Lessons learned in immunizing remote populations on the move: Mid-program review of the Universal Immunization through Improving Family Health Services (UI-FHS) project

Ethiopia has made impressive progress in reducing infant and child mortality rates since 2000, with performance improvements in immunization playing an important role. Despite gains in immunization nationwide, Ethiopia continues to experience significant regional disparities in immunization coverage, including in Afar and Somali Regions, where the health system is fragile and populations are largely pastoralist (nomadic).

Since 2011, JSI’s Universal Immunization through Improving Family Health Services (UI-FHS) project has worked to develop and refine an approach to improve the availability, utilization, equity, quality and sustainability of immunization services in Ethiopia. The Reaching Every District using Quality Improvement (RED-QI) approach has since been introduced in 103 woredas nationwide but focuses on the Developing Regional States (DRS) and on strengthening the routine immunization system in underserved regions. As Ethiopia is working towards improving equitable access to health services for all citizens, it is critical to focus on these underserved populations and to design strategies that specifically address the unique challenges of these regions. The RED-QI approach was specifically tailored for the DRS to address contextual challenges in the regions.

In 2017, UI-FHS conducted a mid-program review (MPR) in Afar and Somali Regions in order to examine the operationalization of the tailored RED-QI approach in pastoralist contexts, examine contextual factors that influence implementation, and assess factors that might hinder or facilitate sustainability. The findings from that mid-program review are described in this brief, and in a full report.