Davis Albohm is a project manager for Stanford University’s Global Supply Chain Management Forum. He spends significant time in Zambia managing the logistics of the Riders for Health impact evaluation alongside his partner, George Muwowo. For more information on our research in Zambia, visit our website.
On a recent trip to Zambia, I witnessed the launch of the nation’s long-anticipated measles vaccination campaign. The goal for the week-long exercise was ambitious – 95 to 100 percent coverage of all children between 6 months and 15 years old – an estimated 6.5 million to be immunized. Here’s what I witnessed on the ground:
As part of a fortuitously timed routine work trip, my partner George Muwowo and I set out from our Livingstone, Zambia office for the most remote district in our study area, Itezhi-Tezhi. Located more than 400 km away from Livingstone, Itezhi-Tezhi lies in the northwest corner of the province, its population living in small villages among the boundless floodplains.
When we arrived, I expected to witness significant challenges for the organizers, especially in a rural setting like Itezhi-Tezhi where the terrain is unforgiving and distances – even between neighboring villages – are vast.
However, we saw first-hand that local health officials were up to the challenge. Uniformed health workers and community volunteers were stationed at schools and health centers methodically moving children from one station to the next, beginning with paperwork and ending with vaccinations. Because of the district’s sparse population, lines appeared to be short.
But all reports noted that turnout was extremely high. Throughout Itezhi-Tezhi and other districts we visited later in the week, there was no evidence of stock outs or delayed immunization deliveries. Children who had the means to travel to an immunization site were treated. Beyond measles, many children also received Vitamin A supplements and polio immunizations.
We spoke with several health workers who cited that a well-executed vaccine distribution plan, advance staff training and strong external support from organizations like UNICEF were critical to the efficiency of the campaign.
But, successful planning and logistics are just part of the success story. Comprehensive social mobilization efforts also appeared to play a key role. I witnessed a widely coordinated media outreach effort which seemed to penetrate much of Zambia. Daily advertisements in the two major national newspapers were published for weeks in advance. The national television broadcaster ZNBC ran PSAs every hour. Billboards were placed all over towns and posters were attached to the walls of every health center and school we visited. People we met reported strong awareness of the campaign, and had enough notice to plan a trip to the nearest immunization site.
While official numbers have not been tallied, the government reports success. As part of our research in Zambia, our team collected immunization data from Environmental Health Technologists (EHTs), the cadre of health workers partly responsible for managing campaign logistics.