Attribution © Biju Boro
Attribution © Biju Boro
Attribution © Biju Boro
Solutions Library
The Solutions Library is a compilation of innovative solutions that have been described in annual Joint Appraisal (JA) and Multi-stakeholder Dialogue (MSD) reports submitted by country governments to Gavi, the Vaccine Alliance. The library currently contains details on various ‘pro-equity’ activities reported on by countries in their 2016, 2017, 2018, 2019 and 2020 reports. Users can filter the database by step along the Journey to Health and Immunization framework, health system factor or action, country, whether or not the solution includes a gender lens, solution title, keyword, relevance to a specific type of zero-dose community, and the type of implementation challenge that the solution was meant to address. Users can also conduct a free word search in the search bar.
For more information regarding any specific solution listed, please contact immunization programme staff in the relevant government and or UNICEF office within the country. For additional questions, please contact health@unicef.org.
The Journey to Health and Immunization
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Step 1 – Knowledge, awareness & belief
Gender/equity issues influencing knowledge and beliefs
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Step 2 – Intent
Gender norms/equity dimensions impacting uptake and delivery
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Step 3 – Preparation, cost & effort
Gender/equity-related costs and benefits of service access/provision
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Step 4 – Point of service
Gender/equity considerations in health service delivery
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Step 5 – Experience of care
Gender dynamics/equity issues in client-provider interactions
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Step 6 – After service
Gender/equity dimensions in follow-up care and services
Find a Solution
Review the solutions library by Step along the Journey to Health and Immunization,
country, health system element/action, gender lens, or by keyword search
| Steps | Health System Element/Action | Country | Gender-lens | Solution Title | Challenge | Solution | Keywords | Special-relevance | |
|---|---|---|---|---|---|---|---|---|---|
| 6 After service | Workforce | Kenya | yes | Take stock of post-care successes and failures | Health workers may need additional skills and motivation to provide quality care | Health non-governmental (NGO) networks-HENNET provide the needed peer support for immunization service delivery (JA 2016) | continuous learning, motivation, peer-to-peer learning, supportive supervision | ||
| 6 After service | Workforce | Malawi | yes | Take stock of post-care successes and failures | Health workers may need additional skills and motivation to provide quality care | Remote supportive supervision of Expanded Programme on Immunization (EPI) services through Whatsapp during the COVID-19 pandemic (Multi-stakeholder Dialogue Report (MSD) 2020) | continuous learning, motivation, peer-to-peer learning, supportive supervision | ||
| 6 After service | Workforce | Mozambique | yes | Take stock of post-care successes and failures | Health workers may need additional skills and motivation to provide quality care | Increased adverse effects following immunization (AEFI) training, update of materials with engagement of pharmacovigilance (JA 2017) | continuous learning, motivation, peer-to-peer learning, supportive supervision | ||
| 6 After service | Workforce | Nigeria | yes | Take stock of post-care successes and failures | Health workers may need additional skills and motivation to provide quality care | Community Cluster Survey is also incorporated into the monthly routine immunization supportive supervision (RISS) exercise and reported monthly on the open-data kit (ODK) platform (JA 2016) | continuous learning, motivation, peer-to-peer learning, supportive supervision | ||
| 6 After service | Workforce | Senegal | yes | Take stock of post-care successes and failures | Health workers may need additional skills and motivation to provide quality care | The organization of a public recognition ceremony for the best performing structures at the operational level according to criteria defined by the EDCs (JA 2018) | continuous learning, motivation, peer-to-peer learning, supportive supervision | ||
| 6 After service | Workforce | Tanzania | yes | Take stock of post-care successes and failures | Health workers may need additional skills and motivation to provide quality care | Engaging health workers in the testing and implementation of program changes through quality improvement teams. A model implemented resulted in increased health worker motivation, productivity (likely through redistribution of workload), and strengthened teamwork. (https://www.usaidassist.org/sites/default/files/tanzania_evaluation_hivhw_performance_collaborative_july2013.pdf) | continuous learning, motivation, peer-to-peer learning, supportive supervision | ||
| 6 After service | Utilization | Chad | yes | Strengthening accountability, trust, and communication for mobilisation 12 | Lack of accountability, trust and communication | Ensure the promotion of immunisation through the activities of the First Lady as champion of immunisation, the different actors and community networks, the media, the use of NICTs, schools and health centers, and ensure their follow-up, supervision and documentation (JA 2019) | acceptability, beneficiaries, community engagement, feedback, quality of care, satisfaction | ||
| 6 After service | Utilization | Djibouti | yes | Strengthening accountability, trust, and communication for mobilisation | Lack of accountability, trust and communication | Social mobilizers contribute to defaulter tracing and tracking of children lost to follow-up or unimmunized, and provide educational talks on the importance of immunization, in urban areas (JA 2019) | acceptability, beneficiaries, community engagement, feedback, quality of care, satisfaction | ||
| 6 After service | Utilization | Eritrea | yes | Strengthening accountability, trust, and communication for mobilisation | Lack of accountability, trust and communication | 250 health workers trained on patient safety and Adverse Effects Following Immunization (AEFI) surveillance; 416 health workers trained on health care waste management (JA 2019) | acceptability, beneficiaries, community engagement, feedback, quality of care, satisfaction | ||
| 6 After service | Utilization | Indonesia | yes | Strengthening accountability, trust, and communication for mobilisation | Lack of accountability, trust and communication | An SMS-based platform (RapidPro) was used to send automated reminders to caregivers about immunisation schedule for their children. This strategy was implemented in poor urban slum areas of Jakarta with low vaccination rates, high frquency of outbreaks and dropouts (JA 2017) Coverage surveys are conducted in low-coverage areas and the Drop-Out Follow Up (DOFU) strategy is applied to target children for immunisation (JA 2016) | acceptability, beneficiaries, community engagement, feedback, quality of care, satisfaction | ||
| 6 After service | Utilization | Mozambique | yes | Strengthening accountability, trust, and communication for mobilisation | Lack of accountability, trust and communication | Increased adverse effects following immunization (AEFI) training, update of materials with engagement of pharmacovigilance (JA 2017) | acceptability, beneficiaries, community engagement, feedback, quality of care, satisfaction | ||
| 6 After service | Utilization | Myanmar | yes | Strengthening accountability, trust, and communication for mobilisation | Lack of accountability, trust and communication | Supported Adverse Effects Following Immunization (AEFI) surveillance, reporting, case investigation and causality assessment (Multi-stakeholder Dialogue Report (MSD) 2020) | acceptability, beneficiaries, community engagement, feedback, quality of care, satisfaction | ||
| 6 After service | Utilization | Nicaragua | yes | Strengthening accountability, trust, and communication for mobilisation | Lack of accountability, trust and communication | 200 health workers from the prioritized municipalities were trained in the key components of surveillance of vaccine-preventable diseases, injection safety and the monitoring of Adverse Effects Following Immunization (AEFI) (JA 2017) | acceptability, beneficiaries, community engagement, feedback, quality of care, satisfaction | ||
| 6 After service | Utilization | Nigeria | yes | Strengthening accountability, trust, and communication for mobilisation | Lack of accountability, trust and communication | Community engagement strategy includes annual non-monetary rewards systems for religious and traditional leaders as recognition for good performance (JA 2019) | acceptability, beneficiaries, community engagement, feedback, quality of care, satisfaction | ||
| 6 After service | Utilization | Sao Tome and Principe | yes | Strengthening accountability, trust, and communication for mobilisation | Lack of accountability, trust and communication | Training on Adverse Effects Following Immunization (AEFI) for epidemiologists, statisticians and pharmacy technicians (JA 2017) | acceptability, beneficiaries, community engagement, feedback, quality of care, satisfaction | ||
| 6 After service | Utilization | Uzbekistan | yes | Strengthening accountability, trust, and communication for mobilisation | Lack of accountability, trust and communication | Assessment of the Adverse Effects Following Immunization (AEFI) system (JA 2019) | acceptability, beneficiaries, community engagement, feedback, quality of care, satisfaction | ||
| 6 After service | Utilization | Zimbabwe | yes | Strengthening accountability, trust, and communication for mobilisation | Lack of accountability, trust and communication | In order to address vaccine hesitancy, the government has continued to pursue a persuasive approach through interpersonal communication, media briefings, community dialogues, and effective responses to Adverse Effects Following Immunization (AEFI) (JA 2018) | acceptability, beneficiaries, community engagement, feedback, quality of care, satisfaction | ||
| 6 After service | Management & Coordination | Kenya | no | Performance rewards | Lack of community engagement | Employed enhanced door-to-door defaulter tracing by community health workers. Facilities with low coverage of their catchment area generated immunization defaulters list from the Immunization Permanent Registers and assigned the list to community health workers (CHWs) from the catchment area who mapped out the unvaccinated children. CHWs and a vaccinator (nurse) visited house-to-house or assembled unvaccinated kids at a central point if area was considered remote. (https://doi.org/10.1186/s12889-019-7415-8) | community engagement, community performance, rewards | ||
| 6 After service | Management & Coordination | Nigeria | no | Performance rewards | Lack of community engagement | Community engagement strategy includes annual non-monetary rewards systems for religious and traditional leaders as recognition for good performance (JA 2019) | community engagement, community performance, rewards | ||
| 5 Experience of care | Utilization | Afghanistan | yes | Adjusting service delivery approach, engaging community to ensure acceptability | Poor client satisfaction will reduce utilisation and continuation of services, lack of community engagement | Specific training for female vaccinators so that women due for tetanus toxoid vaccines can receive their shots since males vaccinators are a barrier in this setting (JA 2018) | acceptability of health worker, client satisfaction, community engagement, physical conditions, treatment by health worker, triage | ||
| 5 Experience of care | Utilization | Bangladesh | yes | Adjusting service delivery approach, engaging community to ensure acceptability | Poor client satisfaction will reduce utilisation and continuation of services, lack of community engagement | Community support groups consisted of house owners at the outreach site, mothers of children who have completed all doses of vaccines, school/college students (both boys and girls), school teachers, Imams (religious leaders), local elites, and health service providers from the DCC and NGOs working in the slums. The functions of the groups were to assist in ensuring that all scheduled Expanded Programme on Immunization (EPI) sessions were held; to assist in ensuring the registration of the Expanded Programme on Immunization (EPI) target population; to assist the providers in implementing the interventions to reduce drop-outs, invalid doses and left-outs; and to organize meetings with the participation of service providers in order to review Expanded Programme on Immunization (EPI) performance. (doi:10.1093/heapol/czp041) | acceptability of health worker, client satisfaction, community engagement, physical conditions, treatment by health worker, triage | ||
| 5 Experience of care | Utilization | Benin | yes | Adjusting service delivery approach, engaging community to ensure acceptability | Poor client satisfaction will reduce utilisation and continuation of services, lack of community engagement | Pilot community mobilization and communication program is in place in 4 zones (Initiative Vaccination Décentralisée), which emphasizes the involvement of municipalities (elected officials, health agents and community members) in community sensitization on the Expanded Programme on Immunization (EPI) diseases, vaccine schedule, immunization booklets and advantages of immunization (JA 2017) | acceptability of health worker, client satisfaction, community engagement, physical conditions, treatment by health worker, triage | ||
