Integration has emerged as a cornerstone technique in Ethiopia’s efforts to speed up the discount of zero-dose (ZD) kids—those that haven’t obtained a single routine vaccination. In accordance with the World Well being Group (WHO) Integration Useful resource Information, integrating well being providers, comparable to vaccination applications, considerably improve useful resource effectivity and improves total healthcare supply. Key advantages embody value effectivity via the pooling of assets, and efforts, minimizing of duplicated efforts, optimized utilization of accessible funding, and expanded entry to healthcare providers by leveraging current infrastructure and networks.
Furthermore, the coordination of a number of well being providers streamlines logistics, facilitates complete information assortment and monitoring, strengthens well being programs via inter-program collaboration, and fosters better neighborhood belief by providing a holistic method to healthcare supply.
Ethiopia has prioritized integration inside its immunization program to maximise affect. In 2023, the nation developed complete pointers to include COVID-19 administration into its broader well being programs, integrating COVID-19 vaccination into routine immunization providers. Consequently, areas at the moment are required to request COVID-19 vaccines alongside routine vaccines.
Moreover, as a part of the Ethiopia Large Catch-Up (BCU) plan, vaccination modalities have been expanded to incorporate routine catch-up efforts, campaigns, outreach applications, Periodic Intensified Routine Immunization (PIRI) campaigns, and integration with different well being providers, as outlined within the catch-up vaccination information. The Ministry of Well being (MoH) has engaged companions and donors to map assets and establish actions for integration, thereby leveraging current immunization assets to deal with gaps successfully.
Following the introduction of a nationwide catch-up vaccination coverage in 2022, the MoH started offering catch-up vaccinations routinely whereas integrating them with different well being alternatives. Via this method, Ethiopia initiated vaccinations for zero-dose kids in 2023, efficiently reaching 334,042 zero-dose kids utilizing routine vaccine shares. These efforts preceded the worldwide immunization neighborhood’s Large Catch-Up (BCU) initiative, which offered extra vaccines to Ethiopia in 2024.
Integration efforts have been carried out throughout a number of thematic areas, together with coordination and management, service supply, well being employee orientation, monitoring and supervision, and demand-generation actions. Excessive-level management engagement performs a crucial function in advocating for integration by encouraging immunization applications to collaborate with different well being and emergency providers. Examples embody partnerships with vitamin applications (for vitamin screening, Vitamin A supplementation, and deworming), maternal and youngster well being applications (addressing clubfoot and obstetric fistula), and outbreak response efforts for measles and polio in collaboration with the Ethiopian Public Well being Institute (EPHI).
Well being employee orientation classes now embody a spread of subjects, together with routine immunization, catch-up vaccination, vitamin, and maternal well being. Equally, service supply has been built-in into varied campaigns to cost-effectively attain broader populations. For example, through the latest spherical one novel oral polio vaccine kind 2 (nOPV2) marketing campaign, integration included interventions concentrating on zero-dose and under-vaccinated kids alongside maternal well being initiatives, comparable to vitamin screening, counseling for kids and pregnant girls, Vitamin A supplementation, and deworming.
Monitoring and supervision instruments have additionally been tailored to help integration. For instance, workforce supervision instruments used through the nOPV2 vaccination marketing campaign in February 2025 integrated zero-dose indicators. Nationwide supervision performed from February to March 2025 built-in routine immunization metrics with catch-up vaccination indicators, additional enhancing oversight.
Efforts in demand technology and neighborhood consciousness have additionally benefited from integration, as messaging now incorporates all related well being providers. Proof demonstrates that such integration fosters better neighborhood belief, enhances service uptake, and contributes to improved public well being outcomes.
The combination of well being providers, notably vaccination applications, has confirmed to be an indispensable technique in Ethiopia’s efforts to scale back the variety of zero-dose kids. By combining assets, optimizing funding, and leveraging current healthcare infrastructure, Ethiopia is enhancing useful resource effectivity and total healthcare supply. This holistic method to healthcare not solely will increase service uptake but additionally improves public well being outcomes, advancing Ethiopia’s immunization objectives and broader healthcare supply aims.