Public Health
Nomadic communities and immunisation
By Emma Hannay
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Getting a step ahead of nomadic communities; five tips to increase immunisation coverage

Many reforms prioritise immunisation due to its cost effective ability to save lives. However, global vaccination coverage has stalled at 86% with no notable change in the past year. One of the hardest types of community to serve are nomadic peoples. We researched a range of expert and academic literature and identified five best-practices to address the unique challenges of serving these groups:

1.   Combine services 

Working with other high-demand services to provide a range of amenities in a single facility can reduce costs and improve engagement. For instance, in Chad health teams conducted joint visits with the government veterinary team who were better trusted by the communities. Leveraging the veterinary team’s reputation dramatically improved community engagement for health services.


2.   Provide services at points of convergence

Identifying points where populations converge and directly providing services at those points can address the challenge of reaching small, scattered populations. Typical convergence locations are transit points, markets or gathering places. For example, a successful polio eradication project in India identified and targeted economic nomads who were travelling between temporary employment at brick kiln sites.   

3.   Engage local community leaders

Working with leaders who understand the unique characteristics of the nomadic communities can shed light on intricacies relevant to particular communities.

For example, a polio eradication project in Northern Nigeria recruited local leaders who identified and liaised with unvisited nomadic groups and worked out ways to safely access the communities.

4.   Engage NGOs and the private sector

Using already established networks amongst NGOs and private sector organisations can save time and reduce costs. For instance, in Afghanistan, rather than develop new public health infrastructure, the government deployed a public-private partnership model in areas not serviced by public health services in which local providers were given the resources to conduct immunisation campaigns. The government leveraged the skills and resources of the private providers to increase the coverage.


5.   Utilise technology

Mapping visits to nomadic communities improves our understanding of their locations which assists in future planning. For instance, in Nigeria, teams worked with community leaders to identify unmapped communities and then geotagged their locations. This information was then used for future campaigns.

Reaching the remaining 14% will require innovative approaches to reach those who currently miss out. Understanding and replicating best-practices from around the world can improve future projects and save lives.

About the Author

Emma Hannay is Director of Health at Acasus and has extensive experience working on public health projects in developing countries.

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