Abstract
Vaccination services for people and livestock often fail to achieve sufficient coverages in Africa's remote rural settings because of financial, logistic, and service delivery constraints. In Chad from 2000 through 2005, we demonstrated the feasibility of combining vaccination programs for nomadic pastoralists and their livestock. Sharing of transport logistics and equipment between physicians and veterinarians reduced total costs. Joint delivery of human and animal health services is adapted to and highly valued by hard-to-reach pastoralists. In intervention zones, for the first time approximately 10% of nomadic children (> 1-11 months of age) were fully immunized annually and more children and women were vaccinated per day during joint vaccination rounds than during vaccination of persons only and not their livestock (130 vs. 100, p < 0.001). By optimizing use of limited logistical and human resources, public health and veterinary services both become more effective, especially at the district level.
Highlights
Vaccination services for people and livestock often fail to achieve sufficient coverages in Africa’s remote rural settings because of financial, logistic, and service delivery constraints
One of the 4 strategies of the World Health Organization (WHO) and the United Nations International Children’s Emergency Fund to achieve their vision of equitable, sustainable, and high-coverage immunization among children and women by the year 2015 is the provision of vaccination services linked to other health interventions
For children and for women of childbearing age, immunization provided through the National Expanded Program on Immunization is considered one of the most cost-effective public health interventions and society’s best healthcare investment, especially in developing countries [5,6]
Summary
The Chadian Ministries of Health and of Livestock Production (hosting the veterinary services), together with the nomadic communities, recommended testing the feasibility of joint human and livestock vaccination campaigns. New nomadic families enter the vaccination zones because of flexible routes and schedules This dynamic is reflected in high estimated emigration rates (on average involving 70% of the total population). Based on the positive outcomes of these pilot campaigns, Chadian public health and veterinary officials are currently planning a common policy for child and livestock vaccination in pastoralist populations. Going to scale at district and national levels with combined public health and veterinary campaigns is sought in concert with other ministries such as education This may become a model for other governments who face similar difficulties in reaching remote livestock keepers because of communities reluctant to comply with public or private officials or insufficient infrastructure and resources
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