How Can Measles Eradication Strengthen Health Care Systems?

Abstract

Elimination and eradication initiatives are generally delivered through a vertical approach, which can potentially hamper health systems. We propose 3 approaches by which a measles eradication initiative can ensure that health systems are left strengthened when the eradication goal has been accomplished. First, focus should be placed on strengthening routine vaccination, which could generate positive trickle-up effects on other primary health care services. Second, increased integration with multifunctional health services should be emphasized. Third, efforts should be made to change traditional donor behavior that prioritizes vaccination campaigns and uses uncoordinated staff incentives.

Meningococcal vaccine introduction in Mali through mass campaigns and its impact on the health system

“…Recommendations to promote health systems strengthening with vertical disease control activities are not new 16 , 19 . However, as long as financing remains vertical, with each program setting its own specific objectives, it will be difficult to mitigate the adverse effects of vaccine campaigns on routine services.…”

“…Once open, a vial should be used within 6 hours.) Several studies have scrutinized vaccination campaigns, some of them pointing to a possible disruption of routine services 16 – 19 …”

Impact of supplemental immunisation activity (SIA) campaigns on health systems: findings from South Africa

“…Although questions about the possible negative effects of mass campaigns on routine services have been raised,11 to date analysis of the impact of SIAs on health systems remains scarce 12 13. Low-income and middle-income countries including SA face an acute shortage of health workers, with issues of absenteeism, high vacancy rates and inequitable distribution of the workforce between rural and urban settings 14–17.…”

Use of measles supplemental immunization activities (SIAs) as a delivery platform for other maternal and child health interventions: Opportunities and challenges

“…They viewed an expanded SIA as a potentially effective means to reinforce and extend the reach of health services, and thus as beneficial for attainment of national objectives such as the Millennium Development Goals. While conscious of the need for careful policy design [8] and consideration of health system issues [14] to ensure success of the strategy, respondents felt that the benefits exceeded the risks. These results cohere with a growing international trend to add interventions to the SIA platform [2,8,15].…”

“…Adding nutritional screening to future follow-up SIAs would enable community sensitization, systematic identification of malnourished children from 9 months to 10 years of age, and effective linkage to programmes offering nutritional supplements such as ICDS [24]. This illustrates how SIAs can be leveraged to revitalise existing services and to improve child health outcomes [14,25].…”