17 September 2020 – From 30 August to 3 September, Somalia conducted an integrated measles and polio campaign in the Banadir region – the first immunization campaign held since the COVID-19 pandemic had reached Somalia. Over the last 6 months, health workers have been fully engaged in fighting the pandemic. This campaign, conducted observing all necessary safety measures amid COVID-19, was a chance to get back on track in protecting children who have missed out on vital immunizations.
The campaign was conducted by Somalia’s Federal Ministry of Health, with technical support from WHO and UNICEF, and financial support from the Global Polio Eradication Initiative and GAVI, the Vaccine Alliance. This particular campaign had initially been scheduled to take place in 2019 as part of a nationwide effort, but was postponed due to technical challenges.
Ahead of the campaign, vaccines were procured and stored in optimum cool conditions. Microplans and maps were updated to help vaccinators reach all children at health facilities and fixed outreach sites. Building population immunity to polio and measles is extremely important in Somalia: Since the start of the year, 744 children in Banadir have contracted measles, accounting for half of the cases nationwide. Two forms of polioviruses, in circulation in Somalia since the end of 2017, have caused paralysis in 19 children across the country.
As part of the planning, 602 teams of carefully selected health workers were given protective face masks and gloves, and were trained rigorously to ensure they kept themselves and their families safe from COVID-19. Every morning, they were checked to see if anyone had symptoms indicating possible infection. Precautionary measures taken during the work day included washing hands regularly, wearing face masks and ensuring physical distancing. Teams were also encouraged to collect supplies for the vaccination campaigns at intervals, to prevent crowding.
On the first day of the campaign, health teams set up fixed outreach vaccination sites and health facilities in different locations in Banadir. The aim was to reach as many children as possible: those living in urban and rural locations, with nomadic lifestyles, as well as those living in camps for internally displaced persons.
All children under 5 who visited facilities during the campaign received deworming tablets and vitamin A, in addition to measles and polio vaccines. The inclusion of other health interventions in polio campaigns is a safe and effective way to help parents give their children the best possible protection against childhood diseases. This is particularly crucial in the Somali context, where children have limited access to health facilities, and population immunity is chronically low.
Two hundred and twenty-four (224) district field assistants supervised more than 3000 vaccinators to ensure health workers were administering vaccinations correctly and observing safety measures for COVID-19. The campaign was also monitored by staff from the Ministry of Health, UNICEF and WHO.
Women and men played an important role in the campaign. Social mobilizers shared messages on the benefits of vaccinations and COVID-19 prevention measures. Additionally, community volunteers helped to control crowds of caregivers who visited health facilities and vaccination sites by ensuring that physical distancing was observed between caregivers from different households.
At the end of the day, all waste products from the campaign, including syringes, sharps and empty vials, were disposed of safely. By delivering multiple health interventions at once, cost savings can be achieved, and environmental impact is reduced when compared to delivering interventions separately.
Vaccination teams provided caregivers with vaccination cards for children, so that monitors could keep track of children who did not receive measles and polio vaccines.
Around 408 000 children aged between 6 months and 5 years (92% of those targeted by the campaign) received vaccinations against measles and 459 000 children aged under 5 (93% of the target) were vaccinated against polio. Ninety-two percent of children also received vitamin A and deworming tablets. This campaign proved that delivering health interventions amid COVID-19 in Somalia is achievable – and paved the way for subsequent campaigns to fill any immunity gaps.