POST 00789E : MEASLES CAMPAIGN AND ITN DISTRIBUTION

POST 00789E : MEASLES CAMPAIGN AND ITN DISTRIBUTION Follow-up on Posts 00763E, 00765E, 00767E, 00768E, 00771E, 00774E, 00778E, 00781E, 00784E and 00789E 15 May 2005 _____________________________________ The first contribution is from Rebecca Fields (mailto:[email protected]) from IMMUNIZATIONbasics/Academy for Educational Development of the United States. The second is from Robert Steinglass (mailto:[email protected]) also from IMMUNIZATIONbasics. Both share similar concerns. In relation with this posting is an interesting presentation by Juan Ortiz and Bob Davis, both from UNICEF entitled "EPI and Accelerated Child Survival". It can be downloaded directly from our site at : http://www.technet21.org/EPI-AccelChildSurvival.ppt (warning: heavy file, 1.4MB) _____________________________________ Dear Colleagues, In the past few months, there has been an active debate under way on Technet about using measles campaigns as an opportunity to provide ITNs for malaria—similar to the way in which polio NIDs have been used to provide vitamin A supplementation. But there has been little discussion about the opportunities that routine immunization provides for other health interventions. Routine immunization is a fundamental and essential health service that is provided in virtually every country, day in and day out. In countries with relative high coverage, it affords the opportunity for five contacts between most families and the health system in a child’s first year of life. Yet these opportunities are traditionally under-utilized, even where coverage rates indicate that the reach of immunization services exceeds that of other health interventions. While EPI contacts are frequently an occasion for conducting growth monitoring or providing health talks, there is probably more that can be done to attend to the health of not just the child but also of her mother and siblings. For example, in the early 1990s, some countries tried out the use of the DTP1 contact at 6 weeks of age to provide the mother with just a few simple messages about family planning: was she aware of it, would she like more information, and an indication of how she could get that information. Perhaps in some places, deworming treatment is provided during EPI contacts. It may be that there is a lot of experience in using routine immunization contacts (either through fixed or outreach services) to promote or provide other family health services. But such experience is not well-documented or easily available to share. So the purpose of this message is ask for a very informal description of experience with which you may be familiar. What interventions have been provided or promoted along with routine immunization? Where, and on what scale? Who was involved? What preparations were needed to make this happen? Were there any special circumstances for doing this? Was the experience successful or not, and why? What lessons, if any, were learned from this? IMMUNIZATIONbasics would like to learn from and build on this experience and share it more widely than has been the case to date. Thanks in advance for helping to build this knowledge base. Rebecca -------------------------------- I want to thank TECHNET for providing this valuable exchange of views. I hope that one of the TECHNET readers, who is more familiar with malaria than me, may suggest a malaria listserv where the discussion could also be cross-posted, because I believe that the discussion is potentially very interesting to anyone in the malaria community trying to balance issues of equity and sustainability, public and private approaches, etc. By the way, TECHNET readers can get a lot of useful information by visiting the RBM website at www.rbm.who.int Immunization program managers and technical agencies, like the mass campaigners, should be thinking about how other interventions can be routinely delivered along with routine vaccinations. When other programs realize that routine immunization programs can be used to achieve their own objectives (vitamin A, de-worming, ITN distribution, intermittent malaria prophylaxis, etc.), sustainable routine EPI programs will be more greatly valued than they are at present. I recently read "Scaling up Insecticide-Treated Netting Programs in Africa: a Strategic Framework for Coordinated National Action." It was published in 2002 by the Roll Back Malaria Technical Support Network for Insecticide Treated Netting Materials. (at : http://www.rbm.who.int/cmc_upload/0/000/015/845/itn_programmes.pdf). It includes a useful section entitled "Lessons Learned from Experience." Among many of the useful lessons, one particularly stands out: "Large-scale and untargeted distribution of no-cost (or highly subsidized) nets is not sustainable and is likely to be counter-productive in the long term." In thinking about the most effective mix of delivery strategies and recognizing that scientific solutions need artful customizing in different contexts, I would like to know if the above statement is still the current thinking? If not, has something changed since this was written by RBM in 2002? In addition to the accumulating evidence of short-term effective distribution of nets during measles campaigns, what evidence is being collected to prove or disprove the above "lesson"? What monitoring is in place to detect early trends? And is there successful experience in adding ITN distribution to routine immunization programs? Thanks. Robert ______________________________________________________________________________ ______________________________________________________________________________ Visit the TECHNET21 Website at http://www.technet21.org You will find instructions to subscribe, a direct access to archives, links to reference documents and other features. ______________________________________________________________________________ To UNSUBSCRIBE, send a message to : mailto:[email protected] Leave the subject area BLANK In the message body, write unsubscribe TECHNET21E ______________________________________________________________________________ The World Health Organization and UNICEF support TechNet21. The TechNet21 e-Forum is a communication/information tool for generation of ideas on how to improve immunization services. 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