Vaccination coverage is growing in developing countries, but some communities are being missed entirely.
Targeted outreach is an important outlet for hard-to-reach communities to access crucial vaccines, such as those protecting against measles or polio. Routine immunisation is effective for vaccinating large numbers of children who can be easily reached, but it often misses out remote communities that are difficult to travel to, or people who do not even know they need measles vaccines.
The importance of outreach monitoring
In low- and middle-income countries (LMICs), communities are often located far away from the nearest health facility. Distances could reach well over 5km or 10km for people who have little or no access to transport. In some countries we work in, over 80% of citizens live at least 5km from the closest health facility. Due to these lengthy distances, outreach monitoring is one of the only ways that many children can still receive essential measles vaccinations.
However, the number of outreach sessions available is often too low. For example, we have seen regions where four outreach sessions are held per month, when 16 is the number needed to provide enough vaccinations for all available children. 25-30% of children are being missed in some regions, showing that there must be a focus on hosting more outreach sessions.
Pursue targeted outreach
While they are important, routine immunisation efforts often miss hard-to-reach communities. This may include riverine communities that can only be accessed by boat, slums, or remote communities far away from towns or cities. In these areas, it is common for children to have never received a measles vaccination, or a vaccine of any kind.
Targeted, region-specific analysis is crucial to ensure that outreach sessions are conducted in all of the right places. Communicating with teachers and local community leaders is an effective way of discovering where the children in need of vaccinations are located in these communities.
Outreach monitoring is potentially the only option for millions of children to receive life-saving measles vaccinations. With large numbers of children being missed through routine immunisation efforts due to being located in hard-to-reach communities, targeted outreach should be pursued. By communicating with local leaders, many of these children can still be vaccinated.
