AFRO-NETS> Mass Immunisation Campaigns (3)

[Aad van Geldermalsen <AadvG@healthnet.zw>]

Mass Immunisation Campaigns (3)
-------------------------------

Dear NID critics,

Alyssa Wigton and Bart Vander Plaetse wrote:


 > This is exactly what we experienced at district level. All
 > attention is withdrawn from the PHC approach into one
 > 'vertical' moment, letting the community and some of the staff
 > believe that this is the way forward.

 >> Let us not be coerced into inappropriate strategies by interna-
 >> tional organisations, but implement what is best for South Africa
 >> at this time.

 > I suggest the same for Zimbabwe. Has anyone done some
 > cost/benefit analysis on the NID's? I hoped they were to be an
 > exception - a forgivable mistake - but it seems NID's are back
 > with us, with little if no explanation to the reason why to
 > do them.

I could not agree with the above expressed sentiments more. The NIDs 
(National Immunisation Days) are an example of the mistaken believe 
that what works in one place (country, specific situation) should 
work in another.

It finds its origin among others in the measurability of its pro-
gramme indicators:

what can be more clearly measured as a circumscript input (through-
put, unequivocal outcome) is more 'donor-acceptable'. In countries 
with an established PHC system including vaccination at the first 
point of contact (Health Centre), NIDs become inappropriate.

Furthermore NIDs undermine the peoples' confidence in the care given 
at the first line. "If we come according to the vaccination schedule 
as indicated on the growth chart, why do we suddenly need extra 
vacccinations?"

"Something must be wrong with the MCH-services at the health centre!"

We have had some outbursts from medical staff regarding the 
(un)usefulness and disruptive nature of NIDs in their area.

An in depth analysis on NIDs in Senegal has been done by JP Unger, 
Soc. Science & Medicine.  1989(?)


Aad van Geldermalsen


--
Aad van Geldermalsen
MOH Epidemiology, 
PMD, Mash.Central
P.O. Box 98
Bindura, Zimbabwe
Tel: +263-71-6/369 /479 /659 /204 (direct)
Fax: +263-71-6956
Home: 449, Cardiff Rd, Bindura
Tel: +263-71-6650
mailto:AadvG@healthnet.zw

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