Clinton Health Access Initiative - Community Engagement Officer - Routine Immunization Access

The Clinton Health Access Initiative, Inc. (CHAI) is a global health organization committed to saving lives and reducing the burden of disease in low-and middle-income countries, while strengthening the capabilities of governments and the private sector in those countries to create and sustain high-quality health systems that can succeed without our assistance. For more information, please visit: http://www.clintonhealthaccess.org

Background :

Through the prioritized implementation of high impact public health interventions like immunization, access to safe drinking water, improved neo-natal and infant care and access to effective treatment for pneumonia and diarrhea, India has reduced its infant mortality rate (IMR) from 89 in 1990 to 32 in 2017 and Under-five Mortality Rate (U5MR) from 126 in 1990 to 39 in 2017[1].

India's Universal Immunization Program (UIP) is one of the largest public immunization programs in the world. It caters to 26.3 million infants and 30 million pregnant women annually through 9 million planned sessions. The program provides access to vaccines against 11 Vaccine Preventable Diseases (VPDs)[2] at the national level and against two VPDs vaccines at the sub-national level[3].

- Under the strong leadership of the Ministry of Health & Family Welfare (MoHFW) and state governments, the entire immunization ecosystem has demonstrated proactive commitment for achieving universal immunization coverage in the country in recent years.

- Strategic projects in this direction include but are not limited to introduction of new vaccines[4], rolling out of data systems[5], strengthening of national immunization centres such as Immunization Technical Support Unit (ITSU) and National Cold Chain & Vaccines Management Resource Centre (NCCVMRC) and successful piloting of initiatives for bolstering health worker capacity building[6].

- Coupled with these initiatives, MoHFW launched Mission Indradhanush (MI) in 2014 and Intensified Mission Indradhanush (iMI) in 2017: catch up and system strengthening campaigns to target underserved, vulnerable, resistant, and inaccessible populations.

iMI has resulted in an increase of 6.7% in full immunization coverage (FIC) after the first two phases in prioritized districts[7]. However, the government and partners recognize the need for further efforts in this direction to reduce the 802,000 infant deaths and 989,000 under-five deaths that occur annually in the country[8].

Uttar Pradesh (UP), the most populous state of India, contributes more than 20% (5.7 million) to India's annual birth cohort. UP has the highest infant mortality (64 deaths per 1,000 live births) and under five mortality rates (78 death per 1,000 live births) in the country[9]. UP's FIC went up from 51.1% in 2015-16, to 65.3% in 2018 through concentrated efforts and catch up campaigns (MI and iMI) in 60 out of 75 districts. However, wide variations in coverage exist across regional and social categories. In 2018, UP accounted for 25% of under-immunized children in India & 9.5% of world's under-immunized children. Improvements in UP's FIC are essential to national and global improvements in immunization coverage, as an increase in UP's FIC from 65 to 90% could increase India's FIC by 6 percentage points, and the global FIC by 1%. The government of Uttar Pradesh (GoUP) is currently rapidly implementing a new strategic roadmap for holistic improvement of immunization outcomes in the state.

Program Overview :

CHAI operates an immunization program in India to support the MoHFW's UIP at the national level and in the focus states of Madhya Pradesh and Uttar Pradesh. CHAI provides catalytic support to the NCCVMRC, which is based out of National Institute of Health and Family Welfare (NIHFW), on national projects for improving availability and efficacy of vaccines and efficiency of vaccines systems by strengthening cold chain management and vaccines delivery & logistics.

CHAI also supports national and state governments on broader operational aspects such as planning, capacity building and systems improvements for immunization service delivery. Supporting GoUP since 2013, the Uttar Pradesh Technical Support Unit (UP-TSU) works closely with the Department of Health & Family Welfare and the Department of Child Welfare of GoUP to improve the availability, quality and utilization of critical reproductive, maternal, natal, child and adolescent health (RMNCH+A) interventions and services and has a deep understanding of UP's health systems, geography and demographics and opportunities.

