Context:

In 2003 the Ministry of Social Protection led the "Puye" campaign with the purpose of improving vaccination coverage in the municipalities of Colombia.



Methodology:

Analysis of the results of the coverage of 21 departments, comparing the year of execution of the campaign (2003) with the previous one (2002), considering that the only difference between both years was the presence of the communication strategy.

The analysis was done in a total of 931 municipalities, utilising information available through the Expanded Programme on Immunisation (EPI) and focusing on the municipalities in which there was information that was comparable over several years. The department of Valle Cauca, for example, could not be analysed because it did not have data for 2002, although posters of the campaign were distributed in this department.

Results of the evaluation:

Total of municipalities where the communication strategy was applied: 405

Total of municipalities where the communication strategy was not applied: 526

In 19 of the 21 departments of Colombia the percentage of improvement was greater in the municipalities where the strategy was applied than in those within which it was not applied. Whereas an average of 77% of the municipalities where the strategy was applied improved throughout the five months of application of the strategy, an average of only 48% of the municipalities with no intervention improved. In addition, the tendency remains stable from August to December.

*See Chart 1.



Conclusions:

The vaccination days of 2003 mark an increase in the coverage and the amount of municipalities that improve their coverage. This explains the peaks in some months like in September after the vaccination day of August 30, and in November after the vaccination day on the 22nd of that month.

Also, it is recurrent that the number of municipalities where the strategy was not applied and showed improvement, the coverage level declines significantly after the vaccination days. This can be noticed especially in the month of October and some cases in August and December, when there was no extraordinary action. These results can clearly be seen in 14 of the 21 analysed departments.

The municipalities where the strategy was applied are also affected by the presence or absence of the vaccination days. But the coverage does not descend so radically in the months without this event. This indicates a presence of the regular programme in many municipalities that maintain the coverage with no need of special vaccination days.

*See Charts 2 and 3.

There are even cases in which the vaccination days no longer make a difference: in 7 departments (Araucan, Calda, Caquetá, Cordoba, Cundinamarca, Magdalena and Norte of Santander) the number of municipalities where the strategy was applied that improved their coverage is the same throughout the five months, whereas the municipalities where the strategy was not applied, of those same departments, show evident peaks and depressions.

*See Charts 4 and 5.

The behaviour of the department of Boyacá, which demonstrates a gradual improvement in the municipalities where the strategy was applied, without the help of the vaccination days, would be the ideal situation.

*See Chart 6.

The case of Risaralda is an example of the consequences of communication activities, mainly of posters displayed. While the municipalities where the strategy was applied have an improvement reaction from September, when already the posters were displayed, the ones where the strategy was not applied only react in November, probably as an effect of the vaccination day of the 22nd of that month.

*See Chart 7.

In the case of Huila, the huge decrease that appears between September and October is much more evident in the municipalities where the strategy was not applied than in those where it was applied.

*See Chart 8.

Cases that stand out:

In 9 of the 21 departments, more than 80% of the municipalities where the strategy was applied improved their coverage.



The cases with best results are:

• In the department of Magdalena 100% of the municipalities where the strategy was applied improved their coverage, whereas in the municipalities where it was not applied an average of only 50% improved.
• In Casanare, an average of 95% of the municipalities where the strategy was applied improved.
• In Nariño, during 4 of the 5 months of the strategy application, 90% of the municipalities where the strategy was applied improved.
• In Norte de Santander, during all five months 92% of the municipalities where the strategy was applied improved.