WHO/Harare

Launched in 2001, Reaching Every District (RED) is a World Health Organization (WHO) strategy of decentralised capacity building to address common obstacles to increasing immunisation coverage, with a focus on planning and monitoring. Presented by Eric Wiesen of WHO/Harare at an RED workshop held in Durban, South Africa (May 10-12 2006), this 31-slide PowerPoint presentation presents a set of strategies for using micro-planning as a means of determining resources and strategies needed to achieve a given vaccination coverage rate, and to develop a plan of vaccination activities - thereby fulfilling the 5 RED operational components:

1. Re-establishing outreach services
2. Supportive supervision
3. Linking services with communities
4. Monitoring and use of data for action
5. Planning and management of resources

Wiesen's focus in this presentation is on micro-planning as a methodology for achieving 100% coverage at the health facilities level in what he describes as a "defined health center zone". In such an area, the catchment area is defined, the population of each village/community in the health zone is known, the distances between villages/communities and the health centre are known, the current vaccination situation has been analysed, and the standards for deciding when to use outreach and mobile strategy are defined.

In this context, the micro-planning approach is initiated in a workshop setting; however, most of the work is done individually by the health centre staff with support and supervision of the facilitators and district medical team. The process involves the following steps, which Wiesen illustrates/elaborates through graphics within this presentation:

1. Analyse coverage by area
2. Create a detailed map of the area - this involves marking what kind of session will be used to reach each village or town using the letters F (fixed - consider the distance mothers are prepared to travel), O (outreach - determine the area that the staff can visit in one day), M (mobile - assess how to reach areas that are not accessible within one day) - with arrows for O and M to show how they will be reached.
3. Develop a plan of immunisation sessions in the area
4. Identify problems and solutions - a list of problems by system components is provided in Slide 19 of this presentation; questions to ask along the advocacy/communication vein include: Is the community aware of the immunisation sessions?
   Is the community involved in providing immunisation services?
5. Develop a workplan
6. Identify resource needs (e.g., human resources, transportation, vaccines/supplies, and so on)
7. Implement the plan - use a monitoring chart, defaulter tracking, and stock management to track progress.

In Wiesen's estimation, the core challenges in this process are supervision, follow-up, and use of data.

To request a copy of the full presentation, please see contact details, below.