| 5 Experience of care | Utilization | Central Africa Republic | yes | Adjusting service delivery approach, engaging community to ensure acceptability | Poor client satisfaction will reduce utilisation and continuation of services, lack of community engagement | Use of community liaisons to search for children who missed their appointment and tracking with “searching for dropouts†indicator, significantly lowered the dropout rates in target districts. Calendars and monitoring sheets to help search fordropouts were being created (JA 2018) Compensating community liaisons who search for Expanded Programme on Immunization (EPI) dropouts (JA 2018) Tools (schedules) were developed and 134 community liaisons at 67 health facilities in the health region were trained to search for persons lost to follow-up (JA 2019) | acceptability of health worker, client satisfaction, community engagement, physical conditions, treatment by health worker, triage | ||
| 5 Experience of care | Utilization | Chad | yes | Adjusting service delivery approach, engaging community to ensure acceptability | Poor client satisfaction will reduce utilisation and continuation of services, lack of community engagement | Organize the active search for lost children in priority health districts and the rest of the country (use of timetables, involvement of health committees and other opinion leaders) (JA 2019) | acceptability of health worker, client satisfaction, community engagement, physical conditions, treatment by health worker, triage | ||
| 5 Experience of care | Utilization | Cote d’Ivoire | yes | Adjusting service delivery approach, engaging community to ensure acceptability | Poor client satisfaction will reduce utilisation and continuation of services, lack of community engagement | Community mobilisation and advocacy are performed for Expanded Programme on Immunization (EPI) (meetings with prefects for advocacy and mobilization) (JA 2017) | acceptability of health worker, client satisfaction, community engagement, physical conditions, treatment by health worker, triage | ||
| 5 Experience of care | Utilization | Democratic Republic of Congo | yes | Adjusting service delivery approach, engaging community to ensure acceptability | Poor client satisfaction will reduce utilisation and continuation of services, lack of community engagement | Outreach (‘approche antenne’) to 144 ZS including community volunteers to identify unvaccinated children, microplanning (JA 2017) | acceptability of health worker, client satisfaction, community engagement, physical conditions, treatment by health worker, triage | ||
| 5 Experience of care | Utilization | Djibouti | yes | Adjusting service delivery approach, engaging community to ensure acceptability | Poor client satisfaction will reduce utilisation and continuation of services, lack of community engagement | Social mobilizers contribute to defaulter tracing and tracking of children lost to follow-up or unimmunized, and provide educational talks on the importance of immunization, in urban areas. Activities are conducted at community development centres and headquarters of community-based organizations (JA 2019) | acceptability of health worker, client satisfaction, community engagement, physical conditions, treatment by health worker, triage | ||
| 5 Experience of care | Utilization | Eritrea | yes | Adjusting service delivery approach, engaging community to ensure acceptability | Poor client satisfaction will reduce utilisation and continuation of services, lack of community engagement | National Union of Eritrean Women Association, in addition to the National Union of Eritrean Youth and Students and religious organizations work closely with the Expanded Programme on Immunization (EPI) program and contribute to commmunity mobilization and reaching unvaccinated children in less accessible areas (JA 2017) | acceptability of health worker, client satisfaction, community engagement, physical conditions, treatment by health worker, triage | ||
| 5 Experience of care | Utilization | Ethiopia | yes | Adjusting service delivery approach, engaging community to ensure acceptability | Poor client satisfaction will reduce utilisation and continuation of services, lack of community engagement | Development of a community scorecard to help in tailoring services (time, location, care, etc.) to meet the needs of caregivers through use of community outreach agents (JA 2019) Use of community outreach agents to perform community-based monitoring of children eligible for vaccinations thus engaging community leaders and volunteers (JA 2019) | acceptability of health worker, client satisfaction, community engagement, physical conditions, treatment by health worker, triage | ||
| 5 Experience of care | Utilization | Haiti | yes | Adjusting service delivery approach, engaging community to ensure acceptability | Poor client satisfaction will reduce utilisation and continuation of services, lack of community engagement | Strategies for Strengthening Vaccination Programs in Poor Urban Settings: implementing a triage system/fast line to prevent mothers or caregivers who come only for vaccination services from wasting time, and ensuring an efficient flow of patients (https://www.jsi.com/resource/strategies-for-strengthening-vaccination-programs-in-poor-urban-settings-lessons-learned-and-recommendations-for-cite-soleil-haiti/) | acceptability of health worker, client satisfaction, community engagement, physical conditions, treatment by health worker, triage | ||
| 5 Experience of care | Utilization | Indonesia | yes | Adjusting service delivery approach, engaging community to ensure acceptability | Poor client satisfaction will reduce utilisation and continuation of services, lack of community engagement | Community Service Organisation (CSO), religious and community leaders support implementation of immunization activities and community empowerment to support immunization at the community level (JA 2017) Provincial and district officers, health workers, teachers, education office, policy makers, community and religious leaders were all trained to support the HPV programme and demonstration project for girls in primary school (JA 2017) | acceptability of health worker, client satisfaction, community engagement, physical conditions, treatment by health worker, triage | ||
| 5 Experience of care | Utilization | Kenya | yes | Adjusting service delivery approach, engaging community to ensure acceptability | Poor client satisfaction will reduce utilisation and continuation of services, lack of community engagement | Community Strategy, community dialogue meetings and use of community volunteers for house mapping, defaulter tracing and social mobilisation (JA 2017 & 2018) Community Health Volunteer (CHV) engagement and capacity building have improved immunization services through community mobilization and have been able to trace defaulters and bring back to care more than 1000 children who missed immunization (JA 2019) | acceptability of health worker, client satisfaction, community engagement, physical conditions, treatment by health worker, triage | ||
| 5 Experience of care | Utilization | Lao People’s Democatic Republic | yes | Adjusting service delivery approach, engaging community to ensure acceptability | Poor client satisfaction will reduce utilisation and continuation of services, lack of community engagement | Quarterly community meetings are conducted by local leaders and village health volunteers to identify missed children/drop-outs (JA 2019) Pilot Interactive Voice Recording (IVR) project (in 2 provinces) allows village chiefs to report Expanded Programme on Immunization (EPI) outreach and defaulter tracking progress to a centalized helpline, allowing real-time data tracking (JA 2019) During national school-based campaign for HPV vaccination, a collaboration between health centres, schools, village heads and village health volunteers allowed tracking and vaccination of girls who are not in school (Multi-stakeholder Dialogue Report (MSD) 2020) | acceptability of health worker, client satisfaction, community engagement, physical conditions, treatment by health worker, triage | ||
| 5 Experience of care | Utilization | Madagascar | yes | Adjusting service delivery approach, engaging community to ensure acceptability | Poor client satisfaction will reduce utilisation and continuation of services, lack of community engagement | Involvement of community workers (CWs) in all immunisation activities by strengthening communication (interpersonal and mass communication); using community registers; monitoring with CWs, immunisation coverage surveys (ICS) and the general population and housing census (GPHC); use of a smaller sector administrative unit instead of fokontany; adapting the number of CWs to the new subdivision; and mapping and identification of UIC (JA 2018) | acceptability of health worker, client satisfaction, community engagement, physical conditions, treatment by health worker, triage | ||
| 5 Experience of care | Utilization | Mali | yes | Adjusting service delivery approach, engaging community to ensure acceptability | Poor client satisfaction will reduce utilisation and continuation of services, lack of community engagement | Capacity building training for members of civil society (women and youth) for the sensitization and research of non-vaccinated children (JA 2019) | acceptability of health worker, client satisfaction, community engagement, physical conditions, treatment by health worker, triage | ||
| 5 Experience of care | Utilization | Mozambique | yes | Adjusting service delivery approach, engaging community to ensure acceptability | Poor client satisfaction will reduce utilisation and continuation of services, lack of community engagement | Defaulter tracking in districts implementing Reaching Every District (RED) occurs through the support of trained community health workers and community leaders via community registers that are harmonized with facility-level health registers (JA 2017) | acceptability of health worker, client satisfaction, community engagement, physical conditions, treatment by health worker, triage | ||
| 5 Experience of care | Utilization | Myanmar | yes | Adjusting service delivery approach, engaging community to ensure acceptability | Poor client satisfaction will reduce utilisation and continuation of services, lack of community engagement | Advocacy and coordination meeting with partners (non-governmental organizations (NGOs), Ethnic Health Organizations, Community Service Organizations (CSOs) and community leaders) at central, State/ Region, Township and Rural Health Centre (RHC) levels for involvement of all partners in detail, implementing work plan meeting with Township Medical Officers and in midterm and annual evaluation meetings at all levels to further enhance coordination and cooperation among health related partners for Expanded Programme on Immunization (EPI) services including evaluation processes (JA 2018) Meetings with Ethnic Health Organizations (EHO) and recruitment of EHO mentors were conducted to improve the coordination of immunization services in hard to reach, migratory, peri-urban and conflict areas (Multi-stakeholder Dialogue Report (MSD) 2020) | acceptability of health worker, client satisfaction, community engagement, physical conditions, treatment by health worker, triage | ||
| 5 Experience of care | Utilization | Nicaragua | yes | Adjusting service delivery approach, engaging community to ensure acceptability | Poor client satisfaction will reduce utilisation and continuation of services, lack of community engagement | 300 community leaders trained in the use of the immunisation card and its monitoring instrument. Counseling was conducted in their communities regarding the importance of vaccines and the immunisation schedule (JA 2017) | acceptability of health worker, client satisfaction, community engagement, physical conditions, treatment by health worker, triage | ||
| 5 Experience of care | Utilization | Nigeria | yes | Adjusting service delivery approach, engaging community to ensure acceptability | Poor client satisfaction will reduce utilisation and continuation of services, lack of community engagement | Promoted community participation inroutine immunization through the involvement of traditional institutions and Community Resource Groups (CRGs). The strategy involves line-listing of newborns, reconciliation of community line-list with health facility registers, and tracking of defaulters (JA 2019) | acceptability of health worker, client satisfaction, community engagement, physical conditions, treatment by health worker, triage | ||
| 5 Experience of care | Utilization | Rwanda | yes | Adjusting service delivery approach, engaging community to ensure acceptability | Poor client satisfaction will reduce utilisation and continuation of services, lack of community engagement | Use of immunisation e-tracker system linked to community health workers’ (CHWs’) phones to better track the defaulters (JA 2019) | acceptability of health worker, client satisfaction, community engagement, physical conditions, treatment by health worker, triage | ||
