6.3 Human resources

6.3.1 Human resource needs

Vaccination campaigns require significant human resources. Be careful not to monopolise the available personnel, thereby compromising regular patient care activities.

The number of teams needed is based on the size of the target population, the expected output per team and the optimal campaign duration (Appendix 28):
– At best, in a densely populated area, a well-trained vaccinator using auto-disable syringes prepared by 2 preparers and working 6 hours a day can vaccinate 1000 to 1200 people a day.
– In sparsely populated areas, a team can vaccinate 300 to 600 people a day.
– The optimal campaign duration per location is estimated based on the number of vaccinators, the personnel available and the expected output.

Note: this planning is theoretical and should be adjusted according to the context and experiences with prior campaigns.

6.3.2 Core vaccination team

The standard core vaccination team has at least six posts and is centred on one vaccinator (Appendix 29).

The number of people needed for each post depends on the context:
– In densely populated areas (urban areas and refugee camps) where a lot of people are expected, vaccination proceeds at a sustained pace. The vaccinator is supported by a large team to ensure a continuous flow.
– In rural areas, the crowds are smaller and the pace of vaccination slower. The team composition is adapted to the target population and expected output.

The key posts (vaccinators, preparers and recorders) are always entrusted to regular qualified or trained personnel. Recording is a key post, since any errors there will affect the vaccination coverage calculation.
The other posts (security, registrars, vitamin A dispenser) require fewer qualifications and may be entrusted to locally recruited, trained and supervised personnel.

Do not underestimate the amount of time needed to fill out a vaccination card. Registration can be a bottleneck and slow the flow of people considerably.

Table 6.1: Core team makeup as a function of the context, and each person’s tasks


Post

Qualification

Tasks
Number of people
UrbanRural
Vaccinator

Nurse, midwife, health worker

Cleans the skin with clean water.
Administers vaccinations.

1

1
Preparer

Health worker, student nurse

Reconstitutes the vaccines.
Fills the syringes.

21
Registrar

People who can read and write: teacher, administrative worker, etc.

Fills out the vaccination cards.
Writes or stamps the date.

2 to 31
Recorder

People who can read and write: teacher, administrative worker, etc.

Fills in the tally sheet.

1

1

Crowd control
officer

Chief of village, volunteers, police

Informs the population.
Selects for the target population
Organises the queues.
Provides crowd control and security at the site.


4 to 6


2 to 4

Vitamin A
dispenser

Volunteers

Administers an age appropriate dose of vitamin A.

11

Depending on additional activities:


Post

Qualification

Tasks
Number of people
UrbanRural

MUAC
measurer

Health worker, student nurse

Measures the mid-upper arm circumference on children under 5 years of age.
Directs the child according to the result.


1



1


MUAC
recorder

People who can read and write: teacher, administrative worker, etc.

Fills out the tally sheet.

1

6.3.3 Supervision team

The supervision team monitors the quality of the campaign. It provides the teams with constant, direct support, observes their work, corrects errors in real time and helps withsolving problems and when the volume is high.

Ideally, it consists of a medical supervisor (Appendix 30) and a logistics supervisor (Appendix 31). The medical and logistics supervisors each get a vehicle and driver.

In urban areas, a supervisor can simultaneously manage teams at several sites. With more than three sites, however, monitoring and coordination become difficult.
In rural areas, the medical supervisor cannot directly oversee each site and so focuses more on general organisation. The first priority is monitoring less experienced teams or sites with special constraints.

On the first day of the campaign, site openings are staggered (one after the other rather than simultaneous); this allows the medical supervisor to supervise the teams at each site to make sure that activities start up properly.

The logistics supervisor focuses primarily on-site organisation, the cold chain and transport. He supports one or two supervisors (no more than six sites at a time).

There should be a daily meeting. This allows all necessary information to be transmitted to the health officials and local authorities, and feedback for the teams the next day.

6.3.4 Training

Training for medical and logistics personnel is essential, and should be done before the start of the campaign.

The training plan includes the training objectives, the course description (objectives, length, number of participants, teaching methods and content) and evaluation.

Job descriptions are established for each team member. These serve as a basis for training, and are distributed to the staff with the manuals and other practical documents.

Practical interactive sessions (simulations, case studies and exercises) should be held the day before the campaign with a simulation at a site, if possible, using the actual supplies and equipment. This allows last minute adjustments and facilitates first day start-up.

Best practices and what to do in case of an accidental exposure to blood (AEB) are an integral part of staff training.

The film “Organising an emergency mass vaccination campaign” is good tool for planning and organising a campaign and for training the teams.