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Immunization at the International Rescue Committee

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WHO WE ARE

The mission of the International Rescue Committee (IRC) is to help people whose lives and livelihoods are shattered by conflict and disaster to survive, recover and gain control of their future. Our vision is that the IRC will lead the humanitarian field by implementing high-impact, cost-effective programs for people affected by crisis, and shape global policy and practice by sharing our learning and experience with others. All IRC programs are designed to achieve meaningful change in people’s healthsafetyeducationeconomic wellbeing and ability to influence the decisions that affect their lives.

With more than 40 years working in crisis and conflict-affected settings, the IRC has extensive experience delivering immunization services across the most challenging contexts.  This includes delivering routine childhood immunizations and executing mass vaccination efforts to tackle infectious diseases with the highest morbidity, mortality and epidemic potential including measles, polio, meningitis and cholera.  With health programs in 31 countries and expertise working in the most challenging, hard-to-reach areas, the IRC is well-positioned to help reach the last mile and reduce cases of zero-dose children.

WHY OUR WORK MATTERS

Vaccines are arguably the single most-effective public health tool ever developed – helping to  tackle a wide range of childhood illnesses including polio, measles, mumps, rubella, diphtheria, pertussis, tetanus, and newer vaccines like those for the Human Papilloma Virus, and rotavirus.

Thanks to advances over the past decade, more children than ever before can access immunizations with approximately 85% of children worldwide receiving their basic vaccines. As a result, the lives of approximately 2 to 3 million children are saved every year, with 13 million deaths averted since 2000, and countless more are protected from debilitating illness.

Despite the progress, millions of children still miss out on the life-saving benefits of immunization every year with more than 13 million children – known as zero-dose children – missing out on immunization services all together. Notably, forty four percent of all zero-dose children live in fragile or conflict-affected contexts leaving them increasingly vulnerable to disease and death.

Key barriers standing in the way of reaching the last 15% of unvaccinated children include:

  1. Weak health systems: In many low- income, public health systems are heavily underfunded and under-resources leading to inadequate infrastructure, lack of supplies and equipment including vaccine stock, shortages of qualified staff, and issues with the quality of care provided. Fragile and conflict-affected countries are often plagued by these challenges after years of instability.
     
  2. Cold chain capacity and storage: It is estimated that more than one-third of vaccine doses are wasted in developing countries due to inadequate temperature, expiring in warehouses, or misuse. The biggest challenges occur in remote areas where electricity is unavailable or unreliable, cold chain infrastructure is inadequate, and there are difficulties transporting vaccine doses to the target population living far from health centers.
     
  3. Mistrust & misinformation: Too often, the poor quality of services—compromised by long-waiting times, vaccine stock-outs and a scarcity of trained health workers— impacts trust in these services and leads to low use. Many caregivers also lack the information necessary to ensure their child receives the doses necessary to complete their immunizations. This is exacerbated by myths and misperceptions around the safety of vaccines.

WHAT WE DO

IRC practitioners provide technical assistance to more than 30 country programs. Technical advisors are charged with staying abreast of the best available research and practices in their respective fields and sharing these with the IRC’s frontline teams. They also lead advocacy strategies to encourage partners and policy makers to adopt the interventions proven to be effective based on our research and experience.

Our key strategies for impact in immunization services include:

  • Strengthening health systems: The IRC works with Ministries of Health (MoH) and other stakeholders to build the capacity of the health workforce and support health facilities. We support supply chains by helping to transport vaccines from central locations to districts and in some contexts we replace, repair, and upgrade cold chain equipment. During acute emergencies, we also work with the MoH to improve epidemiological surveillance.
     
  • Supporting frontline health workers: The IRC has years of experience strengthening the capacity of frontline health workers to deliver vaccines. In Burkina Faso, Ethiopia, Central Republic of Africa (CAR), Chad, Democratic Republic of Congo, Kenya, Mali, Nigeria, Somalia, South Sudan, Syria, Thailand, and Yemen, for example, we work with the MoH to support the WHO’s Expanded Programme on Immunization (EPI), which aims to ensure all children are vaccinated for diphtheria, whooping cough, tetanus, measles, poliomyelitis and tuberculosis, and Hepatitis B.
     
  • Empowering community health workers: CHWs are well placed to promote improved health practices including sharing key messages on vaccines, tracking defaulters, referring caregivers and their children to health facilities for necessary doses, and in some contexts directly distributing the vaccines. In some countries, CHWs have also played a critical role in disease surveillance and mobilization efforts to generate vaccine acceptance and demand.
     
  • Harnessing digital technologies: The IRC developed a mobile health platform, the mReach defaulter tracing data platform, that enables health workers to register eligible children and track their immunization status. It provides automatic alerts for children who have missed an immunization appointment.
     
  • Leveraging other health service delivery points: The IRC implemented an integrated program offering family planning services to postpartum women during infant immunization visits. In Ethiopia, the IRC provided color-coded calendars known as “Enat Mastawesha” (mother's reminder) adapted to help women track both child immunization schedules as well as planning around perinatal care services, skilled delivery, postpartum family planning.
     
  • Targeting cross-border populations: The IRC works to track and support immunization service delivery for children in border regions of Ethiopia, Kenya and Uganda. Across these countries, the IRC supports community mobilization, deployment of vaccination teams, supervision, and the provision of immunization-related communication materials.
     
  • Prioritizing community engagement and mobilization: Any effective vaccination efforts must include proactive community engagement.  In Ethiopia, for example, the IRC works closely with religious leaders to inform them about the benefits of the vaccines, dispel misinformation, and garner their support in mobilizing community members.
     
  • Informing policy and planning: The IRC engages key government officials to help inform national vaccine policies and strategies. In Somalia, for example, we worked to develop an urban immunization strategy that would reach displaced populations in Hargeisa, Bosaso, and Mogadishu. Grounded in qualitative research and interviews with mothers and health workers, the strategy guides UNICEF’s immunization service delivery in Somalia today. The IRC also advocates for the inclusion of refugees and other displaced populations within national vaccine strategies and plans.

Available documents & links