Successes, Challenges and Lessons Learned in Accelerating Introduction of Rotavirus Immunisation in Zambia

Abstract

Introduction: Under five mortality in Zambia is unacceptably high and diarrhoea is the third lead-ing contributor. The Programme for Awareness and Elimination of Diarrhoea (PAED) sought to support the government to accelerate the introduction of new vaccines, including the pneumo-coccal, second dose measles and rotavirus vaccines in Zambia. Here we present our approach, progress and lessons learned in two years of the programme. Stakeholder Engagement: Definite commitment and buy-in and sign off by the MOH were fundamental pre-requisites. National and international stakeholders including the Inter Agency Coordinating Committee (ICC), GAVI Alli-ance, WHO, University Teaching Hospital, Paediatrics Association of Zambia, and UNICEF were en-gaged for stakeholder buy-in and integration. Progress made: Following successful integration, PAED was officially launched in January 2012. Preparatory work done included: Introduction and acceptance of the PAED agenda in ICC, new vaccines proposal to GAVI, resource mobilisation, Ef-fective Vaccine Management implementation, national cold chain scale-up strategy, vaccine ori-entation and adapted data collection tools, health worker training, step-wise vaccine introduction to Lusaka province districts and finally national roll-out of the rotavirus vaccine immunisation. Between January 2011 and November 2013, over 270,000 vaccine doses were distributed in Lu-saka province. When 94,500 infants were fully immunised, adequate preparations had been made to facilitate national launch of rotavirus immunisations countrywide on 27th November 2013. Discussion: The PAED model was successful at resource mobilization; it has demonstrated how private sector can contribute to new vaccine introduction. Lessons learned from this model can be replicated in other countries with similar need and constraints.