| 5 Experience of care | Utilization | Senegal | yes | Adjusting service delivery approach, engaging community to ensure acceptability | Poor client satisfaction will reduce utilisation and continuation of services, lack of community engagement | Action plans developed with input from local civil society organizations, with a focus on specific and innovative communication for the recovery of unvaccinated children (JA 2018) | acceptability of health worker, client satisfaction, community engagement, physical conditions, treatment by health worker, triage | ||
| 5 Experience of care | Utilization | Sierra Leone | yes | Adjusting service delivery approach, engaging community to ensure acceptability | Poor client satisfaction will reduce utilisation and continuation of services, lack of community engagement | Defaulter tracing through community health workers (CHWs) (JA 2018) | acceptability of health worker, client satisfaction, community engagement, physical conditions, treatment by health worker, triage | ||
| 5 Experience of care | Utilization | Somalia | yes | Adjusting service delivery approach, engaging community to ensure acceptability | Poor client satisfaction will reduce utilisation and continuation of services, lack of community engagement | Female health workers travel with mobile populations (nomad, pastoralist and cattle herder populations), to ensure that immunization services occur and to track missed children (Multi-stakeholder Dialogue Report (MSD) 2020) Tracking and registration of nomad populations by clan elders. The list of nomads is compiled by the clan elders and thereafter shared to the health authorities for ease of tracking. 1,300 volunteers have been trained and are usually deployed during supplementary immunisation activities to visit households and remind caregivers about upcoming campaigns (JA 2018) Defaulter tracing through community health workers, community leaders and nomadic leaders (JA 2019) | acceptability of health worker, client satisfaction, community engagement, physical conditions, treatment by health worker, triage | ||
| 5 Experience of care | Utilization | South Sudan | yes | Adjusting service delivery approach, engaging community to ensure acceptability | Poor client satisfaction will reduce utilisation and continuation of services, lack of community engagement | Community mobilizers and vaccinators were trained by Community Service Organizations (CSOs) in community engagement, social mobilization, health education and defaulter tracking (JA 2019) Defaulter tracing, tracking and registering newborns is performed by community mobilizers (JA 2018) | acceptability of health worker, client satisfaction, community engagement, physical conditions, treatment by health worker, triage | ||
| 5 Experience of care | Utilization | Sudan | yes | Adjusting service delivery approach, engaging community to ensure acceptability | Poor client satisfaction will reduce utilisation and continuation of services, lack of community engagement | The majority of volunteer workers providing routine and supplemental immunization services are female. In some areas of Sudan where gender norms limit women from having contact with foreigners (especially men), female vaccinators are selected from local communities, ensuring the respect of social norms (JA 2018) | acceptability of health worker, client satisfaction, community engagement, physical conditions, treatment by health worker, triage | ||
| 5 Experience of care | Utilization | Tanzania | yes | Adjusting service delivery approach, engaging community to ensure acceptability | Poor client satisfaction will reduce utilisation and continuation of services, lack of community engagement | Defaulter tracking performed by Community Health Workers (CHWs) (JA 2019) | acceptability of health worker, client satisfaction, community engagement, physical conditions, treatment by health worker, triage | ||
| 5 Experience of care | Utilization | Timor Leste | yes | Adjusting service delivery approach, engaging community to ensure acceptability | Poor client satisfaction will reduce utilisation and continuation of services, lack of community engagement | Expanded Programme on Immunization (EPI) is supported by school teachers, religious leaders, community-based organizations, mother support groups and local community leaders (JA 2017) | acceptability of health worker, client satisfaction, community engagement, physical conditions, treatment by health worker, triage | ||
| 5 Experience of care | Utilization | Uganda | yes | Adjusting service delivery approach, engaging community to ensure acceptability | Poor client satisfaction will reduce utilisation and continuation of services, lack of community engagement | Village Health Teams (VHTs) register all children in the village and using a tracking tool, track those who have not completed vaccination schedule to ensure they are brought to the session (JA 2018) | acceptability of health worker, client satisfaction, community engagement, physical conditions, treatment by health worker, triage | ||
| 5 Experience of care | Utilization | Yemen | yes | Adjusting service delivery approach, engaging community to ensure acceptability | Poor client satisfaction will reduce utilisation and continuation of services, lack of community engagement | Community Health Volunteers participate in outreach activities and community mobilization for immunization (examples: identifying missed children, encourage referrals to health facilities, etc.) (JA 2016) Inclusion of at least 1 trained female health worker as part of the outreach team to address gender-related barriers to immunization (JA 2016) All community health volunteers are female (JA 2016) | acceptability of health worker, client satisfaction, community engagement, physical conditions, treatment by health worker, triage | ||
| 5 Experience of care | Utilization | Zambia | yes | Adjusting service delivery approach, engaging community to ensure acceptability | Poor client satisfaction will reduce utilisation and continuation of services, lack of community engagement | Defaulter tracing is conducted by community health workers (JA 2018) | acceptability of health worker, client satisfaction, community engagement, physical conditions, treatment by health worker, triage | ||
| 5 Experience of care | Workforce | Burundi | yes | Health workers have the skills and motivation they need | Health workers may need additional skills and motivation to provide quality care | Healthcare worker training in the form of cascade training for the polio vaccine, and interpersonal communication training conducted (JA 2018) | interpersonal communication skills (IPC), pain mitigation, social distance, trust building, work conditions | ||
| 5 Experience of care | Workforce | Central Africa Republic | yes | Health workers have the skills and motivation they need | Health workers may need additional skills and motivation to provide quality care | Renovating 10 high-priority health facilities targeted by the programme (purchasing equipment for health facilities and installing or improving water sources in health facilities) (JA 2018) | interpersonal communication skills (IPC), pain mitigation, social distance, trust building, work conditions | ||
| 5 Experience of care | Workforce | Djibouti | yes | Health workers have the skills and motivation they need | Health workers may need additional skills and motivation to provide quality care | Expanded Programme on Immunization (EPI) training and capacity-building activities in many domains (interpersonal communication, epidemiological surveillance, cascade training, community sensitization, vaccine management and logistics, DHIS2) (JA 2018) | interpersonal communication skills (IPC), pain mitigation, social distance, trust building, work conditions | ||
| 5 Experience of care | Workforce | Eritrea | yes | Health workers have the skills and motivation they need | Health workers may need additional skills and motivation to provide quality care | 250 health workers trained on patient safety and Adverse Effects Following Immunization (AEFI) surveillance; 416 health workers trained on health care waste management (JA 2019) | interpersonal communication skills (IPC), pain mitigation, social distance, trust building, work conditions | ||
| 5 Experience of care | Workforce | Mozambique | yes | Health workers have the skills and motivation they need | Health workers may need additional skills and motivation to provide quality care | Development of an interpersonal communication (IPC) guide, and usage of multiple channels of communication to improve interpersonal communication between caregivers/communities and health system, dissemination of health promotion messages and to encourage community engagement and participation (JA 2017) Increased adverse effects following immunization (AEFI) training, update of materials with engagement of pharmacovigilance (JA 2017) | interpersonal communication skills (IPC), pain mitigation, social distance, trust building, work conditions | ||
| 5 Experience of care | Workforce | Nicaragua | yes | Health workers have the skills and motivation they need | Health workers may need additional skills and motivation to provide quality care | 200 health workers from the prioritized municipalities were trained in the key components of surveillance of vaccine-preventable diseases, injection safety and the monitoring of Adverse Effects Following Immunization (AEFI) (JA 2017) | interpersonal communication skills (IPC), pain mitigation, social distance, trust building, work conditions | ||
| 5 Experience of care | Workforce | Papua New Guinea | yes | Health workers have the skills and motivation they need | Health workers may need additional skills and motivation to provide quality care | Training of all frontline health workers on Infection Prevention and Control (IPC) and Risk Communication and Community Engagement (RCCE) and guidelines for safe conduct of immunization sessions during COVID-19 pandemic (with PPE) (Multi-stakeholder Dialogue Report (MSD) 2020) | interpersonal communication skills (IPC), pain mitigation, social distance, trust building, work conditions | ||
| 5 Experience of care | Workforce | Somalia | yes | Health workers have the skills and motivation they need | Health workers may need additional skills and motivation to provide quality care | Healthcare workers were trained on interpersonal communication (IPC) to improve communication skills with mothers and caregivers (JA 2019) Enhanced used of women community health workers (i.e.: DFID-funded pilot in 8 districts across the country) (JA 2019) | interpersonal communication skills (IPC), pain mitigation, social distance, trust building, work conditions | ||
| 5 Experience of care | Workforce | Tajikistan | yes | Health workers have the skills and motivation they need | Health workers may need additional skills and motivation to provide quality care | Interpersonal communication module developed for training and capacity development of health workers on effective immunization communication (JA 2019) | interpersonal communication skills (IPC), pain mitigation, social distance, trust building, work conditions | ||
| 5 Experience of care | Workforce | Timor Leste | yes | Health workers have the skills and motivation they need | Health workers may need additional skills and motivation to provide quality care | Over 400 primary health care (PHC) workers within 5 municipalities have been trained on interpersonal communication (IPC) (JA 2017) | interpersonal communication skills (IPC), pain mitigation, social distance, trust building, work conditions | ||
| 5 Experience of care | Workforce | Yemen | yes | Health workers have the skills and motivation they need | Health workers may need additional skills and motivation to provide quality care | Inclusion of at least 1 trained female health worker as part of the outreach team to adress gender-related barriers to immunization (JA 2016) All community health volunteers are female (JA 2016) | interpersonal communication skills (IPC), pain mitigation, social distance, trust building, work conditions | ||
| 4 Point of service | Utilization | Bangladesh | yes | Adjust hours/timing of immunization services | Time and opportunity barriers may inhibit utilization | Immunization services are made available on evenings and Fridays to accommodate working mothers in the urban setting (JA 2019) Child immunization coverage in urban slums in Bangladesh. Expanded Programme on Immunization (EPI) services are normally provided from 10:00 am to 2:00 pm. With active collaboration with the DCC and participating NGOs, hours of Expanded Programme on Immunization (EPI) service were extended up to 5:00 pm to enable working mothers to bring their children for vaccination. (doi:10.1093/heapol/czp041) | evening, hours, schedules, time, timing, weekend | Urban | |
| 4 Point of service | Utilization | Cameroon | yes | Adjust hours/timing of immunization services | Time and opportunity barriers may inhibit utilization | Weekend immunization is offered during campaigns or intensified immunization activities, but not routinely (JA 2018) | evening, hours, schedules, time, timing, weekend | Urban | |
| 4 Point of service | Utilization | Cote d’Ivoire | yes | Adjust hours/timing of immunization services | Time and opportunity barriers may inhibit utilization | Immunisation activities are adapted to mothers’ schedules and take into consideration market days and agricultural work responsibilities (JA 2018) | evening, hours, schedules, time, timing, weekend | Urban | |
