Uganda Red Cross Measles Social Mobilization Campaign 2012

1. UGANDA RED CROSS SOCIETY National Headquarters: Plot 551/555 P.O. Box 494, Kampala. UGANDA URCS MASS MEASLES SOCIAL MOBILIZATION CAMPAIGN MAY/JUNE 2012 Presenter: Dr Baguma Bildard

2. INTRODUCTION • The 2012 measles campaign major aim was to increase the number of children under 5years of age vaccinated, regardless of vaccination status and disease history • The Uganda Red Cross used her experiences from past successful measles campaign in 2006 and 2009 to promote community awareness about the 2012 mass measles campaign • The 2012 campaign covered the whole country composed of 112 districts, but URCS with AMCROSS support covered only 14 districts 2

4. GOALS/OBJECTIVES The overall goal of the campaign was to contribute in sustaining reductions in measles morbidity and mortality by raising community awareness, acceptance and demand uptake for measles and polio immunization in these 14 districts in Uganda Objectives • To raise community awareness on the 2012 Mass Measles and polio Campaign and benefits of its interventions in the 14 selected districts in Uganda • To raise community awareness on benefits of routines immunization of under-five children in the14 selected districts • To ensure that at least 95% of eligible children receive Measles, Polio vaccinations, vitamin A and Albendazole during the 2012 Mass campaigns and in addition support in mop up Campaigns were its deemed necessary . 4

5. IMPLEMENTATION MECHANISM/METHODOLOGY • Holding advocacy meetings with religious and other key people in the community- District Stakeholders • Use of local TVs and Radios to disseminate information • One to one encounter during house to house visits • Registration of all eligible children and provision of card for identification/ verification • Dissemination /distribution of IEC materials • Use of mega phones to announce about the campaign in the communities.

6. IMPLEMENTATION MECHANISM/METHODOLOGY URCS Volunteers doing community mobilization and IEC material

7. SUMMARY OF URCS PRE-CAMPAIGN INTERVENTIONS ACHIEVEMENTS • Trained and oriented 36 staff/focal persons • 290 sub county supervisors as TOT for the campaign • 343 Local supervisors (divisional/Parish coaches) and 2,917 village level URCS volunteers participated in social mobilization techniques in the 14 districts URCS volunteers attending the TOT training for district in Eastern Uganda

8. SUMMARY OF URCS PRE-CAMPAIGN INTERVENTIONS ACHIEVEMENTS • Planned jointly with the MOH and district health office on strategic issues • URCS conducted 19 advocacy meetings with key local religious and community representatives notably the Chief Administration Offices (CAOs), District Health Officers (DHOs), Residence District Commissioners (RDCs) Local Councils and others in the 14 districts Mr. Bob Davis and URCS Kampala city team planning for the rapid convenience survey in Kampala.

9. SUMMARY OF URCS PRE-CAMPAIGN INTERVENTIONS ACHIEVEMENTS CONTINUED • Disseminated simple key messages developed jointly with the MoH and other members of the Social Mobilization Committee through distribution and strategic placement of 100,000 stickers, 325,000 fliers and 70,000 posters Poster strategically placed in a place of worship and video/cinema hall for the campaign respectively

10. SUMMARY OF URCS PRE-CAMPAIGN INTERVENTIONS ACHIEVEMENTS CONTINUED • The trained volunteers were able to mobilize parents and care givers in 941,609 households • 1,242,602 children under five (72.3% of the targeted 1,772,085 children) who were eligible for the vaccination campaign were registered. • This made it possible for URCS to provide basic information on missed and defaulting children within their community some of whom were later tracked and immunized. A volunteer registering a child during a house to house mobilization at Kasana Kavule in Luwero

11. Pho SUMMARY OF CAMPAIGN INTERVENTIONS ACHIEVEMENTS • URCS assisted and supported campaign activities at sites in over 5,700 vaccination posts. • URCS Volunteers helped the health workers to tick the names of vaccinated children on their pre-registration lists composed of 1,242,602 children they had registered during house to house campaign • The volunteers also did home follow up on defaulters to ensure that they are immunized. URCS volunteers assisting health workers during the Measles and polio immunization campaign at the vaccination posts.

