Yirimadio CSCOM staff member, Modibo Coulibaly, prepares to administer a vaccine during a vaccination campaign in the Yirimadio neighborhood of Bamako.
In Q3 of 2023, Muso achieved a remarkable improvement in vaccination indicators for children under two in Yirimadio, following several months of analysis and collaborative efforts with our partner community health centers. The project began in 2020, after a local measles outbreak, when Muso's Research, Monitoring & Evaluation, and Programme teams joined forces to explore strategies for boosting childhood vaccination rates. Our goal was to explore ways in which we could more fully integrate vaccination into our Rapid Care approach.
The first step for Muso was to work with our public sector and community partners to identify the primary barriers preventing complete childhood vaccination in Yirimadio. Initial data collection revealed the following constraints:
Difficulty for mothers to bring infants to the health center due to extended waiting times, household responsibilities, and limited transportation options, which can lead to babies starting but not completing their vaccination schedule, or not receiving vaccinations at all;
Frequent loss of vaccination cards in the household;
Insufficient patient awareness of the dangers of specific diseases, such as chickenpox, due to a lack of information and communication;
Inconsistent vaccination strategies between the Yirimadio and Bakorobabougou Health Centers;
Lack of a mechanism or program to support proactive household search for unvaccinated children.
Once these obstacles were identified, Muso collaborated with our partner community health centers to develop a comprehensive approach that would address each one. In May 2023, Muso launched a new immunization initiative in both our Yirimadio and Bankass sites that leverages the core elements of Rapid Care - door-to-door outreach, upgraded health facilities, and care without fees - to increase vaccination coverage for children under 24 months.
To do this we have rolled out new tools and systems for both CHWs and health centers. At the community level, we have added new functionalities into the smartphone-based application used by CHWs, the CHW App, to allow CHWs to record the vaccination status of all children under two, and to ensure referrals to the primary care center for children who have never been vaccinated or who have not yet completed vaccination. At the facility level, we have improved availability of vaccines, trained providers, and increased the number of days primary care centers offer vaccination. We also deployed mobile vaccination teams to conduct vaccinations in households, schools, and markets, and created a documentation system at the health center level to maintain vaccination records and prevent duplicate vaccinations when caregivers misplace their child’s vaccination card.
This new initiative has already resulted in a remarkable increase in vaccination status of children in peri-urban Mali, helping providers identify areas for increased outreach and drive uptake of vaccines at the health center. Between May 1st and September 30, 16,391 children have had their vaccination status registered across our Mali sites. These registrations have led to increased referrals of parents and their children to health facilities to complete vaccine schedules. Our partner primary care centers received 28,513 vaccination visits in the Q2 and Q3 of 2023, a 40% increase compared to vaccinations visits in the preceding six months.
Muso’s next steps include conducting a thorough programmatic analysis to assess which of the new approaches tested were most effective, and if CHWs' data collection capacity improvement played a significant role. This session will be led by Muso’s Programme and Monitoring & Evaluation team, accompanied by representatives from the partner Community Health Centers and the Regional Health Department, as well as CHWs.