The Communication Initiative
Development action with informed and engaged societies
The Communication Initiative
As of March 15 2025, The Communication Initiative (The CI) platform is operating at a reduced level, with no new content being posted to the global website and registration/login functions disabled. (La Iniciativa de Comunicación, or CILA, will keep running.) While many interactive functions are no longer available, The CI platform remains open for public use, with all content accessible and searchable until the end of 2025. 

Please note that some links within our knowledge summaries may be broken due to changes in external websites. The denial of access to the USAID website has, for instance, left many links broken. We can only hope that these valuable resources will be made available again soon. In the meantime, our summaries may help you by gleaning key insights from those resources. 

A heartfelt thank you to our network for your support and the invaluable work you do.
Time to read
3 minutes
Print
a- a+
Published 3 months ago
Last updated 3 months ago
Read so far

Impact Data - Strengthening Immunization Program in Gambella Region, Ethiopia

0 comments
Image
Date

"The program was effective in terms of improving the knowledge and attitude of the community towards the importance of childhood vaccination as well as generating the demand for child immunization."

Save the Children (SC) Ethiopia implemented the Strengthening Immunization Program in Gambella Peoples Regional State for 1.5 years in 3 zones of Gambella region, reaching 11 woredas in the host community and 3 refugee camps. The programme sought to improve vaccination coverage for children under 5 years of age and adolescent girls by improving access to vaccination services, improving demand for vaccination services, and facilitating an enabling environment for the delivery of equitable and quality vaccination service.

Methodologies

The Organisation for Economic Co-operation and Development (OECD)-Development Assistance Committee (DAC) evaluation framework was used to conduct an endline evaluation. The project was evaluated against the criteria of relevance, coherence, effectiveness, efficiency, impact, and sustainability. A mixed-method study design involving both quantitative and qualitative methods was applied, where both components were performed concurrently:
 

  • Quantitative study: A cross-sectional study (household survey) was conducted among 1,568 parents/caregivers of children aged 12-23 months to measure quantitative indicators that are expressed in terms of numbers/percentages.
  • Qualitative study: A programmatic/exploratory qualitative research design was used to assess the performances, activities, and processes of the programme, including by exploring the views of key stakeholders (community, governmental, and non-governmental) in the programme areas. For example, 14 focus group discussions with parents/caregivers of children aged 12-23 months were conducted across the study areas, and 28 key informant interviews of key stakeholders engaged in immunisation-related initiatives in the programme area were held.
Knowledge Shifts
  • Overall, an 8-percentage-point improvement (host: 7.4% vs refugee: 9.9%) in the proportion of mothers/caregivers who have heard about childhood immunisation was documented, compared with the baseline survey.
  • Compared to the baseline findings, similar improvements were documented in the mothers'/caretakers' knowledge of vaccine-preventable diseases in both the host and refugee communities.
  • Compared to the baseline findings, improvements were observed in childhood immunisation knowledge and attitudes of the mothers/caregivers in both the host and refugee communities.
Practices
  • Compared to the baseline study, a considerable improvement in the coverage of all basic vaccinations was noted, where the proportion of children who have received all basic immunisations improved from 28.4% in the baseline to 58.3% in the present endline evaluation. This figure represents a nearly 30-percentage-point improvement.
  • The proportion of children in the host community who have received all basic vaccines was 61.2, as compared to 33.7 children in the refugee camps - with a statistically relevant difference in coverage between the two settings.
  • Compared to the baseline finding, the dropout rate has decreased by 18.9 percentage points for pentavalent vaccination (Penta-1) to Penta-3 and by 25.7 percentage points for Penta-1 to meningococcal vaccination (MCV-1).
  • The number of Bacille Calmette-Guerin (BCG) scars observed during the endline evaluation was found higher than the one reported in the baseline report (baseline: 66.4% vs. endline: 70.6%). Similar improvement was noted in terms of seeing the vaccination card of children (baseline: 41.4% vs. endline: 62.7%).
  • Most of the respondents who took part in the qualitative study also confirmed the substantial improvements documented regarding vaccination coverage and the reduction of dropout rate in their area.
Attitudes
  • The proportion of mothers/caregivers who reported that a child should start immunisation at birth increased from a baseline value of 37.1% to an endline value of 58.5%.
  • Mothers/caregivers who reported some children should not be vaccinated or might be hurt by vaccination have decreased from the baseline level of 34.4% to an endline level of 28.0%.
  • Regarding respondents' satisfaction with the vaccination service provided in the local HFs, 37.9% at the baseline and 69.0% in the present evaluation reported a high level of satisfaction.
Access
  • Compared to the baseline, the percentage of health facilities (HFs) providing an immunisation service increased from 76.9% to 97.6%.
  • In the HFs located in both settings, the availability of all immunisation-relevant items has increased substantially compared to the baseline, except for the availability of immunisation cards among facilities in refugee camps.
  • Based on the report of the HFs, which was confirmed by the observation of the field team, the availability of each of the essential antigens, as well as the availability of all antigens, improved from the level reported during the baseline assessment.
  • For all vaccinations included under the national Expanded Programme on Immunization, the proportion of facilities that reported vaccine stockouts and associated service interruptions decreased from the baseline, except for the oral polio vaccine.
Other Impacts
  • The strong engagement of the local stakeholders operating at the regional, zonal, woreda, and HF levels reportedly meaningfully contributed to the efficient programme implementation.
  • The qualitative enquiry indicated that improving childhood immunisation is among the top agenda of the regional health authorities.
  • SC is implementing different projects in Gambella region that aim to improve child health. The current immunisation programme was viewed to be highly coherent with other developmental and humanitarian interventions implemented by SC.
  • In terms of external coherence, the interventions were found coherent with similar interventions made by the Ministry of Health, Gambella regional, zonal, and woreda health bureau, and other development partners.
Source

Evaluation of Strengthening Immunization Program in Gambella Region, Ethiopia, Jully 2023 - accessed on January 23 2025. Image caption/credit: Mothers and children at a vaccination post in Leitchour refugee camp Gambella region, Ethiopia. ©UNICEF Ethiopia/2014/Bizuwerk via Flickr (CC BY-NC-ND 2.0)