| 4 Point of service | Utilization | Djibouti | yes | Adjust hours/timing of immunization services | Time and opportunity barriers may inhibit utilization | Immunization services are available until 5pm, which improves accessibility. Additionally, private clinics can offer immunization services in the morning (8am-12pm) and in the evening (4pm-9pm) to accommodate families (JA 2019) | evening, hours, schedules, time, timing, weekend | Urban | |
| 4 Point of service | Utilization | Ethiopia | yes | Adjust hours/timing of immunization services | Time and opportunity barriers may inhibit utilization | Development of a community score-card to help in tailoring services (time, location, care, etc.) to meet the needs of caregivers through use of community outreach agents (JA 2019) | evening, hours, schedules, time, timing, weekend | Urban | |
| 4 Point of service | Utilization | India | yes | Adjust hours/timing of immunization services | Time and opportunity barriers may inhibit utilization | Intensified Mission Indradhanush (IMI) which is a strategy of reaching the high-risk populations was launched as one of the PRAGATI initiatives, to accelerate progress in identifying poor performing districts and urban areas to reach them with immunization services (JA 2017) | evening, hours, schedules, time, timing, weekend | Urban | |
| 4 Point of service | Utilization | Kenya | yes | Adjust hours/timing of immunization services | Time and opportunity barriers may inhibit utilization | The Government of Kenya implemented a policy extending opening hours of health facilities in Nairobi, and procured mobile clinics to increase access to immunization service delivery. This will help mitigate the adverse effects on communities and informal settlements who are affected by poor timing of services (JA 2017) | evening, hours, schedules, time, timing, weekend | Urban | |
| 4 Point of service | Utilization | Mali | yes | Adjust hours/timing of immunization services | Time and opportunity barriers may inhibit utilization | Weekend immunization activities occur regularly in the ASACOYIR health area (Commune 6) (JA 2019) Immunization services made available every working day in commune 7 of the District of Bamako (JA 2019) | evening, hours, schedules, time, timing, weekend | Urban | |
| 4 Point of service | Utilization | Pakistan | yes | Adjust hours/timing of immunization services | Time and opportunity barriers may inhibit utilization | Business-hour vaccination sessions introduced in Pakistan’s urban centres (JA 2019) | evening, hours, schedules, time, timing, weekend | Urban | |
| 4 Point of service | Utilization | Senegal | yes | Adjust hours/timing of immunization services | Time and opportunity barriers may inhibit utilization | Multiple methods to improve accessibility such as fixed, mobile and night-time immunisation in certain districts in Dakar, in addition to weekend immunization, as part of the Reaching Every Community (REC) strategy (JA 2019) Vaccination service delivery hours were adjusted to improve service delivery. Services offered in afternoons, Saturdays, and evenings. The altered hours were adopted by 4 of 7 districts in Dakar (center, north, west, and Keur Massar) (Vincent T, Dubourg JC, Correia G, Biey J, Flamigni G. Joint Gavi Alliance Mission Report: Capitalizing on Best practices. Senegal Expanded Programme of Immunization. 16-20 April 2018. Dakar, Senegal: World Health Organisation, Senegal Programme Elargi de Vaccination, UNICEF, Gavi.) | evening, hours, schedules, time, timing, weekend | Urban | |
| 4 Point of service | Utilization | Somalia | yes | Adjust hours/timing of immunization services | Time and opportunity barriers may inhibit utilization | Adjusting immunization services to 6 days per week to acccomodate population needs (e.g. women who are involved in trading activities to support their families) (JA 2018) | evening, hours, schedules, time, timing, weekend | Urban | |
| 4 Point of service | Utilization | Uganda | yes | Adjust hours/timing of immunization services | Time and opportunity barriers may inhibit utilization | Reaching Every Community (REC)-Quality Improvement (QI) approach engaging non-health stakeholders to be served by a routine immunisation service point, and the most convenient location, days and times for outreach and services (JA 2017) Timing for outreach in urban areas changed to weekends especially on Sundays to facilitate better access and coverage for immunization services (JA 2018) | evening, hours, schedules, time, timing, weekend | Urban | |
| 4 Point of service | Utilization | Afghanistan | yes | Tailor location of service delivery | Location barriers may inhibit utilization | 19 cross-border vaccination points have been established (JA 2017) High risk mobile populations are vaccinated by the 378 permanent transit teams (JA 2017) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Bangladesh | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Mass vaccination campaigns conducted among refugee and displaced populations in Ukia and Teknaf upazila (JA 2019) Mapping of hard to reach populations, slums and areas without immunization coverage through geographic information system (GIS) mapping tool (Expanded Programme on Immunization (EPI) app) are carried out to identify unimmunized and zero-dose children (JA 2019) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Benin | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Mixed strategy for delivery of immunisation services, including fixed posts at health centers and advanced strategy in schools and community locations (public and religious spaces) (JA 2017) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Burundi | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Pilot HPV demonstration project for HPV conducted in schools to vaccinate girls in 3rd grade and 10 year olds who are not in school in 2 regions (Ngozi and Rumonge) (JA 2018) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Cameroon | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Mapping of camps and routes for nomadic populations (pygmy populations) and outreach efforts for joint immunisation of children and livestock from these populations (JA 2019) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Central Africa Republic | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Implementation of the Urban Immunisation Strategy in the city of Bangui (JA 2019) Implementation of the immunisation strategy for special populations (nomads, pygmies, IDPs/refugees, fishermen, mining sites, markets, etc.) in the Gavi intervention areas (JA 2019) Implementation of the Reaching Every District (RED) strategy in HRs 1, 2 and 3 (JA 2019) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Chad | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Elaboration of the plan for the revitalization of vaccination in N’Djamena (urban strategy) (JA 2019) Integrate/reinforce vaccination in social centres, army and private health structures (equipment, training, reporting; monitoring; supervision, etc.) (JA 2019) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Cote d’Ivoire | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Immunisation activities are adapted to mothers’ schedules and take into consideration market days and agricultural work responsibilities (JA 2018) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Democratic Republic of Congo | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Updating of the microplanning on the basis of 2016 as per the analysis of equity at all levels (HAs with the community, consolidated at the health zones (HZs) and branches) in the PHDs supported for routine immunisation strengthening (JA 2018) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Djibouti | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Special mobile teams are assigned to deliver essential and integrated services in rural and difficult-to-access areas, and transit point immunization at water points and transhumance corridors for rural and difficult to access areas, normadic and internally displaced populations (JA 2019) Joint effort by the Ministry of Health, the World Health Organization, the Organization of International Migration (OIM) and the UNHCR to map vulnerable target populations who should be immunized. Cross-border zones and migrant corridors have been considered and a polio immunization plan prioritising target populations in refugee camps was developed by the Expanded Programme on Immunization (EPI) (JA 2019) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Eritrea | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Periodic Intensified Routine Immunization (PIRI) activities for hard to reach areas and nomadic populations, including mapping of low coverage areas to determine bottlenecks in immunization delivery and improve defaulter tracking. Examples of outreach methods include renting boat/animals to faciiltate traveling (JA 2019) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Ethiopia | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Development of a community score-card to help in tailoring services (time, location, care, etc.) to meet the needs of caregivers through use of community outreach agents (JA 2019) Mapping of water points and livestock markets and forming a partnership with animal health program to improve access to immunization services (JA 2019) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Ghana | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Screening of school children at entry to school and providing missed vaccinations (JA 2019) Procurement of motorbikes in districts/sub-districts in hard to reach areas to support access to service delivery (JA 2017) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Guinea | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Immunization supplies and equipment are installed in private, religious and armed forces infrastructures, to expand the supply of vaccination services for populations that are harder to reach in urban areas (JA 2019) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Haiti | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Microplanning was performed in 9 departments to guarantee geographic equity in immunisation and community participation in immunisation (JA 2016) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | India | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Intensified Mission Indradhanush (IMI) which is a strategy of reaching the high-risk populations was launched as one of the PRAGATI initiatives, to accelerate progress in identifying poor performing districts and urban areas to reach them with immunization services (JA 2017) Microplans for wards of urban areas developed by utilizing the learnings from the Polio eradication programme (JA 2018) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Indonesia | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Reaching Every Community (REC) activities are conducted in high risk communities in urban slum areas (JA 2017) Sustainable Outreach Services (SOS) are applied in hard to reach areas to target unimmunized children (JA 2016) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Kenya | yes | Tailor location of service delivery | Location barriers may inhibit utilization | The Government of Kenya implemented a policy extending opening hours of health facilities in Nairobi, and procured mobile clinics to increase access to immunization service delivery. This will help mitigate the adverse effects on communities and informal settlements who are affected by poor timing of services (JA 2017) Urban microplanning sessions for immunization (JA 2018) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Kyrgyzstan | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Combination of vaccination stategies for immunization including fixed stationary, reach out and mobile teams (Multi-stakeholder Dialogue Report (MSD) 2020) Conduct immunization sessions by mobile teams in selected remote and hard-to-reach areas and in new settlements in Bishkek and Osh, inhabited mostly by internal migrants (JA 2019) Reaching Every Community (REC) planning approach for hard to reach populations and urban migrant populations (JA 2016) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Lao People’s Democatic Republic | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Activities (microplanning) for immunization include fixed, outreach, and catch-up campaigns for hard to reach and high risk areas (JA 2019) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Lesotho | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Construction of health posts in hard to reach areas, procurement of 4 X 4 vehicles to be deployed in selected districts for the sole purpose of strengthening outreach in these districts, and catering for the provision of lunch when conducting outreach (JA 2016) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Liberia | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Marketplace immunization activities were conducted to reach working mothers and unvaccinated children (JA 2019) Outreach immunization activities every 6 months for populations that live beyond 5km from health facilities (29% of the population) (JA 2019) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Madagascar | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Operational research at the level of the 8 major cities to know the reason for non-vaccination (Mapping of non-vaccinated people through a study of the location and reasons). The implementation of operational research in the 8 major cities planned for the third quarter of 2019 (JA 2019) Determine population targets through mini-census/ use of community registers to inform microplans (JA 2018) Short guide and tools on the urban REC approach has recently been prepared and is ready to be used, initially in the eight large cities of Madagascar (JA 2018) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Malawi | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Mapping of eligible girls for HPV vaccine through teachers in schools and parents, and subsequent vaccination in schools (JA 2019) Immunization activities in rural and urban areas are conducted through fixed (public and private health facilities) and outreach sites (churches, mosques, classrooms, health posts, under a tree, or designated well known areas) in 29 health administrative districts (JA 2018) Mapping of hard to reach poppulationss and implementation of periodic intensification of routine immunization (PIRI) services in those locations (JA 2018) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Mali | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Vaccination points stationed on the routes of working mothers (markets bus stations, fair days, railway stations, in front of mosques, slums) and at group sites (Yirimadio camp in commune 7) (JA 2019) Analysis of equity in immunisation was performed in 11 priority districts and micro-planning action plans were developed to target hard to reach populations (nomads, displaced by conflict, peri-urban, etc.) (JA 2018) Implementation of the Reaching Every Child strategy in 11 priority districts and 12 other districts (JA 2019) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Mozambique | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Fixed vaccination posts are used for finding unvaccinated children (defaulter tracing) and improving immunization coverage (Multi-stakeholder Dialogue Report (MSD) 2020) Reaching Every District/Reaching Every Community (RED/REC) Strategy Digitalisation Proposal developed (and initiated) to map populations and geographic areas with least access to immunization via geographic information systems (GIS) with a geospatial component (MSD 2020) the RED strategy has been implemented in low performing province districts through strengthening of district and health facility-based micro planning and budgeting (JA 2017) Peste des petits ruminants (PPR) strategic plan (“Vaccination Readiness and Response Plan in the Context of COVID-19”) was developed to intensify integrated outreach activities to reach missed children from hard-to-reach/missed communities, zero-dose children and under-vaccinated children (before and due to COVID-19) (MSD 2020) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Myanmar | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Pilot geographic information systems (GIS) project for Expanded Programme on Immunization (EPI) microplanning and monitoring in 5 townships in Yangon region to improve immunization coverage and equity (Multi-stakeholder Dialogue Report (MSD) 2020) Strategic plan for reaching hard to reach developed and implemented, migratory, peri-urban and conflict areas (JA 2017) Urban Immunization strategy was developed with expansion of fixed posts continued under HSS2 implementation. Services will be linked for improved community empowerment (JA 2019) Urban immunization strategy and robust micro plans for urban areas for routine immunization developed (JA 2019) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Nigeria | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Development of geographic information system (GIS)-based Reaching Every Ward (REW) micro-plan in 8 low performing states (JA 2019) Harmonisation of Micro plans – as part of the country’s effort to transition to an integrated system combining routine and supplementary immunization activity (SIA) microplans (Yellow fever, Measles, Menigitis A, Measles second dose and Maternal Neonatal Tetatnus Elimination (MNTE)) (JA 2019) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Pakistan | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Piloting of innovative approaches in close collaboration with Community Service Organizations (CSOs) in urban slums, parliamentarian advocacy activities (JA 2016) Specialized mobile clinics to provide integratedroutine immunization services in slums of targeted mega cities (Karachi, Lahore, Peshawar and Quetta) (JA 2019) Punjab has developed a strategy to target migratory populations at transit points (JA 2016) Transitory point immunization including locations like bus stations, airports and regular transit areas between districts (JA 2016) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Papua New Guinea | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Low coverage areas, underserved communities and unvaccinated children are targeted through the UNICEF equity improvement program (Multi-stakeholder Dialogue Report (MSD) 2020) Support of mobile and outreach sessions by STOP team and WHO short term consultants and guidance issued on how to safely conduct fixed immunization sessions observing infection prevention and control (fixed sessions resumed) (MSD 2020) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Sao Tome and Principe | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Micro planning and mapping of hard to reach areas are performed to reach and improve access to immunisation for specific hard to reach children (JA 2017) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Senegal | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Multiple methods to improve accessibility such as fixed, mobile and night-time immunisation in certain districts in Dakar, in addition to weekend immunization, as part of the Reaching Every Community (REC) strategy (JA 2019) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Solomon Islands | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Reaching Every District (RED) strategy implemented to promote microplanning, defaulter tracking, social mobilization, outreach activities, supervision and national data availability (JA 2019) Outreach activities in low performing zones, including immunization catch up activities and defaulter tracing for hard to reach communities (JA 2019) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Somalia | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Settting up transit point vaccination for populations moving between accessible and inacessible areas (civil war context) (JA 2018) Delivery of services through a multi-pronged strategy composed of fixed, outreach and mobile strategies in 8 districts of the State of Puntland (JA 2019) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | South Sudan | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Fixed, outreach and Periodic Intensification of Routine Immunization (PIRI) activities are used to reach unimmunized populations (missing doses or initiating first doses) (JA 2018) Social mapping in 67/80 counties. Social map is used to develop micro planning for immunization, tracking of missed children and selecting sites for outreach routine Expanded Programme on Immunization (EPI) activities and deployment of community mobilizers (JA 2018) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Sudan | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Combination of fixed, mobile and outreach immunization activities to reach all populations (nomad, displaced) based on the Reaching Every Child/Reaching Every District (REC/RED) strategy, including house visits by vaccinators 4 times a month (JA 2018) The majority of volunteer workers providing routine and supplemental immunization services are female. In some areas of Sudan where gender norms limit women from having contact with foreigners (especially men), female vaccinators are selected from local communities, ensuring the respect of social norms (JA 2018) Conduction of integrated EPI/PHC mobile sessions for disadvantaged populations and communities with low access to fixed facilities in rural and remote settings (JA 2016) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Syria | yes | Tailor location of service delivery | Location barriers may inhibit utilization | National Vaccination Program: Mobile vaccination strategy to reach all women and chilldren in settlements with no health units that provide immunization services. Mobile teams work with local community leaders to conduct communication for immunization, defaulter tracking, and community sensitization | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Tanzania | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Reaching Every Child Strategy is implemented in 610 low performing health facilities around the country to ensure reaching unvaccinated children (JA 2017) Periodical Intensification of Routine Immunization (PIRI) activities were conducted during African vaccination week and contribute to reaching unvaccinated children in rural and urban settings (JA 2017) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Timor Leste | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Immunization services provider through fixed posts, with limited outreach activities. The Family Health Program conducts some home visits for immunization (JA 2016) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Uganda | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Reaching Every Community (REC) Quality Improvement (QI) approach engaging non-health stakeholders to be served by a routine immunisation service point, and the most convenient location, days and times for outreach and services (JA 2017) Through implementation of the Reaching Every District/Reaching Every Community (RED/REC) strategy (linking services to communities component), the social mapping tool was used to identify key community structures and individuals for mobilisation | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Vietnam | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Mobile team outreach immunization activities in hard to reach areas (JA 2018) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Zambia | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Outreach immunization activities are conducted at trading places (fishing camps, market places) to improve access to services (JA 2018) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Zimbabwe | yes | Tailor location of service delivery | Location barriers may inhibit utilization | Reaching Every District/ Reaching Every Community (RED/REC) strategy is implemented in the country (JA 2016) | campaign, church, location, mapping, market, microplan, mobile, mosque, outreach, Periodic Intensification of Routine Immunization (PIRI), Reaching Every Community (REC), Reaching Every District (RED), school, station, time, transhumance, transit sites | conflict affected, Remote rural, Urban | |
| 4 Point of service | Utilization | Bangladesh | yes | Security to allow immunization services to happen safely | Insecurity prohibits access and utilization | Security services deployed during immunization campaigns for refugee populations in Ukia and Teknaf upazila (JA 2019) | evening hours, insecurity, late hours, safety, security | conflict affected, Urban | |
| 4 Point of service | Utilization | Guinea | yes | Integration of immunization with PHC | Vertical immunization programmes create time and opportunity costs for clients | Creation of convergence programme (for synergy and complementarity of actions) by Government and UNICEF, aimed at improving availability of vaccines, complementing support from financial partners and responsibilities of legal officials, champions of immunization and community and religious leaders, as well as organizing community dialogue sessions to promote immunization (JA 2018) | convenience, integration, PHC, primary health care | ||
| 4 Point of service | Utilization | India | yes | Integration of immunization with PHC 2 | Vertical immunization programmes create time and opportunity costs for clients | Vaccines & Immunization Research Network and its “Scientific Advisory Group (SAG)†established for evidence building and to guide new research and rolled-out on vaccines and immunization (JA 2017) Joint Transition Planning Framework (Polio to Public Health, 2017-2026) developed and being implemented as approved by the Government of India (GoI) (JA 2018) Immunization Coverage Improvement Plan (iCIP) developed following comprehensive Urban Immunization Programme (UIP) reviews in targeted states of Bihar, Madhya Pradesh, Maharashtra, Rajasthan and Uttar Pradesh (JA 2019) | convenience, integration, PHC, primary health care | ||
| 4 Point of service | Utilization | Kenya | yes | Integration of immunization with PHC 3 | Vertical immunization programmes create time and opportunity costs for clients | Annual joint planning and forecasting workshops to integrate immunization and other service delivery plans (JA 2017 & 2018) | convenience, integration, PHC, primary health care | ||
| 4 Point of service | Utilization | Kyrgyzstan | yes | Integration of immunization with PHC 4 | Vertical immunization programmes create time and opportunity costs for clients | The Health Sector is supported by the Sector Wide Approach (SWAp) in Kyrgzystan. KfW, Swiss Government and the World Bank support to the health sector is pooled in the SWAp and managed by the World Bank (JA 2017). | convenience, integration, PHC, primary health care | ||
| 4 Point of service | Utilization | Malawi | yes | Integration of immunization with PHC 5 | Vertical immunization programmes create time and opportunity costs for clients | Sector Wide Approach (SWAp) used to coordinate financing of health services and interventions (JA 2018) | convenience, integration, PHC, primary health care | ||
