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MDG-4: Reduce Child Mortality
MDG target 4.A: Reduce by two thirds, between 1990 and 2015, the mortality ConstRaint:
Lack of interventions to Prevent Child Deaths from Measles, Polio, Malaria and Worms
Limited availability of vaccines to prevent measles and polio, mebendazole to treat parasitic worm infections and insecticide treated nets (ITNs) to prevent malaria Togo’s Campaign to Provide Vaccinations aimed to reduce morbidity and mortality in young
children aged 9-59 months by achieving high coverage (>95 percent) of the following health services
over a week-long period: insecticide-treated net (ITN) distribution, measles vaccination, polio
vaccination and anti-helminth treatment. The programme targeted 100 percent of children under 5 in
Togo, which is approximately 866,725 children, with greater than 95 percent coverage for each of the
four interventions.
Project comPonents:
• Established 565 fixed posts, 628 outreach posts and 146 mobile teams. Each fixed post served at
least 300 children daily and was staffed by two vaccinators and two volunteers. Outreach teams included one vaccinator and two volunteers, and mobile teams included one vaccinator and one volunteer. • Supervisors used checklists to monitor the quality of services.
• Thirty-two incinerators for destruction of used injection equipment were rehabilitated to
supplement the 140 existing ones; 99 percent of filled safety boxes were incinerated, and the rest were burned in pits. No severe adverse events were reported. results:
• One month after the campaign, a probability-based survey of 2,599 children aged 9-59 months
from 142 enumeration areas and 6 districts revealed the following coverage obtained among eligible children: • 92.7 percent for mebendazole (used to treat parasitic worm infections) • 90.8 percent for insecticide treated nets (ITNs) • Household ownership of at least one ITN increased from 8.0 percent before the campaign to 62.5
• In September 2004, before the campaign, 0.4 percent of eligible children slept under an ITN
during the night before the survey. A survey conducted after the campaign indicated that 43.5 percent of children under 5 had slept under an ITN during the night before the survey.
• While data for malaria morbidity and mortality are unavailable, when high coverage and
appropriate use of ITNs were achieved in Kenya (a country similar to Togo, with very high perennial malaria transmission), both malaria morbidity in children under 3 years of age and all-cause mortality in children aged 1-11 months were reduced (Hawley et al, 2003; Eisele T et al, 2005). lessons learned:
• An integrated set of high-impact health commodities and services can be delivered quickly and
• The Red Cross volunteer network can be mobilized to deliver integrated health services on a
• Mass distribution of ITNs can be done very quickly and does not compromise the delivery of other
• Post-campaign efforts are needed to encourage sustained, proper use of ITNs.
Background InformatIon:
This campaign was the product of a partnership among the Togolese government, international partner
organizations under the Measles Initiative, and local agencies, such as the Togolese Red Cross. The Togolese government, via an Interagency Coordination Committee (ICC) for the Ministry of Health (MoH) Expanded Program for Immunization, approved the campaign plan, mobilized resources, monitored campaign preparations and disbursed funds. A National Steering Committee under the ICC oversaw three groups: (1) Technical Working Group, which prepared guidelines, reporting forms, and evaluation tools; (2) Logistics Working Group, which prepared the plan for procuring and distributing vaccines, injection materials, ITNs, and mebendazole tablets, and developed the waste-management plan; and (3) Social Mobilization Working Group, which developed communications and social mobilization plans and materials. International and local partners provided funding and consultants to support planning, implementation and evaluation.
In each fixed post, a volunteer tallied eligible children and distributed campaign cards; a vaccinator administered the measles injection; a second vaccinator administered OPV and mebendazole; and a volunteer provided an ITN for each child (or one net per household) and documented services provided on each child’s card. ImplementatIon partners:
The Government of Togo – Ministry of Health, Togo Red Cross Societies, international partners under
the Measles Initiative (e.g., American Red Cross, CIDA, CDC, UNICEF, United Nations Foundation,
WHO)
Other partners: Canadian Red Cross; Church of Jesus Christ of Latter-Day Saints; DHL; Freedom from Hunger; Geneva Universities; Global Fund to Fight AIDS; Tuberculosis and Malaria; International Federation of Red Cross/Red Crescent Societies; Joint United Nations Program on HIV and AIDS; Nestlé; Liverpool School of Tropical Medicine; London School of Hygiene and Tropical Medicine; New Zealand Red Cross Society; Norwegian Agency for Development Cooperation; Norwegian Red Cross; Plan Togo; Population Services International; Reliance Industries; Right to Play; Roll Back Malaria; Rotary International; Sanofi-Synthelab; Togolese Red Cross; Unilever; United Nations Development Program; U.S. Agency for International Development; U.S. Peace Corps; and Vestergaard Frandsen.

Source: http://mdgpolicynet.undg.org/ext/MDG-Good-Practices/mdg4/MDG4A_Togo_Campaign_to_Provide_Vaccinations.pdf