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Increasing Pastoralist Demand for Childhood Immunization through Technology

A pilot designed to test the use of an offline database to track and improve childhood immunization in remote pastoralist communities.

Photo of Jessica Kirk-Bowman
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Describe what you intend to do and how you'll do it in one sentence (required 250 Characters)

This project will empower caregivers in pastoralist communities in Kenya to proactively co-manage their child’s immunization schedules through design and implementation of an offline database aimed at improving completeness of routine immunizations.

Explain the idea (less than 2,000 characters)

Turkana County is home to pastoralists, with many infants consistently missing their immunization appointments due to the population’s mobile lifestyle as well as difficult limited accessibility to health services. The Nomadic Strategy, developed by UNICEF and the Ministry of Health, aims to immunize every child in the nomadic population by integrating health services with veterinary services targeting nomads’ livestock as extra incentive to seek healthcare. However, data showing low coverage of immunization among pastoralists suggests this strategy alone is not enough to ensure that children receive all scheduled vaccinations in a timely manner. The proposed project will increase immunizations among pastoralists by developing a database for all children eligible for immunization. Through a pilot in three facilities within Turkana West, a sub-county with approximately 7,874 children and 30 community health volunteers (CHVs), this offline database will be used to map and register all pregnant women and children. CHVs will complete the offline tool with the details of the pregnant women and children under five and submit the data upon arriving at a location with wifi connectivity to access the main server as well as share geographic coordinates to monitor pastoralist locations. The Expanded Program of Immunization Officer (EPI) will send notifications to community mobilizers and CHVs to inform kraal leadership and caregivers of appointments for child immunizations. CHVs will be trained on social mobilization strategies, behavior change communication, data entry and transmission using the offline system. The project team will conduct meetings with chiefs and hold one on one discussions on registering eligible clients in cross-border areas. CHVs, kraal leaders, and community mobilizers will be provided with mobile phones equipped with the offline database that they can update on a regular basis and use to send the information to a central server for tracking purposes.

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

  • Eastern Africa

Geographic Focus (less than 250 Characters)

Turkana West Sub-County, Turkana County, Kenya, East Africa

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

The end users will be pastoralist caregivers empowered to engage in immunizations for their children. Their children will be linked to a health facility for immunization and caregivers will be reminded via SMS of impending appointments regardless of their current location. The IRC has already been supporting surveillance of disease outbreaks in cross border facilities by enhancing community based surveillance activities and strengthening routine vaccination for eradication of polio. The IRC has established strong community systems and trust with CHVs and kraal leaders who which can be leveraged to carry out this project by implementing behavior change, helping to track pastoralists and disseminating messages to both caregivers and CHVs.

How is the idea unique? (750 Characters)

In collaboration with the Nomadic Strategy project, this proof of concept will be piloted in three cross-border health facilities. Community mobilizers will use an offline tool on mobile phones to track immunization requirements and locations until children complete immunization. This unique approach leverages existing mobile technology in the specific context of remote Turkana County where internet and data connectivity is limited, and thus an offline tool is needed. IRC Kenya already provides healthcare in Kakuma and Hagadera refugee camps using a behavior change communication approach across an integrated program that includes clinical services, community health, reproductive health/HIV and nutrition for refugees and the host community.

Idea Proposal Stage (Select 1)

  • Blueprint: We are exploring the idea and gathering the inspiration and information we need to test it with real users.

How many months are required for the project idea? (140 characters)

Following 3 months of offline tool development, immunizations will be tracked for 3 months for a total pilot project period of 6 months.

Organization Name (less than 140 characters)

International Rescue Committee

Type of Submitter

  • We are a registered NGO or Non-Profit Organization

Organizational Characteristics

  • Women’s health/rights focused
  • Disabled Persons organization (DPO)
  • International/global organization (implementing in multiple countries)

Organization Location (less than 140 Characters)

IRC Kenya, based in Nairobi, has headquarters in New York, New York, USA.

