The Big Catch-Up

The Alliance Lift is a series that spotlights the journeys of policy-makers, researchers and practitioners shaping health systems around the globe. In this Q&A, Daniela Rodriguez of the Alliance for Health Policy and Systems Research speaks with Dr Shalom Ndoula, Country Director of the Expanded Programme on Immunization at Cameroon’s Ministry of Public Health. 

With more than 20 years of experience spanning clinical medicine, district health management and national immunization leadership, Dr Ndoula has played a leading role in some of Cameroon’s major immunization milestones, including the rollout of the world’s first malaria vaccine and the efforts that led to the country being declared free of wild poliovirus in 2020.

Reflecting on his transition from clinical medicine into public health leadership, Dr Ndoula discusses the importance of adapting evidence-based policy to local realities and the tensions that can emerge between global recommendations, resource constraints and community expectations.

Drawing on Cameroon’s experience with embedded implementation research through initiatives such as MAINSTREAM and the Big Catch-up case studies, they also talk about how policy-makers, frontline health workers and researchers can work together to build more responsive immunization systems.

Also available as a video and podcast, the interview explores the growing pressures facing immunization programmes globally, the long-term implications of declining health financing and why reaching zero-dose children ultimately means strengthening the relationship between communities and the health system itself.

The Big Catch-Up (BCU) initiative was launched to support countries in identifying and vaccinating children who missed routine immunization during the COVID-19 pandemic. To better understand implementation experiences and operational lessons, several countries conducted case studies examining different aspects of BCU implementation. UNICEF, in collaboration with Gavi, WHO and partners, hosted a webinar to share insights from three selected case studies and reflect on lessons from programme implementation.

The session included:
• Country presentations highlighting experiences implementing BCU activities (Ethiopia, Kyrgyzstan, Mozambique)
• Reflections on operational approaches used to reach zero-dose and under-immunized children
• Discussion of lessons related to programme coordination, service delivery adaptations, and digital health systems
• Interactive Q&A and discussion

By the end of the session, participants had:
✔ Gained an understanding of how countries implemented BCU activities in different operational contexts
✔ Learned practical approaches used to identify and reach missed children
✔ Explored lessons related to programme coordination, service delivery, and monitoring systems
✔ Reflected on implications for strengthening routine immunization recovery efforts

Presentation slides available https://docs.google.com/presentation/d/1EuTugKJ8SOAx9ddLB03ftGLmh9dwkgvg/edit?usp=drive_web&ouid=111152928728150180193&rtpof=true

Presenters:

• Violet Mathenge
• Ibrahim Dadari
• Remy Mwamba
• Amsalu Shiferaw
• Assel Mussabekova
• Galina Solodunova
• Esmeralda Karajeanes
• Arlindo Banze
• Alex Garraud
• Phionah Atuhebwe