September 2022 — Immunization represents one of public health's most valuable, impactful, and cost-effective interventions and delivers positive health, social, and economic benefits. Globally, an estimated 2-3 million child deaths and 600,000 adult deaths are prevented by vaccination on an annual basis. However, immunization coverage in Ethiopia remains low (overall coverage is 43%, mini DHS 2019).

In response to the low coverage, recently UNICEF Ethiopia has been supporting the MOH of Ethiopia and Regional Health Bureaus (RHBs) to apply the Human-centered design (HCD) initiative to inform a tailored program to reduce hesitancy and dropout rates in immunization and other MNCH services. The HCD initiative aimed to understand the factors influencing immunization, identify problems and issues that stand in the way of immunization demand growth and equitable coverage and bring diverse perspectives together to facilitate ways to promote and create demand for immunization in the most vulnerable areas.

To implement and scale up the initiative, a capacity-building training for public health practitioners was delivered from 11-29 May 2022 by moving to 8 Zones in Oromia Region. Objectives of the training were to introduce HCD methodology and tools for tailored immunization/MNCH services demand generation and to acquaint the application of HCD for identifying barriers and enablers of immunization/MNCH services, generating ideas and designing tailored immunization demand generation strategies/solutions and subsequent implementation.

Throughout the training rounds, a total of 348 participants were trained. In each zone, the training was delivered for two consecutive days in an interactive way using different learning methods, including interactive discussion, different small group activities, question and answering, etc. At the end of the training, feedback was obtained from some of the participants regarding their perception of the HCD training. Accordingly, most participants are excited by the training nature and its ultimate purpose. The participants also indicated that they are keen to take part in the implementation of the training.

“The training was new for all of us, however, I found that it is very crucial training to address our recurring demand-side problems of immunization and other health services if we implemented it as planned” (HCD training participant from Jimma Zone)

Next to this zonal level capacity-building training, the HCD initiative team planned to start implementation on a small scale in the training delivered zones of the Oromia region to promote demand for and uptake of routine immunization. For the time the idea/strategy selected for implementation is undertaking “community dialogues” among mothers/caregivers in selected kebeles (the smallest administrative structure) of the intervention zones of the region.

Watch the video documenting an overview of the HCD initiative in Ethiopia with a focus on the training of health workers.