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Reaching the Hard to Reach

By Jason Walton, change management lead, the BID Initiative

Jul 24, 2014

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Country EPI programs continue to face challenges reaching remote or isolated populations. Oftentimes, the specific country context is integral to identifying the appropriate solution. However, during the recent BID Learning Network (BLN) meeting in Kigali, country EPI managers had the opportunity to discuss some of their mutually-shared challenges regarding their ability to reach the hard to reach. For a given country, this group varies. For some, it’s young boys involved in cattle camps, others pastoralist communities across a broad swath of underpopulated land, whereas others identify out-of-school youth in urban settings as inaccessible. The challenges are immense for each and facility-based or outreach services continue struggling with adequately accounting for these children.

Despite the many issues compounding each of the target populations, EPI managers participating in the BLN meeting focused on the communication links to each of the specific communities as the crux of the problem. Countries shared their experiences leveraging various resources such as community health workers or collaborative activities with other ministries, i.e. the Ministry of Education. Candid appraisals, both of the successes and failures, were shared and further discussed. For instance, the data stemming from a particular school system demonstrated the inability of schools to identify which students are enrolled in their primary level facilities. This point saliently demonstrated to the group the challenges inherent in data across sectors, not just the health system.

Despite the focus on detailing their individual challenges, the group was encouraged by the attention and potential solutions being discussed within the BID Initiative to address these critical populations. Immunization registries and shared health records resonated throughout the group as a tremendous step forward. The ability to provide facilities and community leaders with data-driven lists of children needing to be immunized within a given month or outreach session was received with great optimism. Similarly, the BID Initiative’s intention to bolster the relationship between the community and the facility, as well as, strengthening the network between facilities was viewed as another step forward. The EPI managers felt that this network approach provides a more comprehensive service delivery solution. Understanding and identifying ways to strengthen the communication and awareness between these hard to reach populations and the facilities that aim to serve them was the takeaway message from the session.

Now it’s time for the partners and collaborators on the BID Initiative to develop and test these possible solutions, along with others that surface during the process; with the intention of providing these very EPI managers with tangible and tested country solutions.

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