Module D: Implement

Welcome to Module D!

Purpose

This module focuses on finalising the Demand Strategy and preparing for a successful implementation by thinking of indicators for your solutions, developing a timeline and budget, and assigning roles for implementation.

What You’ll Achieve

By the end of this module, participants will have:

Identified impact indicators for each solution.
Developed a timeline for when each solution will be completed.
Assigned clear roles and responsibilities for implementing the demand strategy.
Created a budget plan to support the implementation of the demand strategy.

What You Need

Room Set-up

Activity #1: Measure the success of your solutions

ℹ️ In this activity, participants will learn about the different impact indicators and identify practical ones for each solution to measure the potential long-term impact of their solutions.

How to prepare

If you haven’t already, put up the header poster for Module D on the main wall.
Give one set of Prompt Cards: Implement to each group.
Give one copy of Table Worksheet: Indicators Worksheet to each group.
Give three copies of the Strategy Summary Poster 4 to each group.

📝 If anyone in your team or in the room has experience in monitoring and evaluation, or developing indicators to measure impact of a solution, their experience will be essential for this module. If possible, split anyone with this experience across the different groups, or ask them to rotate between the groups during the first activity to support the groups as they develop impact indicators for their solutions.

Facilitation Steps

Introduce how to measure the success of solutions
- Start by giving an overview of this activity: “In this session, we’ll create ways to measure or monitor if an implemented solution has achieved its goal or intended impact. To know whether a solution is working and has achieved its goals, we create indicators to monitor the progress of solutions during implementation and evaluate their impact over time. In this activity, we will be creating indicators for each of the prioritised solutions to measure if the solution has had an impact on the immunization barrier it aimed to solve.”
- Provide an example of an impact indicator: “An impact indicator shows us if a solution has the impact or desired result we hoped it would have in the long term. As an example:
  - Solution: Create a network of vaccine champions from the community trained in how to share vaccine information, who will promote vaccines to their community.
  - Impact indicators:
    - Percentage of trained vaccine champions from [target community] who have increased knowledge of vaccine.
    - Percentage increase in awareness/knowledge of vaccination amongst community members.”
    - Ask groups to review the Prompt Cards: Impact Indicators Card 1 and, for each of their solutions, discuss the guiding questions on the back of Indicators Card 1:
- What impact to measure:
  - What does success for your solution look like?
  - What behaviours, attitudes, or practices need to change for the solution to succeed?
  - How will you know if these changes are happening?
- How to measure impact:
  - How can you reliably measure the impact of this solution with the available resources, tools, and data systems?
  - Are there existing data sources or tools that can help collect this data?
Develop impact indicators for each priority solution
- Ask groups to review Prompt Cards: Impact Indicators Card 2 to understand what an impact indicator is, and how to develop them.
- On the Worksheet: Impact Indicators, each group should identify the key indicators they want to measure for each of their priority solutions. Ask each group to:
  - Review the priority solutions they documented on Strategy Summary Poster 3
  - For each solution, they should think about what immunization barrier categories the solution aims to solve.
  - The Worksheet: Impact Indicators provides examples of indicators for each of the barrier categories. For each solution, groups should review the indicators in the relevant barrier category list.
    - E.g. Solution: A mobile vaccination site. Main barrier targeted: improve access to vaccination. This barrier is in the “Practical Barriers and Experience of Care” barrier category, as vaccination centres being far away or hard to access is a Practical Barrier. For this solution, you would review the indicators in the “Practical Barriers and Experience of Care” list on the Table Worksheet to see which indicators are most relevant to the mobile vaccination solution.
    - For each solution, you will choose the most appropriate and relevant indicator to measure success and impact of the solution by matching their solution to the barrier category it aims to solve.
  - Using the Worksheet: Impact Indicators , they should select one to three indicators for each solution. Many solutions may only need one or two indicators to measure success—it’s important to choose indicators that will be feasible to measure, and relevant to the solution.
    - If groups feel like the examples in Table Worksheet: Impact Indicators do not adequately measure impact of their solutions, encourage them to build out an indicator that is more relevant to their solution. They can use the below guidance, found on the back of Indicators Card 2 to help develop their own indicator:
      - Who does the solution target? Remind participants that solutions can target one group/community, e.g. caregivers, while using a different group to deliver the solution e.g. healthcare providers, vaccine champions, etc. In some cases, changes may need to be measured across both types of groups to understand the success of a solution.
      - Where do these groups come from, e.g. the target communities prioritised earlier in the DSB process?
      - When or at what time-point must the change in behaviour or attitude in the target population/community be achieved?
Once the impact indicators have been confirmed, ask each group to add their final one to three impact indicators for each solution to the Strategy Summary Poster 4.