Recognizing the vision and ambition of the GoUP on improving immunization coverage and equity outcomes in the state, CHAI and UP-TSU are undertaking a transformative project to provide support to GoUP at the state and district levels and in prioritized blocks. A purposely-formulated immunization project management unit (PMU) nestled within the UP-TSU will anchor this support to GoUP. The PMU will design and deploy catalytic support to GoUP based on the guiding principles of impact, integration, investment, and innovation. The PMU will support GoUP on the state's plans for strengthening evidence-informed decision-making, enhancing state capacity to manage and govern immunization service delivery and augmenting immunization systems in prioritized blocks of the state.

Role Overview :

CHAI seeks a highly motivated and entrepreneurial individual for the role of Community Engagement Officer. The officer will report to a Cluster RI Lead, within the Immunization PMU. The Officer would be responsible for diagnosing immunization demand challenges, developing community engagement strategies and executing focused community interventions in poor performing blocks/districts within a cluster.

The ideal candidate would have rich experience of implementing and customizing community interventions across different types of immunization demand challenges.

The Community Engagement Officer must be able to function independently, be comfortable working across geographies, be flexible, and have a strong commitment to excellence. CHAI places great value on relevant personal qualities: resourcefulness, responsibility, tenacity, independence, energy, and work ethic.

[1] Unicef on behalf of UN IGME (2018). Level and Trends in Child Mortality Report 2018 Estimates developed by the UN Inter-agency Group for Child Mortality Estimation. New York

[2] Diphtheria, pertussis, tetanus, polio, measles, rubella, severe form of childhood tuberculosis, rotavirus diarrhoea, hepatitis B, meningitis and pneumonia (caused by hemophilus influenza type B)

[3] Pneumococcal pneumonia and Japanese Encephalitis

[4] Rotavirus Vaccine, Pneumococcal Conjugate Vaccine, Measles Rubella vaccine, Injectable Polio Vaccine, Tetanus Diphtheria vaccine

[5] electronic Vaccine Intelligence Network (eVIN), National Cold Chain Management Information System (NCCMIS), ANM Online (ANMOL), Surveillance and Action for Events Following Vaccination (SAFE-VAC)

[6] Rapid Immunzations Skills Enhancement (RISE)

[7] Gurnani et al (2018). Improving vaccination coverage in India: lessons from Intensified Mission Indradhanush, a cross-sectoral systems strengthening strategy. BMJ 2018; 363; k4782

[8] Ibid1

[9] National Family Health Survey-4, MoHFW, GoI

Responsibilities :

1) Leverage Human Centered Design (HCD) methodologies to identify root behaviors, attitudes and influences underlying immunization demand challenges

2) Design community engagement initiatives such as capacity building workshops, IEC materials, multi-stakeholder dialogue, ICT solutions and any other relevant interventions.

Support the creation of strategies for effective community engagement plan for priority blocks/districts, with specific focus on demand generation activities and community interventions

3) Ensure implementation of demand and community interventions to districts/blocks through regular progress tracking

4) Build trust-based relationships & identify synergies with district & block level health leadership, partner organizations, civil society organizations, key opinion leaders, community champions and other stakeholders for improving immunization demand in identified geographies

5) In collaboration with district/block health authorities under GoUP, identify poor performing areas where community engagement on immunization is critical. With the support of other stakeholders such as ICDS, PRI & SHGs, prepare community level action plans to address the barriers to immunization coverage

6) Travel across the assigned blocks on a regular basis and to other parts of the state as and when required

7) Undertake any other duties and responsibilities as assigned by the Supervisor

Qualifications :

1) Bachelor's/Master's in mass communication, journalism and allied fields

2) 4+ years of experience in community engagement roles with demonstrated experience in designing & implementing behavior change interventions

3) Demonstrated experience in planning, facilitating and leading dialogue with diverse community groups

4) Strong analytical (qualitative and quantitative) and communication (written and verbal) skills

5) Prior exposure to public health campaigns with strong experience in IEC and BCC strategies

6) Entrepreneurial mind-set, including ability to work independently, self-motivate, and propose and implement new initiatives

7) Motivated to travel frequently to meet the needs of the program and deliver impact effectively

8) Proficiency in Microsoft Office, particularly Excel, PowerPoint and Word

9) Fluency in English & Hindi

Preferred :

1) Experience of working in public health/immunization

2) Experience of working in UP