Behind the two drops: The people making every polio vaccination count

For a mother watching her child receive two drops of polio vaccine, the moment takes only a few seconds. But behind those two drops is a much bigger effort: health authorities planning the campaign, community leaders mobilising families, community health workers moving from household to household, vaccinators delivering the vaccine, data teams tracking progress, supervisors responding to gaps. 

During Tanzania’s polio vaccination campaign, these people form a chain of effort that begins long before the vaccinator reaches a household. 

It starts with planning and leadership 

Long before vaccination teams enter communities, government officials including national, regional and district health authorities working closely with partners, Gavi, the Vaccine Alliance, UNICEF, and WHO, organise teams, supplies, community mobilisation and monitoring to ensure children can be reached, including those in hard-to-reach areas. 

For Dr. Andrew Method, Regional Medical Officer for Manyara Region, successful vaccination starts with preparation. “As we make sure that people of Manyara have access to quality healthcare, we have a campaign aimed at protecting children against polio. For us to achieve this, a successful vaccination campaign needs to start with preparation. We need to know where the children are, where our teams need to go and what support they need to reach every community, including difficult-to-reach areas.” 

But planning alone is not enough. The campaign also depends on the trust and participation of communities.

Before the vaccinator knocks 

Community and religious leaders help connect the campaign with families, sharing information, encouraging caregivers to participate, and addressing questions or concerns. 

Pastor Amos Z. Nahhato, Elim Pentecostal Church Babati, says trusted local voices can help families understand what to expect. “People listen when information comes through someone they know and trust. We help explain when the vaccination teams will come and why it is important for parents to make their children available.” 

With communities informed, the work moves to the doorstep. 

Going from household to household 

For community health workers, reaching children means going beyond the health facility and into the places where families live. 

Agnes Frednand Njaiko moves from household to household, identifying eligible children, speaking with caregivers and helping ensure that no child is missed. “Our work is not just to knock on the door. We have to explain to the caregiver why the vaccine is important; answer their questions and make sure we find every eligible child.” 

Sometimes that means returning to a household when a child is absent. “Sometimes you arrive and the child is not there, so you have to come back. You cannot just say we did not find the child and move on.” 

When the vaccinator arrives

At the household, the campaign becomes visible. The vaccinator confirms the child, administers the vaccine and records the vaccination before moving to the next household. 

For Ester Njidile, the two drops are only one part of the responsibility. “Giving the two drops takes only a few seconds, but we have to make sure we have reached the right child, given the vaccine correctly and recorded the information before moving to the next household.” 

And then the team moves on. 

Turning information into action 

While vaccinators are moving through communities, the data management team is working behind the scenes. Information collected in the field helps show where teams have worked, how many children have been reached and where gaps may remain. The data team checks and compiles this information so that programme teams can monitor progress and act on emerging gaps. Elizabeth Changendo, Data Manager  

“The information coming from the field tells us what is happening on the ground. Our role is to make sure that information is complete, accurate and available on time so that teams can act on it.” 

That information then feeds back to supervisors in the field. 

Erick Bunziya Peter, a team supervisor, uses the information alongside field observations to identify where teams may need to follow up. “My role is to know where the teams are, what they are finding and whether there are children who have not yet been reached. If there is a problem, we need to address it while the campaign is still ongoing.” 

When information points to gaps, teams can investigate, return to households and continue the search for children who may have been missed. It is a continuous cycle: reach, record, review, and respond. 

At the centre of it all: the family 

For caregivers, the campaign is much simpler: a health worker arrives at their home, explains the purpose of the visit and asks them to make their child available for vaccination 

Jamila Eddy received the vaccination team at her home in Magugu, Babati. “When they came, I listened to what they explained. I wanted to understand why my child needed the vaccine. I had many questions, and the vaccinator explained them to me. That gave me confidence to let my child receive the drops.” 

Her experience brings the campaign back to where it matters most: the child. 

From regional planning and community mobilisation to household visits, vaccination, data and follow-up, each part of the chain contributes to reaching children. 

More than two drops 

For a family, the vaccination visit may last only a few minutes. But for the people behind it, reaching that doorstep represents planning, mobilisation, travel, communication, vaccination, data collection, supervision and follow-up. 

And then the team moves on, to the next household, and the next child. Because behind every two drops is a much bigger effort: a community and health system working together to reach children and strengthen protection against polio.  

“A successful vaccination campaign depends on strong government leadership and the collective effort of health workers, communities and partners. WHO continues to provide technical support to strengthen the systems that help Tanzania reach children with polio vaccines and use campaign information to identify and address gaps,” said Dr Alex Gasasira, WHO Representative Tanzania