Health workers share measles outbreak experiences at Teach to Reach 9

02/11/25 • 29 min

# Health workers share measles outbreak experiences in global learning exchange During the October 13, 2023 session of Teach to Reach 9, immunization professionals from India, Nigeria, Pakistan, and Uganda exchanged specific experiences responding to measles outbreaks. The session focused not on technical guidelines, which participants already implement through their national programs, but on the practical challenges and solutions they have developed in their local contexts. ## Field experiences and local innovations Dr. Isha Goyal, WHO surveillance officer in India, described analyzing outbreak data that revealed 90% of cases concentrated in a single community. Despite engaging religious and community leaders, vaccination coverage remained at 60-70% post-outbreak. She noted that the same community consistently refused vaccines across different immunization programs, raising questions about current engagement approaches. In Nigeria, Mudassir Abdullahi from Skano State Hospital outlined how response teams mapped affected settlements and conducted household assessments that revealed missed vaccinations. The team combined awareness activities with vaccination services, leading to reduced cases in previously affected areas. Dr. Bala Ganesh Kumar, WHO medical officer in South India, shared a systematic response protocol initiated by a hospital case notification: - Sample collection for laboratory confirmation - Formation of epidemic response teams at district and block levels - House-to-house surveys in affected areas and schools - Line listing of fever/rash cases from previous 90 days - Catch-up vaccination for children with immunity gaps Dr. Kamran Khan described Pakistan's 2021 nationwide campaign strategies that achieved 95% coverage: - Public vaccination of policymakers' children - School-based outreach covering 70% of target population - Direct engagement with hesitant parents through schools - Coordinated media management for adverse events ## Implementation challenges identified Participants shared several common challenges: 1. Data and tracking: - Mobile population movement during investigations - Incomplete vaccination records for second doses - Limited data sharing between facilities 2. Vaccine delivery: - Supply chain disruptions - Reluctance to open multi-dose vials - Geographic access barriers 3. Community engagement: - Persistent vaccine hesitancy in specific groups - Limited success with traditional approaches - Need for new strategies for consistently refusing communities ## Analysis and recommendations Lora Shimp synthesized three key approaches from the shared experiences: 1. Data utilization: "Using data to really help us identify where we have missed infants or younger children who may have received one dose of measles, but not two doses." 2. Health system operations: "Working with the health system to address these problems, to better communicate how to get, not to turn people away, what are the best ways to organize these services." 3. Campaign duration: "That campaign shouldn't just stop the day we're doing vaccination... planning for four weeks so that you also follow up with those communities that have been missed." ## Next steps The session highlighted several areas requiring further examination: - Analysis of patterns in vaccine refusal across programs - Development of new approaches for consistently refusing communities - Improved systems for vaccination record keeping - Strengthened preparedness planning Participants continued discussions through networking sessions to explore specific challenges in more detail. Note: Names have been transcribed from the session recording. Their spelling therefore may be inaccurate.

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Field workers share innovative approaches to HPV vaccination acceptance (Teach to Reach 9)

