Can intensive campaigns dynamize front line health services? The evaluation of an immunization campaign in Thiès health district, Senegal.

With the aid of UNICEF, Senegal has implemented an intensive national vaccination campaign, the first phase of which extended over 4.5 months in 1986 and 1987, the second and third phases being held exactly 1 and 2 years later. The present article evaluates its effects in Thiès health district. It seeks to establish; whether the objectives of the campaign were achieved and maintained beyond the intensive phase; whether the organization of the campaign was appropriate and did dynamize the first-line health services. The low sustainability, the interference with other activities of the services and some technical deficiencies are shown. They are related to the managerial characteristics of an intensive campaign. The conclusions of this evaluation question (1) the possibility of developing basic health services under one or two programs, (2) the appropriateness of 'Universal Child Immunization in 1990' and (3) the value of accelerating immunization activities when no epidemics occur. Two types of alternatives are suggested: technical options to improve UCI sustainability, and a reorientation of health policy that advocates district management and the administrative as well as operational integration of vertical programs.