Abstract

Abstract We have been working on a community-based project aiming to improve access to quality Immunization by strengthening the capacity of health structures and communities with identified immunization gaps in the Galgaduud and Jubaland states in Somalia. The project is delivered in partnership with Ministry of Health, UNICEF (strategic partner), Acasus (for data management using digital platform), and two local implementing organization WASDA and WRRS as local implementing agencies. Owing to the varying levels of insecurity in the regions targeted, to deliver to ensure optimal immunization services to communities without delay, we operationalized a rapid and intensive scale-up of immunization services in 27 health facilities and sites following a phased approach. The project also supported the set-up and strengthening of community-driven immunization systems as well as district-level immunization management systems to promote ownership of the immunization programs within the target locations. To achieve this the project is anchored on four pillars namely capacity strengthening (at community, facility, and district/regional level), immunization logistics and supply chain strengthening, use of data for decision making and scaling-up innovative approaches. The project efforts achieved most of its targets throughout the implementation period, more so in the second and third year. Between April 2021 and February 2022, supportive supervision was increased from 54% to 100% of facilities and the average number of monthly fixed and outreach immunization sessions increased by 54% and 31%, respectively. We found the number of Penta3 doses delivered was more than double while we compared data for 2021 and 2022. These encouraging results suggest critical importance of local community engagement in planning and monitoring plus having local community-based organizations for implementing the project in similar remote rural areas with high security risks in Somalia. Key messages • Without having intensive community engagement efforts, immunization project implementation in high security risk areas in Somalia is almost impossible. • Local community-based organizations as implementing partner is the other critical mass for success in achieving immunization target in similar high security risk areas like Somalia.

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