| 4 Point of service | Utilization | Mozambique | yes | Integration of immunization with PHC 6 | Vertical immunization programmes create time and opportunity costs for clients | The country has an Inter-agency Coordinating Commity (ICC) to provide oversight, mobilize resources and coordinate partner support to the program. The National Logistics Working Group addresses specifically Expanded Programme on Immunization (EPI) supply chain and logistics issues – members include VillageReach, CHAI, UNICEF, USAID, CMAM and HAI (JA 2017) Costing study is underway to inform the Ministry of Health for planning and replication (JA 2017) | convenience, integration, PHC, primary health care | ||
| 4 Point of service | Utilization | Nepal | yes | Integration of immunization with PHC 7 | Vertical immunization programmes create time and opportunity costs for clients | Nepal Health Sector Strategy is modeled on the Sector Wide Approach (SWAp) and focuses on partnerships and multi-sectoral approaches for health development (JA 2018) | convenience, integration, PHC, primary health care | ||
| 4 Point of service | Utilization | Nigeria | yes | Integration of immunization with PHC 8 | Vertical immunization programmes create time and opportunity costs for clients | Development partners and Bauchi State Ministry of Health (MoH) signed a Memorandum of Understanding (MoU) in support of one state-wide plan that is coordinated through a primary healthcare technical working group (JA 2018) Bill and Melinda Gates Foundation (BMGF) and Dangote Foundation are supporting 6 states in the form of an MoU to address primary health care (PHC) and routine immunization (JA 2019) (https://www.unicef.org/nigeria/media/2426/file/AAI%20Bauchi.pdf) | convenience, integration, PHC, primary health care | ||
| 4 Point of service | Utilization | Senegal | yes | Integration of immunization with PHC 9 | Vertical immunization programmes create time and opportunity costs for clients | Local government operational plans (POCLs) – which take into account immunization activities and the budgets and contributions of partners, the community and local authorities (JA 2018) | convenience, integration, PHC, primary health care | ||
| 4 Point of service | Utilization | Solomon Islands | yes | Integration of immunization with PHC 10 | Vertical immunization programmes create time and opportunity costs for clients | Memorandum of Understanding (MoU) between Ministry of Health and Medical Services (MHMS) and the Solomon Island Churches Association (SICA) to improve program-focused work (JA 2019) | convenience, integration, PHC, primary health care | ||
| 4 Point of service | Utilization | Sudan | yes | Integration of immunization with PHC 11 | Vertical immunization programmes create time and opportunity costs for clients | Federal Minstry of Health (MOH) has adopted the “One Plan, One Budget, One Report” approach to harmonize implementation of immunization strategies (JA 2018) To counter the costliness and unsustainability of the mobile strategy for immunization delivery, Ministry of Health (MoH) expanded fixed immunization network as part of the primary health care (PHC) expansion project (aims at ensuring universal coverage by basic PHC immunization services) (JA 2016) | convenience, integration, PHC, primary health care | ||
| 4 Point of service | Utilization | Uganda | yes | Integration of immunization with PHC 12 | Vertical immunization programmes create time and opportunity costs for clients | Joint planning and quarterly review meetings with district health stakeholders in Kalungu over the past year (JA 2018) | convenience, integration, primary health care (PHC) | ||
| 4 Point of service | Management & Coordination | Afghanistan | no | Negotiating access to populations affected by conflict | Populations may be inaccessible by health providers or may not be able to access services during conflict | Public Private Partnership (PPP) model as an innovation which provides basic reproductive and immunization services in the remote and insecure districts of six provinces in the country where both government and non-governmental organizations (NGOs) are not able to provide these services to the people (JA 2016) Rounds of accelerated immunization activities conducted in conflict affected and high-risk provinces (JA 2019) | access during conflict, conflict zones, corridors of peace, insecurity, negotiating with rebel groups, safe havens, sanctuaries of peace, security, zones of peace | Conflict | |
| 4 Point of service | Management & Coordination | Cameroon | no | Negotiating access to populations affected by conflict | Populations may be inaccessible by health providers or may not be able to access services during conflict | Humanitarian assistance plan was developed based on Reaching Every District (RED) and Missed Opportunities for Vaccination strategies to ensure that routine immunization services and activities continue in conflict setting in Northwest and Southwest regions and in the districts at risk for epidemics (JA 2018) | access during conflict, conflict zones, corridors of peace, insecurity, negotiating with rebel groups, safe havens, sanctuaries of peace, security, zones of peace | Conflict | |
| 4 Point of service | Management & Coordination | Central Africa Republic | no | Negotiating access to populations affected by conflict | Populations may be inaccessible by health providers or may not be able to access services during conflict | Equipment (solar panels and refrigerators) will be equipped with anti-theft mechanisms due to the security context in the Central African Republic (CAR); aside from physical security for equipment, the deployment plan will include community involvement to ensure security of the facilities (JA 2018) | access during conflict, conflict zones, corridors of peace, insecurity, negotiating with rebel groups, safe havens, sanctuaries of peace, security, zones of peace | Conflict | |
| 4 Point of service | Management & Coordination | Chad | no | Negotiating access to populations affected by conflict | Populations may be inaccessible by health providers or may not be able to access services during conflict | Intensified Vaccination Activities implemented in 7 areas that are difficult to access (JA 2016) | access during conflict, conflict zones, corridors of peace, insecurity, negotiating with rebel groups, safe havens, sanctuaries of peace, security, zones of peace | Conflict | |
| 4 Point of service | Management & Coordination | Eritrea | no | Negotiating access to populations affected by conflict | Populations may be inaccessible by health providers or may not be able to access services during conflict | Tracking of less accessible geographical areas is done by community groups, who participate in microplanning and facilitate the Expanded Programme on Immunization (EPI) activities in less accessible areas (ex: lending camels to Expanded Programme on Immunization (EPI) staff to access difficult areas), as per the Reaching Every District/Reaching Every Community (RED/REC) approach (JA 2017) | access during conflict, conflict zones, corridors of peace, insecurity, negotiating with rebel groups, safe havens, sanctuaries of peace, security, zones of peace | Conflict | |
| 4 Point of service | Management & Coordination | Mali | no | Negotiating access to populations affected by conflict | Populations may be inaccessible by health providers or may not be able to access services during conflict | Recruitment of vaccinators from the communities in conflict-affected areas and use of animal-drawn carts to access these populations (in the context of restricted circulation of motorized vehicles in those areas) (JA 2019) | access during conflict, conflict zones, corridors of peace, insecurity, negotiating with rebel groups, safe havens, sanctuaries of peace, security, zones of peace | Conflict | |
| 4 Point of service | Management & Coordination | Nigeria | no | Negotiating access to populations affected by conflict | Populations may be inaccessible by health providers or may not be able to access services during conflict | Dialogue with bandit groups to allow access for immunization services (JA 2019) Special strategies such as hit and run and collaboration with the military authorities in security compromised areas (JA 2016) | access during conflict, conflict zones, corridors of peace, insecurity, negotiating with rebel groups, safe havens, sanctuaries of peace, security, zones of peace | Conflict | |
| 4 Point of service | Management & Coordination | Somalia | no | Negotiating access to populations affected by conflict | Populations may be inaccessible by health providers or may not be able to access services during conflict | Setting up mobile teams to provide services to populations displaced by conflict (JA 2018) | access during conflict, conflict zones, corridors of peace, insecurity, negotiating with rebel groups, safe havens, sanctuaries of peace, security, zones of peace | Conflict | |
| 4 Point of service | Management & Coordination | South Sudan | no | Negotiating access to populations affected by conflict | Populations may be inaccessible by health providers or may not be able to access services during conflict | Rapid Response Mission (RRM) teams provide immunization services (and WaSH, nutrition) in hard-to-reach locations and conflict-affected states (JA 2018) | access during conflict, conflict zones, corridors of peace, insecurity, negotiating with rebel groups, safe havens, sanctuaries of peace, security, zones of peace | Conflict | |
| 4 Point of service | Management & Coordination | Sudan | no | Negotiating access to populations affected by conflict | Populations may be inaccessible by health providers or may not be able to access services during conflict | CSO trained volunteers to respond to health emergencies (such as acute watery diarrhea) and provide basic health services in security compromised areas (JA 2018) | access during conflict, conflict zones, corridors of peace, insecurity, negotiating with rebel groups, safe havens, sanctuaries of peace, security, zones of peace | Conflict | |
| 4 Point of service | Management & Coordination | Syria | no | Negotiating access to populations affected by conflict | Populations may be inaccessible by health providers or may not be able to access services during conflict | National Vaccination Program: Mobile vaccination strategy to reach all women and chilldren in settlements with no health units that provide immunization services. Mobile teams work with local community leaders to conduct communication for immunization, defaulter tracking, and community sensitization | access during conflict, conflict zones, corridors of peace, insecurity, negotiating with rebel groups, safe havens, sanctuaries of peace, security, zones of peace | Conflict | |
| 4 Point of service | Management & Coordination | Yemen | no | Negotiating access to populations affected by conflict | Populations may be inaccessible by health providers or may not be able to access services during conflict | Integrated Outreach Rounds (IOR) activities were implemented for hard to reach areas, security compromised areas, internally displaced populations, and high risk populations. IOR involve immunization activities, defaulter tracking, integrated management of childhood diseases and nutrition, among others (JA 2019) Access to hard to reach or conflict populations is mediated by third parties (NGOs) due to security concerns, instead of Government involvement (JA 2016) | access during conflict, conflict zones, corridors of peace, insecurity, negotiating with rebel groups, safe havens, sanctuaries of peace, security, zones of peace | Conflict | |
| 4 Point of service | Management & Coordination | Bangladesh | no | Improved information and data management systems | missing data, inaccurate data, poor monitoring, parallel systems of data management, lack of birth registration, inaccurate population denominators | Government of Bangladesh developed an Immunization Individual Tracking System (online registration) for tracking child immunization status through DHIS2-based android app with both offline and online functionality, and with availability of system generated SMS services to remind mothers and care-givers for due and overdue vaccination. The e-Tracker is an effective and reliable registration system of children that can monitor unvaccinated, partially vaccinated and fully vaccinated children (JA 2019) In 2019, the Android version of DHIS2 Expanded Programme on Immunization (EPI) e-Register (both online and offline) was developed and rolled out in seven Upazilas and one zone of city corporation. The scale-up of the e-registry and tracker is envisaged with the HSS3 programme in Bangladesh. (https://doi.org/10.1186/s40249-019-0538-4) | bracelets, cards, Civil Registry Vital Statistics (CRVS), data, DHIS2, district health information system software, eHMIS, Electronic Immunization Registry (EIR), eLMIS, Health Management Information System (HMIS), home-based records, monitoring, population estimates, registers, registration | ||
