Brave & Bold Heroes: Activating communities in Pakistan

 

Ahmad Naveed Nusrat is a School Health & Nutrition Supervisor in Okara, Pakistan, a mostly agricultural district where temperatures can reach 113 degrees in summer and rural, hard-to-reach, and nomadic communities that move every two to four weeks. As part of his role in the Ministry of Health, he works at the district, sub-district and health facility levels overseeing immunization for children in the region and leads a 12-person immunization team that typically conducts four childhood vaccination outreach campaigns per year to provide routine immunizations for children who do not attend school. The area he covers is geographically separated by a river, which causes unique challenges for these vaccination campaigns. In addition, "In rural areas, I face the challenge of people not willing for their children to get vaccinated, as they think it is not safe for them," he says.

Ahmad became a part of Sabin's Boost Community in April 2020, after he heard about the program through colleagues. Since then, he has taken a number of courses with Boost, and is an alumni of the first group of Storytelling for Change, an introductory, self-paced virtual course designed to strengthen skills around generating public emotion, values and action, available on the Boost Community platform.

New Skills Through a Fellowship

After the course, Ahmad says he was eager to embark on the 2021 Boost Flagship Fellowship in community activation and adaptive leadership because he saw a "dire need for using adaptive decisions in different situations and learning how a good leader can use his or her role to boost vaccinations." This inaugural fellowship involved four months of training and practice sessions with expert facilitators and a cohort of peers via Zoom to develop and deepen leadership skills in advocacy, community organizing and facilitation. He says he learned "different techniques for activating the communities, such as getting all on one page by realizing their importance in achieving the desired targets of vaccination."

"I used different techniques for activating the communities, such as putting all stakeholders together in a committee to conduct meetings on a monthly basis to discuss the issues which were faced in that month and make a suitable strategy to tackle them."

Ahmad Naveed Nusrat

School Health & Nutrition Supervisor in Okara, Pakistan

"I used different techniques for activating the communities, such as putting all stakeholders together in a committee to conduct meetings on a monthly basis to discuss the issues which were faced in that month and make a suitable strategy to tackle them," he says. One group included landlords, religious leaders, representatives from local government, school administrators, and parents. He encourages them to spread the message about vaccination campaigns with their neighbors and community.

Reaching Zero-Dose Children

Ahmad also put his newfound skills into action as he led his team to improve immunization coverage for the children in his service area. Because the populations they work with have low literacy levels, including low health literacy, it was an uphill climb. In one cluster of twenty households, the team encountered three zero-dose children under 2 years old (meaning children who had never received any routine vaccines). "The prime focus is to reach each and every child, wherever they are," he says. He developed a systematic mechanism for all Skilled Birth Attendants, Medical Practitioners, and Community Health Workers (both governmental and private) to communicate with the nearest Health Unit about new births so that children could be counted and included in all vaccination campaigns.

Another reason the team is now able to reach every house is that they also improved the accuracy of their data collection and management. Ahmad created a team culture "focused on support and learning" as he encouraged working through mistakes and seeking improvement as a team. This focus on improvement has allowed the team to increase the coverage of polio, typhoid, measles and pediatric COVID vaccinations.

Ahmad credits growth in this area to changes he made in his supportive supervision. "I encourage my vaccination staff and tried to do things better by learning from past experiences," he says, noting that giving his team positive support has enabled them to do the work without as much intensive supervision. "This is an ongoing practice and not something that shifted overnight."With the group now committed to spreading positive information about vaccinations, Ahmad's team was able to vaccinate every child in the service area, including in the nomadic population, against polio – a celebratory milestone for Ahmad and his team. "I am so proud we were able to do what had never been done before."

A new iteration of Storytelling for Change will begin on Monday, March 20, in French and English with both a live and self-paced track. Register today to discover how storytelling can transform the health of your community.

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This article was originally published by Sabin Vaccine Institute on 15 March 2023.