Explain to participants:“The goal of the whole strategy is to increase immunization rates and/or reduce immunization drop-out. Each of these solutions will work together to reduce the immunization barriers that prevent communities accessing vaccination. By implementing these solutions together, we hope to reduce the prioritised barriers to immunization, and ultimately increase immunization rates.”

Facilitation Tips:

For some participants, this might be their first time working on indicators. Use clear examples and revisit the definitions if needed to ensure everyone understands what they’re meant to do.
Move around the groups to answer questions, offer guidance, and keep them on track.
Remind groups that indicators should be specific and actionable.

Activity #2: Assign roles and responsibilities

ℹ️ In this activity, participants will define who will lead and support the implementation of each solution.

How to prepare

Ask participants to refer to Prompt Cards: Implement for this activity.

Introduce the idea of roles for implementation

Explain why defining roles is critical for successful implementation: “Each solution requires clear leadership and support to ensure successful implementation. For this activity, we'll look at who will take responsibility, provide assistance, and approve the implementation of each of the solutions in our demand strategy. This will help us build a strong, accountable team for each solution.”
- Ask participants to review Prompt Card: Implement (Roles card), and consider the three key roles to support implementation:
  - Lead implementor: The individuals or organisations with primary responsibility for implementing the solution.
  - Supporters: Those who assist the leader by coordinating and providing resources or skills, e.g. they may provide technical support, access to communities, or support in fundraising.
  - Approvers: Key stakeholders who need to grant permissions or approvals.
Assign key roles
- In their groups, participants lead a discussion around who should be responsible for each activity, using the guiding questions on the back of the Prompt Card: Roles.
  - Which individuals and organisations have the mandate and capacity to lead or implement each activity?
  - Who can be a champion for certain activities? Who has the experience, expertise, and reach?
  - Who has the influence to help move the implementation process forward?
  - What partners and donors need to be involved for implementation?
  - What kind of coordination mechanism is needed to make sure you have the needed support to move forward?

Ask each group to document the lead implementors who will drive implementation of each solution on Strategy Summary Poster 4.

Activity #3: Develop an implementation timeline

ℹ️ In this activity, participants will create a realistic timeline or plan for implementing their solutions.

How to prepare

Ask participants to refer to the Prompt Card: Implement (Timelines card) for this activity.

Facilitation Steps

Introduce the need for a timeline for implementation
- Explain: "We’ll be creating a timeline for each solution to set clear targets, anticipate challenges, and track progress effectively.”
Refer participants to the Prompt Card: Implement (Timelines card), and review the three considerations on the card:
- Steps or activities involved in implementing your solution
- Availability of individuals and organisations
- Availability of funding
- Key milestones to achieve in the first month, 3 months, 6 months, and year of implementation.
Create timelines for implementing each solution
- In their groups, participants will now review each solution and think about a realistic timeline for when the solution can be implemented. Encourage them to read the guiding questions below, found on Prompt Card: Timelines:
  - What approvals or funding processes do you need to enable implementation of this solution?
  - What steps or activities do you need to do to develop this solution? For example, for a mobile vaccination site, do you need to procure mobile vehicles? Do you need to train healthcare workers in how to run a mobile vaccination site?
    - Think about how much time the different steps and activities to implement this solution will need
  - Are there any existing resources that can help implement this solution faster? What is the desired timeline for having this solution implemented? Six months? One year?
  - Does the completion of this solution depend on the completion of other solutions? If so, what needs to be adjusted?