12. SUMMARY OF POST CAMPAIGN INTERVENTIONS ACHIEVEMENTS • URCS also provided logistical support and deployed 17 vehicles that helped during the campaign to move vaccines/health workers. • Interviews with caregivers showed that TV and radio, in both English and Luganda, came in first as information sources. • House visits (by Red Cross and other partners, such as the LDS Church) reached some persons not accessible by the mass media. The little used megaphones did well. Team of vaccinators arrive using URCS vehicle

13. SUMMARY OF POST CAMPAIGN INTERVENTIONS ACHIEVEMENTS • URCS conducted a rapid convenience survey which revealed that 71.9% of children under five had been vaccinated in Kampala (57.1%) during mass campaign and 14.8% mop up). • URCS supported in the mop up campaign in Kampala with the administrative data only 54.38% coverage had been registered and improved the coverage by 13.75% to 68.13 %. The independent monitoring report data puts the coverage at 80% for Kampala city. • Other post campaign intervention included debriefing of the volunteers, report writing, monitoring and evaluation. • URCS also attended the post campaign meeting with UNEPI, MoH, UNICEF and other partners at Silver springs hotel. Results from various district and branches where URCS operated, indicated that an overall 102.4% achievement in mass measles vaccination was registered during the campaign as compared to the national one which was at 100% for measles.

14. TABLE : PERCENTAGE TARGET OF BENEFICIARIES REACHED WITH THE MASS MEASLES VACCINE

15. CHALLENGES • Some household did not cooperate with volunteers during house visits due to misinformation by some local leaders who were not paid. • In Kampala vaccine delivery process delayed and some of the posts which were identified as vaccination posts were found not open during the SIA days. This made parents to wait for longtime with many going back home. • In some parts of the country it rained during the 2nd day of the SIA days which made the exercise to delay leading to low attendance of children. • Change of vaccination posts at the last minute. This happened especially in Kampala where initially some of the Local council offices were planned to be vaccination posts, however these posts were changed without prior notification to parents and caretakers.

16. CHALLENGES CONTINUED • The number of days for the mass campaign was not sufficient to cover all the children more especially in Kampala. • Fewer Volunteers were planned for Kampala city and hence not all the households within the city could be reached • Fewer vaccination posts compared to the number of population leading parents and caretakers to walk long distances to the vaccination posts. • The general turn up and demand for vaccination was good but in Kampala due to poor logistics movement and the past experience of nonpayment to vaccinators in the previous campaigns, the campaign was affected negatively. • The vaccinators with held results for Kampala due to non payment and hence the administrative data for Kampala can not be relied on.

17. REASONS FOR UNDER ACHIEVEMENT IN KAMPALA CITY • Poor Immunization Material logistical movement • Lack of motivation from the vaccinators due to the past experience of nonpayment of their allowances hence the lowest coverage was registered. • Poor micro planning by the Divisions health authorities in Kampala • Delays in transfer and confirmation of funding support for the mass measles campaign for Kampala City Authority. • Withholding of tally sheets by the vaccinators due to non payment hence affecting the coverage and credibility of the administrative data for Kampala. • Fewer Volunteers were planned for Kampala city and hence not all the households within the city could be reached with the campaign message in time using the house to house approach. • Fewer vaccination posts compared to the number of population leading parents and caretakers to walk long distances to the vaccination posts.

18. LESSONS LEARNED FOR FUTURE PROGRAMS • Social mobilization for the mass measles and polio immunization should be started a month earlier than the immunization days • Involvement of both parents to participate and support each other in issues pertaining to protection of their children health is critical • Use of the media, House to house helped to reach the unreached give good results. • Close collaboration with all partners involved in the SIA campaigns from Division level to village level enabled Red Cross Kampala Central branch volunteers to receive maximum supervisory support throughout the campaign period.

19. LESSONS LEARNED FOR FUTURE PROGRAMS CONTINUED…. • Partners need to plan adequately to support the districts in the movements and pre-positioning of immunization logistics if success is to be achieved • Kampala city alone needs a minimum of 1,000 volunteers for any future campaign if all the households are to be reached with the immunization campaign messages. • Future campaigns need more days in order to reach all targeted children.

20. END OF PRESENTATION