Mohamed Nassor, Simba Daudi, Mphuru Alex, Lyimo Dafrossa, Kyesi Furaha
World Health Organization (WHO), P.O. Box 9292, Dar es salaam, Tanzania.
Muhimbili University of Health and Allied Sciences (MUHAS), P.O. Box 65001, Dar-es-Salaam, Tanzania.
Vaccine. 2020 Nov 17;38(49):7741-7746. doi: 10.1016/j.vaccine.2020.10.050. Epub 2020 Oct 22.
To achieve Measles and Rubella elimination and Polio Endgame goals, Tanzania implemented country-wide integrated Supplementary Immunization Activities (SIAs) in October 2019 involving two injectable vaccines of MR and IPV. The SIAs targeted children aged between 9 and 59 months for Measles-Rubella and 18 to 42 months for IPV vaccines. This article aims to share lessons learnt in the implementation of SIAs field guidelines in Tanzania in 2019 to inform future implementation of the SIAs within and outside the country's boundaries.
Focus groups discussions (FGDs) were conducted among Regional Immunization and Vaccines Officers from all regions and National Supervisors and Partners responsible for implementing the SIAs. Key areas discussed were pre-planning activities, implementation, monitoring and evaluation of the SIAs based on key thematic areas including; planning and coordination, logistics management, trainings, and demand creation. Pre-described templates were used to guide the discussion and keep record of the discussions.
The SIAs achieved national target based on administrative coverage. This was due to a high sense of ownership of the SIAs and strong staff commitment to attain high coverage rates manifested through effective planning and coordination within and between levels; effective execution of SIAs activities; involvement of key stakeholders at all levels; and strong advocacy, communication and social mobilization activities. Despite the success observed through administrative coverage, the WHO target of attaining 95% coverage using the gold standard - national coverage survey, was not reached. The main barrier to success was inadequate and delayed disbursement of funding.
The 2019 SIA achieved high administrative coverage as a result of effective coordination; adequate micro-planning; timely logistical preparations; and effective demand creation activities. Future campaigns need to give high priority to hard-to-reach and densely populated areas during planning and ensure timely disbursement of funds to the operational level during implementation.
为实现消除麻疹和风疹以及消灭脊髓灰质炎的目标，坦桑尼亚于2019年10月在全国范围内开展了综合补充免疫活动（SIAs），涉及两种注射用疫苗，即麻疹风疹联合疫苗（MR）和脊髓灰质炎灭活疫苗（IPV）。这些补充免疫活动的目标人群为9至59月龄儿童接种麻疹风疹联合疫苗，18至42月龄儿童接种脊髓灰质炎灭活疫苗。本文旨在分享2019年坦桑尼亚在实施补充免疫活动现场指南过程中吸取的经验教训，以为该国境内外未来实施补充免疫活动提供参考。
与来自所有地区的区域免疫和疫苗官员以及负责实施补充免疫活动的国家监督员和合作伙伴进行了焦点小组讨论。讨论的关键领域是基于关键主题领域的补充免疫活动的前期规划活动、实施、监测和评估，这些主题领域包括规划与协调、后勤管理、培训以及需求创造。使用预先描述的模板来指导讨论并记录讨论内容。
基于行政覆盖率，补充免疫活动实现了国家目标。这归因于对补充免疫活动的高度主人翁意识以及工作人员为实现高覆盖率而表现出的坚定承诺，具体体现为各级内部和各级之间的有效规划与协调；补充免疫活动的有效执行；各级关键利益攸关方的参与；以及强有力的宣传、沟通和社会动员活动。尽管通过行政覆盖率取得了成功，但并未达到世界卫生组织使用金标准（全国覆盖率调查）实现95%覆盖率的目标。成功的主要障碍是资金发放不足和延迟。
由于有效的协调、充分的微观规划、及时的后勤准备以及有效的需求创造活动，2019年的补充免疫活动实现了较高的行政覆盖率。未来的活动在规划期间需要高度重视难以到达的地区和人口密集地区，并确保在实施期间及时将资金发放到业务层面。
