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Community M&E system for immunization program

Design of a Monitoring & Evaluation (M&E) system for Immunization program at the community level for enhancing compliance

Photo of samuel maina
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Describe what you intend to do and how you'll do it in one sentence (required 250 Characters)

Karate Community Health Volunteers (CHV) Unit aims to develop an M&E system in order to increase compliance for immunization at the community through the identification of immunization defaulters and dropouts and also by providing timely reminders.

Explain the idea (less than 2,000 characters)

Karati community, has a population of 8,228 and 1,828 households. It is in a rural setting with members engaged in subsistence farming and others working in horticultural growing farms in the surrounding area earning less than 3$ a day. The compliance rates of immunization for children below 5 years and for expectant mothers attending ANC clinic is usually 70-80%. Delay of pregnant mothers in attending ANC clinics predisposes mothers to complications during delivery. More so, ANC clinic defaulters have been identified through experience as one of the most significant factors contributing to home deliveries which is a major factor contributing to neonatal deaths. For children under 5 years, underimmunization is correlated to patterns of mother ANC attendance and significantly impacts on both children mortality and morbidity rates. This intervention proposed intends to address the gap in immunization by developing an M&E system that will enhance immunization compliance in the community for expectant mothers and for children below 5 years. The M&E system will have a database of the target population in order to monitor their uptake of immunization services and thereby through use of the system identify immunization dropouts and defaulters. Presently, there exists a record of details of persons attending immunization usually recorded in facility immunization attendance registers. However, what has been lacking is (1) a system that allows easy identification of immunization dropouts and defaulters and (2) targeted efforts of reaching them thro follow up. Our approach will rely on use of the community health workers volunteers (CHV) to follow up on any immunization defaulters in their villages (household level). By sending a list of defaulters in the villages CHV will be empowered to do follow-ups. CHV presently works at the household level, and by sharing with them data of defaulters in their areas will provide essential intervention needed to achieve high compliance.

Which part(s) of the world does this idea target?

  • Eastern Africa

Geographic Focus (less than 250 Characters)

Karati community, located in Nakuru County, Gilgil Subcounty, Malewa West Ward in Karati location is found in Kenya, East Africa region.

Who are your end users and how well do you know them? (750 characters)

My end users will be expectant mothers and their children below 5 years. I work as a Community Health Extension Worker (CHEW) in Karati community, as well as the Public Health Officer in the community. My work involves implementing broad-based health interventions programs notably; disease surveillance, WASH programs, school health, immunization programs, sanitation (CLTS) etc. I work at the community level with the help of Community Health workers volunteers totalling 17 who have been trained through various partner initiatives to deliver health care services at the household level. By working as part of a government agency we (me and CHVs) have advantage of working in the community many years and knowing every member of the villages.

How is the idea unique? (750 Characters)

The innovation is; (a) Creation of an M&E system which does not currently exists at community/facility level that is customized and captures details of the household members including phone numbers for tracing (b) The M&E system will highlight details of defaulting persons and the data shared to specific CHVs who will be mandated to make follow-ups and ensure the defaulters are reminded and understand the importance of immunizations interventions. The innovation is this aspect is that reminder messages will not be sent to defaulters directly but rather to the health worker volunteer in charge of the specific households with defaulters. We have an advantage in that we are part of a government agency presently working towards the same

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)

12 months

Organization Name (less than 140 characters)

Karati Community Health Workers Volunteer Unit

Type of Submitter

  • We are part of a Government Agency

Organizational Characteristics

  • Women’s health/rights focused
  • Locally/community-led organization

Organization Location (less than 140 Characters)

Kenya Nakuru County Naivasha town Karati villages

What is the current scale of your organization’s work?

  • Community (working within one or a few local communities within a region)

Website URL


Tell us more about your organization/company (1-2 sentences)

Karati health volunteers unit is a group working at the community level to enhance health outcomes of individual members at the household level. It is a unit comprised of 17 members working in conjunction with the Public health officer assigned for the community.

Who will work alongside your organization in the project idea? (750 characters)

Collaborative partners include the community health workers volunteers in the community which is part of the team. The Public health office, which is under my jurisdiction will also collaborate in implementing this project since the goals of the project and the mandate of the community health volunteers are the same.

