Improving immunization uptake using organized community groups and tracing drop-outs in Karkar region, Puntland-Somalia.
SFHSO designed an innovative approach to increase uptake on immunization and reduce drop-out rate through active defaulter tracing
Describe what you intend to do and how you'll do it in one sentence (required 250 Characters)
SFHSO aims to increase uptake of immunization services by dispelling myths and misconception on vaccines using father-to-father and mother-to-mother support group approach and tracing immunization defaulters in Karkar region Puntland Somalia.
Explain the idea (less than 2,000 characters)
The under-five mortality rate is 137 per 1,000 live births, 30% of which is contributed by vaccine preventable diseases. The overall rate of immunization coverage in Somalia remain very low; DPT3 of 31% and measles of 24% against the global target of >80%(WHO2018) . There is generalized misconception on the use of immunization services compounded by high illiteracy levels among care givers.
The primary target audience are caregivers who have children aged below one year in Karkaar region. Using mother-to-mother and father-to-father support group sessions, the project aims at increasing knowledge on immunization while dispelling myths and misconception. The program targets to reach approximately 10,000 caregivers through group discussions and additional 20,000 through radio messaging and information education materials (IEC).
We aimed to use 40 existing female and male champions at 40 rural health facilities across the Karkaar region Somalia to facilitate group sessions, create awareness and refer eligible cases for immunization. In addition, male champions will carry out fathers, elders and religious group meetings. The champions will undergo training using communication for development (C4D) strategy.
Religious leaders and traditional elders command loyalty among the Somali society hence the project aims to engage them so as to shape opinions on immunization. The project will also conduct monthly testimonial campaigns using champion caregivers to depict their satisfaction and how the project benefited them.
The project will hire local artists and communication experts to develop tailored messages and info-graphics on vaccination to create positive perception on immunization which can be disseminated through folk media and local radio channels.
Focus group discussions targeting beneficiaries and in-depth interviews with health care providers and opinion leaders will be conducted at inception of the project to understand the specific barriers to immunizatio
Which part(s) of the world does this idea target?
Geographic Focus (less than 250 Characters)
The idea will be targeted Karkar region Somalia, the region separated from Bari region, it has five districts with an estimated population of 300,000
Who are your end users and how well do you know them? (750 characters)
Our end users are resident of Karkar region, we have prior engagement with the community, Since we were working on last two years.
we currently implementing family planning project in partnership with Open idea through DFID funded project which targeted male involvement in family planing.
Our role was to create awareness on family planning, maternal and child health services. Additionally we have skilled community resources persons whom we trained on different primary health care concepts.
we organizing jointly mobilization campaigns with health authorities to respectfully discuss local communities, sheikhs, youth groups, women, how best they could address maternal health problems and come up with durable solution, to improve acces.
How is the idea unique? (750 Characters)
Firstly, this approach of using mother-to-mother and father-to-father support groups has not been piloted in Somalia. Besides, the Somali women have great role in raising children and influence decisions on health seeking for children. Since immunization services are provided free, there is high prospect of success for this project. The project shall involve men to support their families in accessing maternal and child health services as they control resources. The use of folk media, and testimonials are culturally accepted, act as edutainment and increase demand.
This project will leverage on the existence primary health care facilities run by the Ministry of Health which can effectively respond to the demand created by this project.
Idea Proposal Stage (Select 1)
Prototype: We have done some small tests or experiments with prospective users to continue developing the idea.
How many months are required for the project idea? (140 characters)
24 Months. including prototyping, piloting, and implementation of the idea.
Organization Name (less than 140 characters)
Somali Family Health service organization
Type of Submitter
We are a registered NGO or Non-Profit Organization
Women’s health/rights focused
Organization Location (less than 140 Characters)
the Organization is registered at government of Puntland Somalia, and based on Garowe the capital city of Puntland.
What is the current scale of your organization’s work?
National (expansive reach within one country)
Tell us more about your organization/company (1-2 sentences)
Somali family health service organization aims to tackle community health problem. It is oriented towards this condition somewhere women and children get equal main concern as the Health and Education improvement than further group of the general public and make a nation that is model meant receive it easy through with access to quality reproductive and child health services which are affordable, sustainable and provided through an efficient and effective support system.
Who will work alongside your organization in the project idea? (750 characters)
We shall partner with ministry of health Puntland, who are providing immunization service at health facilities. We shall also work with different community groups such as religious leaders, community elders, women and men groups to create demand for health services.