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

  • Global (within 2 or more global regions)

Website URL

www.rescue.org

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

The International Rescue Committee’s mission is to help the world’s most vulnerable people survive, recover, and gain control of their future. This project will assist nomadic populations, often afflicted by drought, to improve their health through completing childhood immunizations.

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

IRC will work with the Turkana County department of health’s sub county health management team who are managing the health facilities and ensuring project implementation. The IRC has worked with the county government previously on nutrition, health and livelihoods projects and will be able to leverage these strong relationships in carrying out this pilot project.

How many people are on your team?

43

Tell us more about you and your team

The team will include a health coordinator who will supervise the overall health program; a Core Group Polio Manager to oversee the project at the sub county level; and an expanded program of immunization project officer. They will work with health facility nurses and community health assistants who will supervise and monitor community mobilizers/CHVs/kraal leaders; directly engaging caregivers, tracking all the pastoralist communities and linking them to the nearest health facilities. The IRC already works in cross border facilities to strengthen community based monitoring and routine immunization focused on the eradication of polio. The IRC has strong partnerships with the Turkana County government and NGOs to jointly carry out cross border programs in neighboring countries to reach pastoralists with immunization services. The IRC will develop the software, provide training for healthcare workers and support implementing the strategy in collaboration with the county government.

Overview of How Your Concept Has Evolved (5-6 sentences):

1 We were able to develop a simple mobile app to enable community health volunteers to gather information of beneficiaries living in hard to reach villages and those who are moving from one place to another. The major feedback from the community was to make the app available in Swahili. 2 We identified partners and specific roles. We identified key activities through mapping population movement, and training community health promoters who will link beneficiaries to services and inform health care workers to take services to beneficiaries through outreaches. 4 We developed a mobile app to gather data for immunization that tracks movement of nomads and then shares data for targeted outreach immunization services and linkage to facilities

Viability (3-4 sentences and activity upload):

https://canvanizer.com/canvas/4oQkb1h1VV2DrNQz73SJspIf9nseZoBJ

Feasibility (3-4 sentences):

We will use a community health strategy to implement the project where trained community health volunteers attached in villages will support tracking the movement of nomads through an offline app technology and share the information immediately for action. The community health workers are able to gather immunization data for children and transmit the data among the nomadic community in Turkana which will inform the health facility on the population who are not able to access the services in a timely manner and target those groups for outreach activities.

Desirability (3-4 sentences and activity upload):

We will use existing structures to implement the project where kraals leaders and the community will be key pillars in implementation to ensure we are able to take service closer to beneficiaries and empower beneficiaries through face to face contact - thus building trust and relationships with beneficiaries. The county government will be taking the lead to ensure they own the process and ensure sustainability.

Community Focus (2-3 sentences):

The pastoralist community depends on livestock for their livelihood. Whenever drought or lack of pastures and water for their animals strikes, they move from one place to another searching for pasture and water for their animals. The children of the pastoralists most often do not get immunization due to lack of accessibility and linkages to the nearest health facility. With an offline mobile app we are able to track the children, know their location and either reach them through outreach efforts or link them to the nearest facility for immunization services.

Community Impact (2-3 sentences):

We will now be able to identify community movement patterns and reach pastoralists with timely immunization services to prevent disease outbreaks and strengthen the effort to eradicate of polio and other immunizable diseases in the county. We will involve the county government of Turkana during enrollment of the program and advocate for them to own the process to guarantee the sustainability and empower community health volunteers and kraal leaders to use the mobile app in tracking the children who are eligible for immunization.

6 comments

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Photo of Marichu Carstensen
Team

Hi Jessica, I am glad to know that there is a possibility to gather data off line easily. Will there be some sort of tagging? How will it avoid double entry since they are nomads or pastoralists. I hope to see the user experience map to get a better idea of it.
It is good that someone is focusing on unnoticed groups like them. The resurgence of diseases such as polio is always being feared as they can still be present in poorly vaccinated groups corners of the developing nations.
Congratulations and good luck!

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