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2012 Côte d'Ivoire: Evaluation of the measles caimpaign’s best practices



Author: Synergie Expertise SARL

Executive summary

"With the aim to continuously improve transparency and use of evaluation, UNICEF Evaluation Office manages the "Global Evaluation Reports Oversight System". Within this system, an external independent company reviews and rates all evaluation reports. Please ensure that you check the quality of this evaluation report, whether it is "Outstanding, Best Practice", "Highly Satisfactory", "Mostly Satisfactory" or "Unsatisfactory" before using it. You will find the link to the quality rating below, labeled as 'Part 2' of the report."

Background:

Between 24 to 30 November 2011, the Ministry of Health organized the third follow-up campaign for measles, modeled on lessons learned from Addis Ababa and with the aim to vaccinate at least 95 per cent of all children in Cote d'Ivoire aged between 9 and 59 months nationwide. An evaluation of this measles campaign was carried out by a private company called Synergie Expertise.

Purpose/Objective:

The main objectives were to: 
i) analyze national and regional level measles and polio immunization coverage rates among children aged between 9 and 59 months; 
ii) Assess the knowledge, attitudes and practices of mothers, fathers and guardians of children aged 9-59 months; and
iii) Assess the implementation of the best practices identified at different levels of the health system at all levels - national, regional and district

Methodology:

Three data collection strategies have been implemented: 
i) a desk review focused on the best practices taken from Addis Ababa, previous campaigns reports and general information on the Expanded Programme on Immunization; 
ii) a qualitative survey conducted at the community level and at health facilities and targeting groups of mothers, community and opinion leaders, CHW and mobilizing agents health workers at districts level, Regional Directors and EPI managers at central level; 
iii) an immunization coverage survey conducted on a random sample in 20 strata, 800 clusters and 5,534 households.

Findings and Conclusions:

The coverage obtained during the campaign was 90 per cent, which was below target coverage rate of 95 per cent. The cost to vaccinate one child was calculated at 561 fCFA, which was much higher than how much it had cost to vaccinate a child in Côte d'Ivoire in 2008 (347 fCFA) and Mali in 2011 (356 fCFA). The implementation of the campaign, however, reached more than 25 per cent of additional target and strengthened the capacity of the system for the prevention of measles.

Recommendations:

Strengthen health system through EPI, organize review of the EPI, and support a biannual monitoring of the routine EPI 

Lessons Learned:

The stronger the health system, the more efficient are strategies and the campaign results



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