Empowering adolescent school girls (Kiran Sitaras; Star Rays) for improving immunization coverage and timeliness in the slums of Karachi
We will increase caregivers' immunization knowledge, and connect under-vaccinated children in urban slum communities to vaccination services
Describe what you intend to do and how you'll do it in one to two sentences (required 350 Characters)
IRD aims to scale up a school-based training initiative in urban slums in Karachi that equips adolescent girls to become community advocates for immunization. In addition to increasing demand via information dissemination, participating girls identify un- and under-immunized children within their communities, and link them to vaccination services.
Explain the innovation (2,500 characters)
Populations in urban slums are often disenfranchised from basic health services as they inhabit areas which are frequently beyond or on the border of health centers and outreach activities. A robust outreach network, which can improve immunization demand among such populations via information dissemination, and connect under-immunized children with vaccination services, does not exist. Traditional methods to tackle the above situation, i.e., door-to-door interventions, are unsustainable and of limited applicability in urban slums due to dense population, informal addresses and vertical living. Moreover, these communities are often cautious due to high crime within the regions and are not welcoming of unfamiliar health workers. Our intervention is to deploy a community force of adolescent school girls (Kiran Sitaras; KS) to boost demand for immunization services in urban slum areas. Using a cascade model, master trainers will train teachers in target schools, who will in turn train their students, i.e., girls enrolled in grades 8-10, on the importance of immunization. They will equip them with knowledge to detect never-and under-immunized children in their communities, and hone their leadership and communication skills to effectively guide caregivers. The KSs will then conduct door-to-door visits in their neighborhoods to identify never- and under-immunized children and link them to vaccination services by sharing the children’s data with program team and partners, plus provide practical immunization information to caregivers. Our innovation leverages the familiarity of the youth within their communities to overcome the mistrust of unfamiliar CHWs and reach families living in unregistered homes within multi-story buildings. The beneficiaries of our intervention include under-2 children residing in urban slums of Karachi who will be immunized as a result of the intervention, as well as the 15,000 participating girls, who will learn key health information and advocacy skills. Our innovation is a proven solution as during a pilot, 45 trained KSs found 209 under-2 children in 504 households, out of whom 7% were unvaccinated and 7% were under-vaccinated. The accuracy of identifying never‐ and under‐immunized children was 94% and 76%. These children were subsequently provided age appropriate vaccinations by the outreach vaccinators, after their data was shared with program team.KS is currently being implemented in Gaddap Town, and is delivering promising results
Which part(s) of the world does this innovation target?
Our innovation targets slums in Karachi city of Sindh province. With a population of 14.9 million, Karachi is the largest city of Pakistan. Karachi encompasses approximately 1,000 slums; only 13% of these slums have a fixed EPI center, and only 58% are covered by official outreach services.
Who will work alongside your organization in the project idea? (1,000 characters)
Our implementing partners include:
● Education Department, Government of Sindh
Letter of support has also been secured from the Government of Sindh, School Education and Literacy Department for collaboration with IRD to work in Girls Secondary Schools (2017-2020) under the KS Program.
● Expanded Program for Immunization (EPI), Sindh.
The IRD team has been directly engaged with EPI at the provincial and national level in Pakistan since 2000.
How is your idea unique? (750 characters)
We are the first to introduce adolescent girls as social health leaders, and leverage girls’ schools to improve immunization via information dissemination and under-immunization screening in their communities. Traditionally, such initiatives have relied on CHWs.
Our idea also constitutes a paradigm shift in social norms in inherently patriarchal societies, and recognizes the extraordinary power of adolescent girls to transform community health outcomes. Our team is uniquely equipped to implement this program as our organization has previously utilized this approach successfully for tuberculosis screening of 10,000 patients and already has the connections in place with schools and communities to target immunization coverage.
What is the name of your organization
Explain your organization (250 characters)
IRD is a not for profit independent global health delivery and research organization working in over 15 countries. The IRD team leverages process and technology innovations to address global health delivery gaps in low resource environments.
Type of Submitter
We are a registered NGO or Non-Profit Organization
Women’s health/rights focused organization
Gender and Diversity (500 characters)
IRD is an equal employment opportunity employer and proactively recruits applicants with diversified candidature. HR policies focus on nurturing a women-friendly culture and providing universal career advancement opportunities, resulting in women comprising of 44% of the overall workforce. A strict workplace harassment policy is enforced to ensure universal protection of rights, and all programs implemented by the organization undergo review to ensure gender-awareness within their protocols.
Organization Location (less than 250 Characters)
IRD is headquartered in Singapore, and our team is based in Karachi, Pakistan. In addition to Pakistan and Singapore, IRD has country offices in the UAE, South Africa, Bangladesh, Indonesia, Phillipines, and Vietnam.
Size of organization (number of employees):
Scale of organizational work
Global (within 2 or more global regions)
Tell us more about you
Our team consists of Subhash Chandir (doctorate in Global Disease Epidemiology and Control with certificate in Vaccines Science & Policy from Johns Hopkins University), Danya Arif (Masters in Development Management from the London School of Economics), Mehr Munir (Masters in Humanities from New York University), Ayesha Rehman (Development economist), Qadeer Baig (Masters in NGO Managment from London School of Economics). Our connection with local partners are already established, and our experience of working on immunization across Sindh, as well as of working with adolescent girls, makes us the right team to implement this project. In our work, we prioritize ethical responsibility towards our subjects and beneficiaries.