| 4 Point of service | Management & Coordination | Benin | no | Improved information and data management systems | missing data, inaccurate data, poor monitoring, parallel systems of data management, lack of birth registration, inaccurate population denominators | Implementation of a computerized logistics information system (SIIL) in the health zones implementing the Optimized Logistics System (SLO). The SIIL is an electronic system for the management of logistic information for health products, allowing to follow a certain number of logistic indicators (JA 2017) | bracelets, cards, Civil Registry Vital Statistics (CRVS), data, DHIS2, district health information system software, eHMIS, Electronic Immunization Registry (EIR), eLMIS, Health Management Information System (HMIS), home-based records, monitoring, population estimates, registers, registration | ||
| 4 Point of service | Management & Coordination | Central Africa Republic | no | Improved information and data management systems | missing data, inaccurate data, poor monitoring, parallel systems of data management, lack of birth registration, inaccurate population denominators | Set up this DHIS2 in the seven HRs, for data encoding by health facility and MAGPI data import (JA 2019) | bracelets, cards, Civil Registry Vital Statistics (CRVS), data, DHIS2, district health information system software, eHMIS, Electronic Immunization Registry (EIR), eLMIS, Health Management Information System (HMIS), home-based records, monitoring, population estimates, registers, registration | ||
| 4 Point of service | Management & Coordination | Chad | no | Improved information and data management systems | missing data, inaccurate data, poor monitoring, parallel systems of data management, lack of birth registration, inaccurate population denominators | Computerized tools for the management and monitoring of stocks of vaccines and consumables (stock management tool (SMT) and the District Vaccination Data Management Tool (DVD-MT) at the central, provincial and district levels (JA 2019) Use New Information and Communication Technologies (NICT) for data management at all levels. To this end, the tablets will be acquired in the framework of this PSR to help solve the problem of data timeliness and facilitate interoperability between DHIS2 and SIGL relating to the monitoring of stock management in real time (JA 2019) | bracelets, cards, Civil Registry Vital Statistics (CRVS), data, DHIS2, district health information system software, eHMIS, Electronic Immunization Registry (EIR), eLMIS, Health Management Information System (HMIS), home-based records, monitoring, population estimates, registers, registration | ||
| 4 Point of service | Management & Coordination | Democratic Republic of Congo | no | Improved information and data management systems | missing data, inaccurate data, poor monitoring, parallel systems of data management, lack of birth registration, inaccurate population denominators | Improvement of data quality and use of quality data: decentralisation of databases in six provinces and training of personnel for quality monitoring and analysis (JA 2018) | bracelets, cards, Civil Registry Vital Statistics (CRVS), data, DHIS2, district health information system software, eHMIS, Electronic Immunization Registry (EIR), eLMIS, Health Management Information System (HMIS), home-based records, monitoring, population estimates, registers, registration | ||
| 4 Point of service | Management & Coordination | Djibouti | no | Improved information and data management systems | missing data, inaccurate data, poor monitoring, parallel systems of data management, lack of birth registration, inaccurate population denominators | Implementation of an early warning system (EWARN) is in its final phase. DHIS2 is being finalised to help with reporting and declaring cases in routine surveillance (JA 2019) Desk review of data with assessment of completeness, timeliness and triangulation with other data sources. Objective to conduct quantitative verifications of data with the different collection tools concerning two vaccines, and qualitative assessment of the components of immunisation (through questionnaire) (JA 2019) Improvements and planning of monitoring, evaluation and reporting systems continue. Tools are completed and up to date (JA 2019) | bracelets, cards, Civil Registry Vital Statistics (CRVS), data, DHIS2, district health information system software, eHMIS, Electronic Immunization Registry (EIR), eLMIS, Health Management Information System (HMIS), home-based records, monitoring, population estimates, registers, registration | ||
| 4 Point of service | Management & Coordination | Eritrea | no | Improved information and data management systems | missing data, inaccurate data, poor monitoring, parallel systems of data management, lack of birth registration, inaccurate population denominators | Expanded Programme on Immunization (EPI) data is integrated with the health management information system (HMIS). DHIS2 is used at the Zoba level currently with plans for expansion to districts (JA 2019) | bracelets, cards, Civil Registry Vital Statistics (CRVS), data, DHIS2, district health information system software, eHMIS, Electronic Immunization Registry (EIR), eLMIS, Health Management Information System (HMIS), home-based records, monitoring, population estimates, registers, registration | ||
| 4 Point of service | Management & Coordination | Ethiopia | no | Improved information and data management systems | missing data, inaccurate data, poor monitoring, parallel systems of data management, lack of birth registration, inaccurate population denominators | Enhance facility level vaccine and supplies stock visibility through eCHIS in 1000 health posts. New Home Based Recording endorsed, produced, and printed (JA 2017, 2018) Use of electronic community health information systems (eCHIS) in immunization reporting and monitoring (JA 2017) | bracelets, cards, Civil Registry Vital Statistics (CRVS), data, DHIS2, district health information system software, eHMIS, Electronic Immunization Registry (EIR), eLMIS, Health Management Information System (HMIS), home-based records, monitoring, population estimates, registers, registration | ||
| 4 Point of service | Management & Coordination | Ghana | no | Improved information and data management systems | missing data, inaccurate data, poor monitoring, parallel systems of data management, lack of birth registration, inaccurate population denominators | Printing of Child Health Records Books (JA 2019) | bracelets, cards, Civil Registry Vital Statistics (CRVS), data, DHIS2, district health information system software, eHMIS, Electronic Immunization Registry (EIR), eLMIS, Health Management Information System (HMIS), home-based records, monitoring, population estimates, registers, registration | ||
| 4 Point of service | Management & Coordination | Guinea | no | Improved information and data management systems | missing data, inaccurate data, poor monitoring, parallel systems of data management, lack of birth registration, inaccurate population denominators | Immunization data is collected through child health cards, maternal health cards (JA 2018) | bracelets, cards, Civil Registry Vital Statistics (CRVS), data, DHIS2, district health information system software, eHMIS, Electronic Immunization Registry (EIR), eLMIS, Health Management Information System (HMIS), home-based records, monitoring, population estimates, registers, registration | ||
| 4 Point of service | Management & Coordination | India | no | Improved information and data management systems | missing data, inaccurate data, poor monitoring, parallel systems of data management, lack of birth registration, inaccurate population denominators | An urban dashboard has been developed based on HMIS data review, an immunization dashboard to improve quality and use of reported data on immunization to promote programmatic actions for addressing the challenges in strengthening UIP. Monthly immunization dashboards are released for the NUHM cities (JA 2019) The Electronic Vaccine Intelligence Network (eVIN) rolled out and hardware procured – smart phones and temperature loggers (JA 2017, 2018 & 2019) | bracelets, cards, Civil Registry Vital Statistics (CRVS), data, DHIS2, district health information system software, eHMIS, Electronic Immunization Registry (EIR), eLMIS, Health Management Information System (HMIS), home-based records, monitoring, population estimates, registers, registration | ||
| 4 Point of service | Management & Coordination | Kenya | no | Improved information and data management systems | missing data, inaccurate data, poor monitoring, parallel systems of data management, lack of birth registration, inaccurate population denominators | One integrated reporting system for Routine Immunization data through DHIS2 across the country which is accessible from sub county to national level and some facilities. Electronic Logistics Management Information System (eLMIS) is implemented and functional at National, Regional and sub-Counties stores to monitor the vaccine stock management. Availability of geo-coded Master Facility List can support GIS mapping (JA2019) Through Gavi support, the Health Information system has been enabled to undertake population denominator harmonization to create harmony across all programs. The program is working with counties to create synergy with the World Bank funded “Transforming Health Systemsâ€(THS), an initiative to counties improve reproductive, maternal, neonatal, child and adolescent health (JA 2018) | bracelets, cards, Civil Registry Vital Statistics (CRVS), data, DHIS2, district health information system software, eHMIS, Electronic Immunization Registry (EIR), eLMIS, Health Management Information System (HMIS), home-based records, monitoring, population estimates, registers, registration | ||
| 4 Point of service | Management & Coordination | Lesotho | no | Improved information and data management systems | missing data, inaccurate data, poor monitoring, parallel systems of data management, lack of birth registration, inaccurate population denominators | Ministry of Health has built a data collection platform using DHIS2, which allows health facilities to enter their reports directly to a central database using tablets. This is not currently being used for Expanded Programme on Immunization (EPI) reporting data, but there are plans to incorporate all necessary Expanded Programme on Immunization (EPI) indicators into the database including stock management and wastage. The MoH has also initiated capacity building efforts geared towards health facility level in data use (JA 2017) | bracelets, cards, Civil Registry Vital Statistics (CRVS), data, DHIS2, district health information system software, eHMIS, Electronic Immunization Registry (EIR), eLMIS, Health Management Information System (HMIS), home-based records, monitoring, population estimates, registers, registration | ||
| 4 Point of service | Management & Coordination | Liberia | no | Improved information and data management systems | missing data, inaccurate data, poor monitoring, parallel systems of data management, lack of birth registration, inaccurate population denominators | Real-time electronic vaccine tracking system was developed for immunization activities (Multi-stakeholder Dialogue Report (MSD) 2020) | bracelets, cards, Civil Registry Vital Statistics (CRVS), data, DHIS2, district health information system software, eHMIS, Electronic Immunization Registry (EIR), eLMIS, Health Management Information System (HMIS), home-based records, monitoring, population estimates, registers, registration | ||
| 4 Point of service | Management & Coordination | Malawi | no | Improved information and data management systems 15 | missing data, inaccurate data, poor monitoring, parallel systems of data management, lack of birth registration, inaccurate population denominators | Expanded Programme on Immunization (EPI) and routine immunization data is captured in both DHIS2 and the excel-based District Vaccination Data Management Tool (DVDMT) (parallel reporting), with the ultimate goal of transferring all data to DHIS2. Data elements and indicators in DHIS2 were customized to reflect the DVDMT (JA 2018) | bracelets, cards, Civil Registry Vital Statistics (CRVS), data, DHIS2, district health information system software, eHMIS, Electronic Immunization Registry (EIR), eLMIS, Health Management Information System (HMIS), home-based records, monitoring, population estimates, registers, registration | ||
| 4 Point of service | Management & Coordination | Mauritania | no | Improved information and data management systems 16 | missing data, inaccurate data, poor monitoring, parallel systems of data management, lack of birth registration, inaccurate population denominators | Mastercard Wellness Pass – Pilot project in the Nouakchott wilayas and Ouad Naga districts, collaboration bettween MasterCard, WHO, GiftedMom and the Government of Mauritania. Immunization registration and follow-up appointments are linked to a MasterCard, a bank account and an SMS reminder system (JA 2018) | bracelets, cards, Civil Registry Vital Statistics (CRVS), data, DHIS2, district health information system software, eHMIS, Electronic Immunization Registry (EIR), eLMIS, Health Management Information System (HMIS), home-based records, monitoring, population estimates, registers, registration | ||
| 4 Point of service | Management & Coordination | Mozambique | no | Improved information and data management systems 17 | missing data, inaccurate data, poor monitoring, parallel systems of data management, lack of birth registration, inaccurate population denominators | Electronic System for Vaccine Logistics (SELV) led by VillageReach has been implemented and scaled-up to cover 10 provinces. The system supports use of data for planning and decision-making in the Expanded Programme on Immunization (EPI) (JA 2017) | bracelets, cards, Civil Registry Vital Statistics (CRVS), data, DHIS2, district health information system software, eHMIS, Electronic Immunization Registry (EIR), eLMIS, Health Management Information System (HMIS), home-based records, monitoring, population estimates, registers, registration | ||