# Field workers share innovative approaches to HPV vaccination acceptance at Teach to Reach 9 Healthcare workers and community leaders from multiple countries shared their frontline experiences with HPV vaccination programs during a special session at Teach to Reach 9, highlighting successful strategies for building vaccine confidence and overcoming hesitancy. The session, which followed up on discussions from Teach to Reach 8, focused on the critical question "How have you made HPV vaccination work for girls and women?" Against the backdrop of concerning statistics - 600,000 new cervical cancer cases and 340,000 deaths annually, with vaccination coverage declining since the COVID-19 pandemic - participants shared concrete examples of local solutions. ## Nigeria launches nationwide campaign Boma Otobo, an adolescent health and HPV vaccine introduction consultant to Lagos state, described Nigeria's preparations for a major HPV vaccination campaign launching October 24, 2023. The initiative targets girls aged 9-14 years through both school-based and community outreach approaches. "We have done the micro plan in Nigeria. We have been able to get our HR requirements sorted. Logistics have moved," Otobo explained. The program conducted rapid community assessments and extensive engagement with schools, religious groups, and traditional leaders to address concerns and build support. ## Community-level innovation Several speakers highlighted the critical importance of direct community engagement: Zuhura Gaki Ahmed, a community health worker from Meru, Kenya, described her successful approach to addressing vaccine hesitancy: "I talked to both the mother and the girls...I gave them an example of a certain lady who had this problem. When she was asked whether she had ever been vaccinated, she said she had never been vaccinated." In Uganda, Rebecca Akelo, a public health nurse, leveraged concerning data on teenage pregnancies to build support for HPV vaccination. She engaged education officials and school leaders, using parent-teacher meetings to explain the science behind the vaccine. "I had to draw for them the uterus and locate where the cervix is and how the vaccine will prevent cervical cancer. They really appreciated the science behind that," Akelo shared. ## Integration and partnership approaches Michael Jones from Sierra Leone described an innovative approach of integrating HPV vaccination with COVID-19 vaccination, which helped overcome resource constraints while achieving higher than expected coverage. The program vaccinated girls at age 10 for HPV and both boys and girls at age 12 for COVID-19. In India, Dr. O.P. Kansal highlighted a new initiative to address hesitancy among medical professionals themselves. The American Cancer Society, working with the Indian Academy of Pediatrics and Federation of Obstetrics and Gynecologists Society of India, launched virtual training programs to build healthcare provider confidence in recommending HPV vaccination. ## Key success factors Laura Shimp, director of the Immunization Center at JSI, identified three critical elements for successful HPV vaccination programs: 1. Leveraging girl advocates and peer-to-peer learning 2. Partnering with cancer prevention groups to emphasize the vaccine's role in cancer prevention 3. Building strong partnerships with education ministries and religious groups Deepa Pokhrel from UNICEF headquarters emphasized the importance of: - Conducting rapid community assessments to understand local concerns - Engaging young people directly in program design - Addressing misinformation quickly through trusted community channels - Moving beyond mass media to focus on sustained community engagement The session demonstrated how local innovation and adaptation, combined with strong partnerships and community engagement, can help overcome hesitancy and build acceptance of HPV vaccination. These insights will be particularly valuable as more countries launch or expand their HPV vaccination programs. ## About Teach to Reach Teach to Reach is a global forum where healthcare workers, community leaders, and public health professionals share field experiences and practical solutions. The format combines plenary sessions with networking opportunities, allowing participants to learn both from formal presentations and direct peer-to-peer exchanges. This session was part of Teach to Reach 9, building on discussions from previous events while incorporating new experiences and innovations from the field.

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Europe-wide Network supporting Ukrainian Children announces first 34 Focal points (11 February 2025)

# Europe-wide Network supporting Ukrainian Children through Psychological First Aid (PFA) announces first 34 Focal points A Europe-wide initiative to support Ukrainian children through psychological first aid (PFA) marked several key developments during its February 11, 2025, Leaders and Partners meeting. The Certificate peer learning programme on Psychological First Aid (PFA) in support of children affected by the humanitarian crisis in Ukraine provides innovative opportunities to strengthen immediate mental health support to children in crisis, is rapidly scaling up into a comprehensive network spanning 27 countries. ## First wave of PFA Focal Points The initiative announced its first 34 PFA focal points - volunteer representatives who will coordinate support within their organizations and regions. While most focal points are based in Ukraine working directly in fragile contexts, the network includes practitioners from Poland, Romania, and Iceland, creating a bridge between local needs and international support. ## Building local capacity “We work with children in Kyiv region, Ivano-Frankivsk region, Chernihiv region, and Sumy region. We travel to locations and conduct psychosocial sessions with children,” explained I. from Yellow-Blue Wings, describing their direct work with affected communities. “When I went through this training that lasted several weeks, it was both learning and active participation... you felt like you leveled up a bit,” shared A. from Platform of Unity, a Ukrainian humanitarian organization working in the Kharkiv region. ## Practical peer learning approach The program combines several key elements: - Certificate-based peer learning exercises providing structured training - Bi-weekly “PFA Connect” sessions for rapid knowledge exchange - New courses based on practitioners’ real-world experiences - An Impact Accelerator to support practical implementation ## Measuring impact on children A new measurement tool is being developed by this network to evaluate effectiveness of support to children at the local level. The tool examines children’s functioning, well-being, distress levels, coping ability, social behavior, and connectedness. ## Cross-border collaboration “This is just a wonderful way of connecting with others across the world who are dealing with the same challenges and issues and concerns and learning from each other,” noted W. from a National Red Cross. ## Looking ahead The program aims to reach 4,100 professionals by June 2025. The next “PFA Connect” peer learning session on February 12 will address three critical topics: recognizing severe reactions in children, managing multiple children in crisis, and providing remote psychological support. The initiative, funded through the EU4Health program, represents a shift from traditional training approaches by emphasizing peer learning and practical implementation while maintaining professional standards through certification. These regular Leaders and Partners meetings ensure the program continues to evolve based on practitioners’ needs and experiences in supporting children affected by the ongoing crisis.