Lifesaving Vaccinations in Lebanon

The impact of the COVID-19 pandemic has been pervasive, reaching people in various geographies, and all walks of life – albeit affecting people to different extents. Since the initial outbreak, new programs have been introduced to deal with the effects of COVID-19 and to reduce the spread of the virus, while making measures such as social distancing, regular and thorough hand washing, and personal protective equipment (PPE) daily practice.

Vaccinations and Impact of COVID-19

In the meantime, many existing public health programs have been affected, due to a combination of redirected resources and staffing, and reduced attendance by patients (partially through adhering to government-mandated isolation or social distancing procedures). Immunization is one such area that has been affected by the crisis, with fewer children receiving their routine vaccinations and the supply of vaccines being disrupted due to transport restrictions. As UNICEF noted back in May: “efforts to reach every child under the age of five with lifesaving vaccines are under serious jeopardy”.

With our reliance on empirical data and tracking initiatives to deal with coronavirus, the current crisis has emphasized the importance of being able to record, collect, and analyze public health data. This information enables us to learn from previous programs by identifying gaps and opportunities, and observing patterns and trends that might indicate useful ways forward. One of Sayara’s strengths is collecting and analyzing data in complex environments – it’s something the team does every day.

Expanded Immunization Program in Lebanon

In the case of work commissioned by UNICEF in 2018, we were tasked with evaluating an expanded immunization program (EPI) in Lebanon that ran from 2013 to 2017. The EPI aimed to elevate routine vaccination coverage to 95% in every region in Lebanon, preserve the country’s status as a polio-free country, and eradicate measles and rubella by the end of 2018.

However, during the period the program was in operation, Lebanon faced continuous socio-economic and political challenges – including a stagnant economy and the conflict in neighboring Syria – that increased pressure on public services to cope, and negatively impacted the quality of lives of families and children across the country. Syria’s conflict led to a significant increase in Lebanon’s population during 2013 – 2015, and authorities needed to ensure that all children under the age of 5 were protected with safe, quality vaccines.

Methodologies & Challenges

Taking a primarily qualitative approach towards data collection for this project, we built up a comprehensive picture to enable thorough evaluation of the immunization program. Over six months, the team tackled a combination of key informant interviews, focus group discussions, in-depth interviews, desk review, and structured observations of vaccination sites. Through these chosen methodologies, we focused on analyzing the relevance, effectiveness, efficiency, and sustainability of the program.

Evaluating a program that took place over the five years prior presents its own difficulties. For instance, datasets recorded at the time were challenging to deal with both in terms of limited accuracy and transparency, and due to gaps in the documentation. However, we navigated this complex environment with an analytical and methodical approach, and were able to present UNICEF with properly-evidenced findings and considered recommendations to inform future interventions.

Looking Forward

In 5 years’ time, if we are tasked with evaluating the current COVID-19 programs, what data will we find and what will our recommendations be for facing the next pandemic? Will the fallout – or secondary effect – from pausing immunization programs prove to be as great an issue over the longer term as coronavirus itself?

We know how important vaccination is, and how vital it is to ensure that coverage is maintained. Of course, COVID-19 measures are crucial to stop the pandemic, but immunization programs should continue where possible, or resume as soon as it is safe to do so – otherwise, we risk reversing the progress achieved so far. After all, a country that is declared free of a particular disease needs to operate an immunization program continuously to stay that way.

Learn More

To learn more about our work in immunization and health more broadly, or the various projects implemented by our regional hub in Beirut, Lebanon, get in touch with our team.