How many people are on your team?


Tell us more about you and your team

The team comprises; Senior Public Health Officer - In charge of the team as well as providing the lead on project management. I have a Bachelors degree in Public Health coupled with more than 8 years working with communities mostly in rural setups 17 Team Members - These are community members selected from villages that make up Karati community and have been trained as Community Health Volunteers (CHV) on a wide range of health issues ranging from diseases surveillance, immunization, health education, family planning, safe delivery among other areas. They have experience working in this community for close to 7 years since the Unit was founded. They are conversant with every household member residing in their villages and provide an essential linkage of devolved healthcare at the household level. Therefore, they will be a critical part in implementing this project since they will be the one to be notified of immunization defaulters in their areas in order to enable them to follow up.


Join the conversation:

Photo of Marichu Carstensen

Hi Samuel Mania , I believe that you have a great advantage in following your idea through because you are at the forefront of the immunization drive in your community.
I have several questions. First, do you have regular volunteers that can be trained adequately and reliable enough to do the monitoring and evaluation? Since they are volunteers, can you be strict enough to make sure that they are have the qualifications to do such tasks? Will there be enough volunteers all through out the year?
How will you set your digital M and E system? Do you have the right infrastructure in your community to support this idea? Are there existing monitoring systems that are being used in others fields that you can ride on? Can it be an app that can be easily used or some kind of RFID (Radio Frequency IDentification) set up?
I am also thinking that even this M and E is digital in nature, caregivers still need a tangible object to hold on to. I hope you can create something interesting for them to take part in the monitoring themselves, something to remind them that they too are a part of the vaccination effort.
Good luck on your project!

Photo of Manisha Laroia

Hey samuel maina 
Thank you for sharing your idea in the challenge.It amazing to read about your experience with the community and the how you have explained a need with a human centered approach. It is interesting to note how you have considered ANC clinics and pregnancy to be an important early step in the caregivers journey through immunization.I was curious to know more specifically how the idea will work, What are its specific and how do you intend to run the M&E system. Is it paper based, digital, incentive based. A more specific description will help.Also it will be great if you could share more detailed about you interaction with mothers and health-workers as part of your research. You could use the attachment feature to add more information to your idea.

Isaac Jumba Would love to get your perspective on the idea?

Photo of samuel maina

Thank you, Manisha for your initial feedback on this proposal. I would take some time in adding more details regarding the proposal on the attachments in the next few days.
In regard to the clarifications that you needed, the M&E system that I propose is digital based where all details of community members targeted for immunization will be documented, and their details entered in registers. This actually already happens in government facilities where they usually obtain the immunization services. But there are gaps in two aspects;
(1) The facility immunization register is only able to identify immunization defaulters of previously attending members that have defaulted. If a member has never attended the facility and is defaulting, they cannot be tracked or identified
(2) The immunization register indicates the attendance rates for immunization services by each member already registered and will highlight any defaulting members. Because this process is manual and is done on a hardcopy register, the process of follow-up of defaulters becomes cumbersome and often impossible to undertake especially since contacts details are not provided which means it is not possible to directly reach out to defaulters using reminders.

Hence, an M&E system would address both of these challenges in that the system will target the community and record all persons targeted for immunization services and their details captured. Secondly, the functionalities of the system will allow immunization defaulters to be highlighted and the details of the defaulters (such as village, household names, telephone) sent to the community health volunteer in charge of the area who will then do follow up and ensure the defaulter resumes immunization services. By sending sms reminder of details of the defaulters to the community health worker instead to the defaulter themselves means we can significantly reduce non-delivery of reminders when targeted to defaulters which through experience has proved unreliable due to factors such as; illiteracy levels, poverty (inability to afford a cellphone), switched off cellphones and largely due to constant change of contact telephone numbers even for those with cellphones.

Let me know if that clarification helps


Photo of Temba Vicent

Hi samuel maina Thank you for your idea on M&E system.Kindly I am interested to know how your idea reduce the time for data entries in understaff facilities? How will you collect the feedback from facilities users in order to improve your system? Thank you

Photo of Manisha Laroia

Hey Samuel
Please have a look at this idea and see if you both could inspire each other from your experience of your respective context.
@Shishu, Sui Aur Dhaga
(The child, thread and needle)