Each group should document the estimated time it will take to implement each solution: 30 days, three months, six months, one year, or more than one year.

Ask each group to document the estimated time for implementation of each solution on Strategy Summary Poster 4.

Facilitation Tips:

Encourage participants to consider the logical sequence of activities and any dependencies (e.g. some activities may need to happen before others can begin) involved in implementing each solution.
Participants might not have knowledge of available resources and funding. This is okay. They can make an estimate, using their available experience. Remove the pressure that responses are final.

Activity #4: Estimate budget and funding sources

ℹ️ In this activity, participants will estimate how much it will cost to implement each solution, and ensure they have funding, or a plan, to get it.

How to prepare

Ask participants to refer to Prompt Card: Implement (Budget card) for this activity.

Facilitation Steps

Introduce the budgeting process
- To begin the budget planning process, explain: “We will now create budget estimates for implementing each solution, identify potential funding sources, and address any resource gaps. The goal is to ensure that each solution is both actionable and financially feasible.”
- Ask groups to review the Prompt Card: Budget, explaining the three budget categories on the card:
  - Administration: Printing and distribution of materials, engagement with decision makers, travel, production
  - Implementation: Staff, training, supplies and equipment, office expenses, translation
  - Measurement: Data collection and analysis, software, technical support
Estimate the budget to implement your solutions
- Explain to participants that they will now discuss in their groups the costs required to implement each solution. Using post-it notes, ask participants to:
  - Write down all the resources required referring to the three budget categories.
  - Write down cost estimates for each resource based on available data and knowledge.
  - Write down where the money will come from.
- Remind participants to use the questions on the back of the Prompt Card: Implement (Budget card) to support their discussion.
  - Are there existing funding mechanisms for implementing the Immunization Demand Strategy solutions in the short or long term?
  - Does the budget for this solution fit into existing national plans or objectives, or is it a stand-alone budget?
  - Do you have any resources that can be reallocated to support this solution? If so, from where?
  - Do you need to advocate for funds?
  - What are some budgetary challenges you foresee for this activity?

Ask each group to document 1) the budget estimates for implementing each solution, and 2) the potential funding sources on the Strategy Summary Poster 4.

Tips and Considerations

Encourage groups to discuss and note any limitations or support needs for each role, such as the need for additional training or external assistance.
Participants might not have knowledge of individual or organisation capacity.. This is okay. Remove the pressure that responses are final.

Activity #5: Feedback and strategy finalisation

ℹ️ In this final activity, groups will have the opportunity to share their implementation plans, hear other groups' approaches, and finalise their demand strategy.

How to prepare

Ask participants to focus on the Strategy Summary Poster 4 for this activity.

Facilitation Steps

Finalise the Immunization Demand Strategy
- Each group should make any final adjustments needed to the key decisions they have made on their Strategy Summary Posters.
- You should put all the Strategy Summary Posters from both workshops on the main wall next to each other so they show the final strategy across all communities/groups on the wall. Each group will need to place their Summary Posters 2, 3 and 4 sequentially so they can see their community/group’s strategy.

🎉This is a big moment! Take a few moments to celebrate the hard work in reaching this important milestone.

Share the strategies
- Each group should present their full strategy and implementation plan, highlighting:
  - Their priority community
  - Priority immunization barriers
  - Priority solutions for each barrier
  - Timelines and key milestones for implementation
  - Budget considerations and funding sources
  - Roles and responsibilities required to carry out activities

After all groups have presented, thank participants for sharing their plans, and highlight how all of their hard work has combined together to build a comprehensive Immunization Demand Strategy focused on the highest risk communities in your context!

Facilitation Tips:

Suggest groups practise beforehand to ensure they stick to the eight minute limit.
Use a timer to keep presentations on track and ensure every group has an equal chance to share.
Encourage groups to focus on clarity and keep the presentation short to ensure all groups have enough time.