization, Lusaka, Zambia.
Insights
Zambia
Area of Science:
- Public Health
- Epidemiology
- Immunization Programs
Background:
- COVID-19 disrupted routine immunization, increasing vulnerability to measles and rubella.
- Ongoing measles outbreaks necessitated urgent intervention in Zambia.
- Addressing immunization gaps is critical for global disease elimination goals.
Purpose of the Study:
- To evaluate microplanning effectiveness in Zambia's 2024 Measles-Rubella Supplementary Immunization Activity (SIA).
- To assess the feasibility of real-time digital monitoring during the SIA.
- To determine the equity of reaching zero-dose children in underserved areas.
Main Methods:
- Mixed-method approach combining quantitative and qualitative data.
- Utilized Google Sheets and Open Data Kit for digital monitoring.
- Conducted over 7,500 supervisory visits for quality assurance.
Main Results:
- Achieved 97% national coverage for the Measles-Rubella SIA.
- Successfully reached 165,000 previously zero-dose children.
- Identified challenges including funding delays and logistical constraints.
Conclusions:
- Comprehensive microplanning and community engagement are vital for successful SIAs.
- Real-time digital monitoring facilitates rapid adaptation and improved campaign management.
- Timely funding, robust cold chains, and data verification are crucial for equitable immunization in resource-limited settings.
Abstract:
Zambia's 2024 Measles-Rubella Supplementary Immunization Activity (SIA), conducted from 23 to 28 September across all 116 districts, targeted children aged 9-59 months to address immunization gaps exacerbated by COVID-19 disruptions and responding to ongoing measles outbreaks. This community case study evaluates the effectiveness of microplanning, the feasibility of real-time digital monitoring, and the equity of reaching zero-dose children during Zambia's 2024 Measles-Rubella SIA, using a mixed-method approach to inform scalable immunization strategies in resource-limited settings. Through comprehensive microplanning, strategic community engagement, and real-time digital monitoring, the campaign achieved 97% national coverage and reached 165,000 previously zero-dose children in underserved communities. Implementation utilized Google Sheets and Open Data Kit tools, with quality assurance through over 7,500 supervisory visits. Despite achieving high overall coverage, several challenges emerged: funding delays, logistical constraints in remote areas, and data quality issues. Key lessons include the necessity of timely funding disbursement, strengthened cold chain infrastructure, and rigorous data verification processes. Community involvement through local leadership engagement and radio campaigns proved essential to success, while digital monitoring enabled rapid adaptation to emerging challenges. This case study provides actionable insights for designing equitable immunization campaigns in resource-limited settings, supporting global measles and rubella elimination goals through evidence of effectively tailored, data-driven strategies.