The engagement of above stakeholders will ensure ownership and sustainability of the project. More importantly, the religious leaders are most trusted stakeholders in the community and proved to be resourceful in our previous engagement.
How many people are on your team?
Tell us more about you and your team
we are a team of four members include Mr. Jamal Mohamed Warsame who has a master of Sexual reproductive health and rights from Dalarna University Sweden, have solid experience in maternal and child health programs. Dr. Mohamed Hussein who holds Bsc. in Community Health and Development and is pursuing a Master of Public Health from Kenyatta University. He is an expert in Health service management, worked with different international NGOs and UN agencies. Abdikani Hersi Shire, Master of Public health from Mount-Kenya University, Kenya, an expert of reproductive, worked with Save the children as Reproductive health manager. Saytun Abshir, has a BSc of BBA from East Africa University, Somali, she has experience in community mobilization. Our organization will play a vital role in prototyping, piloting of this idea. We are a partner with Ministry of health and jointly carry out health activities in regular base
Jamal Mohamed is a health professional, Held master of Sexual reproductive health and rights in Dalarna University Sweden, he has over six years of experience working maternal and child health programs, and he is founder of Somali Family Health Service organization. He will plan to improve access of quality reproductive health for Somali women, mobilization campaigns in rural and urban regions to end bad cultural practice, advocate ending early marriage and empowerment of women for better health
Overview of How Your Concept Has Evolved (5-6 sentences):
The mother-to-mother and father-to-father support group tool was largely appreciated by both the participants, religious leaders, and the health care workers and is believed to achieve the intended result. Besides, the project will engage religious leaders to pass information through radio talk shows, Friday sermons, and TV channels. The project also use pictorial and folk media. The health authority suggests that immunization champions trace children who miss immunization appointment. More insight is found in working with community organization and health care workers.
The expert webinar helped us to understand and internalize the process of behavior change and this helped us in the design of prototype questions
Viability (3-4 sentences and activity upload):
First, we share project information with the Ministry of health and jointly agree on a clear implementation plan including conduct training for 40 immunization Champion as well as immunization workshop for 20 religious and community leaders, air 30 immunization messages on monthly basis using local media, conduct six radio talk show on a quarterly basis. Conduct 40 mother-to-mother and father-to-father group sessions, develop and disseminate information education and communication (IEC) materials on immunization and conduct project Monitoring and Evaluation.
Finally, conduct daily tracing of those children who miss their appointment and refer eligible children from the community to healthfacili
Feasibility (3-4 sentences):
The group sessions approach was an effective strategy to create demand and empower caregivers. Somali people are oral society and this approach (meetings, open discussions, Q & N) could increase the level of knowledge of caregivers and is the preferred mechanism for information sharing. The testimonials from the most trusted people (religious leaders, community elders,) are the most powerful tools to nudge people to change their behavior. The initiative of tracing the children who miss vaccine appointment by champions and referral of eligible children can increase vaccine coverage
Desirability (3-4 sentences and activity upload):
Mothers and fathers were worried about the quality of vaccine and they have a misconception about it, they believe that vaccine contains toxic substances and could cause infertility and has other future negative consequence on the child’s health). Also, the caregivers believe they are Muslims and they believe in fate and only the things our God decreed for us will happen to our children. Fathers and grandmothers are decision-makers in the family and without their prior acceptance mothers can’t vaccinate the child. thus engaging men, religious leaders, and community elders are crucial for our programs to be effective and change community attitudes and behavior.
Community Focus (2-3 sentences):
The under-five mortality rate in Somalia is 137 per 1,000 live births; 30% of which is attributed to vaccine-preventable illnesses with very low vaccine coverage. This attributed to the low literacy of the community and misconception on vaccines. Our idea targets to empower key community gate-keepers (religious/community elders) to influence the perception of caregivers on immunization thereby increasing uptake of immunization and reduce child mortality. The project will largely use local resources and leverage on the existing support systems to ensure the sustainability of the project impact.
Community Impact (2-3 sentences):
As a result of implementing the idea it will improve health seeking behaviour toward demand and uptake of immunization with the scale of increasing 20% of caregivers who knows the importance and adhere to the schedules of routine immunization, Increase the number of fully immunized children by10% from the baseline in Karkaar region within 2years by understanding/prioritizing key influencers and desired change (norms, attitudes/ behaviors, practices). The idea will be carried out through partnership with Ministry of Health, Community influencers, NGO for impact, sustainability, and ownership.