Impacts of accelerated measles elimination activities on immunisation services and the health system in Ethiopia


Abstract Background: Ethiopia introduced accelerated measles elimination activities (AMEAs) as part of the global effort to eliminate the disease. However, the impact on immunisation and other health services has not been previously examined. Objectives: The overall aim of the study was to evaluate the impact of AMEAs on routine immunisation services and on the health system at large. Methods: A mixed-methods approach was used, combining key informant interviews, a staff profiling survey and relevant document reviews. Data were collected at the national level and in two districts: Kolefe-Keranyo sub-city in Addis Ababa city administration and Wegera district in North Gondar. Results: Supplementary immunization activities (SIAs) tended to increase community demand for vaccines through social mobilization. Add-ons such as distribution of vitamin A, de-worming drugs and insecticide-treated nets improved the efficiency of SIAs. Improving staff capacity through planning and strengthening of the health management information system and cold chain management were felt to be added advantages of SIAs. On the other hand, SIAs caused interruptions to the delivery of the Expanded Program for Immunizations (EPI) and other services (except emergency services). Conclusion: SIAs impacted the routine EPI and other health services both positively and negatively. While maintaining the positive impacts, strategies to minimize negative impacts, including disruption of routine immunization and other health services, need serious attention. [Ethiop. J. Health Dev. 2015; Special Issue 1:23-30]