| 4 Point of service | Management & Coordination | Myanmar | no | Improved information and data management systems 18 | missing data, inaccurate data, poor monitoring, parallel systems of data management, lack of birth registration, inaccurate population denominators | Development and roll out of mobile based app for monitoring and supervision of Expanded Programme on Immunization (EPI) sessions in fixed and outreach areas and Adaptation efforts due to COVID-19: vaccination checklists and COVID-19 precautionary measures were developed and deployed in the Kobo collect app (Multi-stakeholder Dialogue Report (MSD) 2020) Supported Adverse Effects Following Immunization (AEFI) surveillance, reporting, case investigation and causality assessment (MSD 2020) Developed Myanmar and English versions of the microplan and workplan standard operating procedures (SOP); revised and developed DHIS2 module to expand it at health facility level (MSD 2020) Logistics Management Information System (LMIS) international consultant was hired to conduct the assessment of the existing electronic LMIS (eLMIS) initiatives in Myanmar including field visits and interviews with key personnel at eLMIS implementation sites (MSD 2020) Use of single platform (DHIS2) for all Expanded Programme on Immunization (EPI) data, with single data entry at township level (JA 2017) Advance electronic health management information system (eHMIS) and eLMIS integration (Paper based LMIS – rolled out, Integration of aggregated Expanded Programme on Immunization (EPI) supply data into DHIS-2 – Ongoing) (JA 2019) vLMIS pilot project in 3 townships and 2 Regions completed (JA 2019). This is a management information system capable of collecting and reporting data along with a stock inventory control system to ensure proper management of all supplies. Design and pilot eLMIS including cold chain management information system (enhance integration with DHIS2/HMIS, as aligned with recent draft strategic data improvement plan recommendations) (JA 2017) Procured laptops, and 2 DHIS-2 national consultants were recruited for revision and development of DHIS 2 module, manual and conduct trainings (MSD 2020) | bracelets, cards, Civil Registry Vital Statistics (CRVS), data, DHIS2, district health information system software, eHMIS, Electronic Immunization Registry (EIR), eLMIS, Health Management Information System (HMIS), home-based records, monitoring, population estimates, registers, registration | ||
| 4 Point of service | Management & Coordination | Nepal | no | Improved information and data management systems 19 | missing data, inaccurate data, poor monitoring, parallel systems of data management, lack of birth registration, inaccurate population denominators | DHIS2 electronic reporting is done at the district level, but not at the facility level (paper-based records) (JA 2018) | bracelets, cards, Civil Registry Vital Statistics (CRVS), data, DHIS2, district health information system software, eHMIS, Electronic Immunization Registry (EIR), eLMIS, Health Management Information System (HMIS), home-based records, monitoring, population estimates, registers, registration | ||
| 4 Point of service | Management & Coordination | Nicaragua | no | Improved information and data management systems 20 | missing data, inaccurate data, poor monitoring, parallel systems of data management, lack of birth registration, inaccurate population denominators | Rapid Coverage Monitoring is conducted at least twice a year in all municipalities by staff from national, departmental and municipal levels, to ensure that no children are missing vaccine doses (JA 2017) Data quality assessment and operational research aimed at highlighting data quality problems was undertaken (JA 2017) | bracelets, cards, Civil Registry Vital Statistics (CRVS), data, DHIS2, district health information system software, eHMIS, Electronic Immunization Registry (EIR), eLMIS, Health Management Information System (HMIS), home-based records, monitoring, population estimates, registers, registration | ||
| 4 Point of service | Management & Coordination | Nigeria | no | Improved information and data management systems 21 | missing data, inaccurate data, poor monitoring, parallel systems of data management, lack of birth registration, inaccurate population denominators | Integrating existing logistics management information systems (LMIS) with the Visibility Analytics Network (VAN) (JA 2015/2016) Integrating stock management systems into Navision (Last mile Integration) (JA 2015) Integration of VAN with DHIS2 and other stock management application within the Nigerian iSC ecosystems (JA 2017) Strengthen community-based surveillance using e-surveillance (JA 2019) Theroutine immunization SMS tool ensuresroutine immunization data is available on the SMS/DHIS2 instance immediately after sessions are conducted (JA 2019) Name-based records of target population piloted in MOU states and support reconciliation of data with health facility records (JA 2019) Use of dashboards in immunization, Daily SMS dashboard review in most Local Government Authorities (LGAs). Data are used to follow up with HFs on non-conduct of planned sessions and children immunized (JA 2019) District Health Information System 2 (DHIS2) and theroutine immunization Short Message Service (SMS) is used to track the conduct of daily fixed sessions which is a key pillar of the OIRIS approach (JA 2019) Memorandum of Understanding (MoU) to implement an “Immunization Service Delivery Accountability†approach, which aims to address data accuracy/quality and reduce pressure on the health care worker to falsely report on targets (JA 2017) | bracelets, cards, Civil Registry Vital Statistics (CRVS), data, DHIS2, district health information system software, eHMIS, Electronic Immunization Registry (EIR), eLMIS, Health Management Information System (HMIS), home-based records, monitoring, population estimates, registers, registration | ||
| 4 Point of service | Management & Coordination | Pakistan | no | Improved information and data management systems 22 | missing data, inaccurate data, poor monitoring, parallel systems of data management, lack of birth registration, inaccurate population denominators | Health facilities up to Rural Health Centres submit surveillance data through an online surveillance dashboard on a daily basis (JA 2019) Zindagi Mehfooz (ZM) DIR includes features such as individual-level data to track each child in the community, web-based dashboard, unique QR code-based identification mechanism, interactive (2-way) SMS text reminders, a decision support system to guide vaccinators for routine and catch-up immunizations (JA 2019) | bracelets, cards, Civil Registry Vital Statistics (CRVS), data, DHIS2, district health information system software, eHMIS, Electronic Immunization Registry (EIR), eLMIS, Health Management Information System (HMIS), home-based records, monitoring, population estimates, registers, registration | ||
| 4 Point of service | Management & Coordination | Rwanda | no | Improved information and data management systems 23 | missing data, inaccurate data, poor monitoring, parallel systems of data management, lack of birth registration, inaccurate population denominators | All health centers were equipped with computers and electronic individual records for vaccination (with unique identifiers) were generated (JA 2019) | bracelets, cards, Civil Registry Vital Statistics (CRVS), data, DHIS2, district health information system software, eHMIS, Electronic Immunization Registry (EIR), eLMIS, Health Management Information System (HMIS), home-based records, monitoring, population estimates, registers, registration | ||
| 4 Point of service | Management & Coordination | Senegal | no | Improved information and data management systems 24 | missing data, inaccurate data, poor monitoring, parallel systems of data management, lack of birth registration, inaccurate population denominators | Equity improvement plan – Immunization records were linked to birth records, in addition to records on Vitamin A supplements and deworming in 11 priority districts (7 of which are urban). Specific innovative strategies were established for urban locations (JA 2019) Integration of Expanded Programme on Immunization (EPI) data into DHIS2 and training of all actors at the peripheral level in data entry and analysis and acquisition of equipment to support the implementation of DHIS2 in addition to training sessions (JA 2018) | bracelets, cards, Civil Registry Vital Statistics (CRVS), data, DHIS2, district health information system software, eHMIS, Electronic Immunization Registry (EIR), eLMIS, Health Management Information System (HMIS), home-based records, monitoring, population estimates, registers, registration | ||
| 4 Point of service | Management & Coordination | Sierra Leone | no | Improved information and data management systems 25 | missing data, inaccurate data, poor monitoring, parallel systems of data management, lack of birth registration, inaccurate population denominators | Using VaxTrac vaccination registry system to enroll children for vaccination and defaulter tracing in urban areas (JA 2018) | bracelets, cards, Civil Registry Vital Statistics (CRVS), data, DHIS2, district health information system software, eHMIS, Electronic Immunization Registry (EIR), eLMIS, Health Management Information System (HMIS), home-based records, monitoring, population estimates, registers, registration | ||
| 4 Point of service | Management & Coordination | Solomon Islands | no | Improved information and data management systems 26 | missing data, inaccurate data, poor monitoring, parallel systems of data management, lack of birth registration, inaccurate population denominators | DHIS2 national platform was created, with Expanded Programme on Immunization (EPI) specific applications and software revisions including disaggregated provincial recall of vaccination records (JA 2019) Memorandum of Understanding (MoU) between the Ministry of Health and Medical Services (MHMS) and the Ministry of Home Affairs to strengthen civil registry and vital statistics (CRVS) mechanisms and improve reliability of data for service planning and monitoring (JA 2019) | bracelets, cards, Civil Registry Vital Statistics (CRVS), data, DHIS2, district health information system software, eHMIS, Electronic Immunization Registry (EIR), eLMIS, Health Management Information System (HMIS), home-based records, monitoring, population estimates, registers, registration | ||
| 4 Point of service | Management & Coordination | Somalia | no | Improved information and data management systems 27 | missing data, inaccurate data, poor monitoring, parallel systems of data management, lack of birth registration, inaccurate population denominators | Various data collection and monitoring tools were printed and distributed to the health facilities providing immunisation services. These tools include child passports, vaccine monitoring charts and Expanded Programme on Immunization (EPI) registers (JA 2019) The e-EWARN surveillance system is used to report 14 health events/priority diseases/syndromes on a weekly basis, including vaccine preventable diseases. Currently 455 health facilities are actively reporting on a weekly basis using the e-EWARN mobile application (JA 2019) | bracelets, cards, Civil Registry Vital Statistics (CRVS), data, DHIS2, district health information system software, eHMIS, Electronic Immunization Registry (EIR), eLMIS, Health Management Information System (HMIS), home-based records, monitoring, population estimates, registers, registration | ||
| 4 Point of service | Management & Coordination | Sudan | no | Improved information and data management systems 28 | missing data, inaccurate data, poor monitoring, parallel systems of data management, lack of birth registration, inaccurate population denominators | 3 component reform has been implemented for the HIS to improve the quality and strengthen it. These include: integrated health information system (HIS), DHIS2, strengthen the community health information system. This also includes financial and material support from health systems strengthening (HSS) partners (JA 2016) | bracelets, cards, Civil Registry Vital Statistics (CRVS), data, DHIS2, district health information system software, eHMIS, Electronic Immunization Registry (EIR), eLMIS, Health Management Information System (HMIS), home-based records, monitoring, population estimates, registers, registration | ||
| 4 Point of service | Management & Coordination | Tajikistan | no | Improved information and data management systems 29 | missing data, inaccurate data, poor monitoring, parallel systems of data management, lack of birth registration, inaccurate population denominators | Piloting mother child passports in the Khatlon region (Multi-stakeholder Dialogue Report (MSD) 2020) | bracelets, cards, Civil Registry Vital Statistics (CRVS), data, DHIS2, district health information system software, eHMIS, Electronic Immunization Registry (EIR), eLMIS, Health Management Information System (HMIS), home-based records, monitoring, population estimates, registers, registration | ||
| 4 Point of service | Management & Coordination | Tanzania | no | Improved information and data management systems 30 | missing data, inaccurate data, poor monitoring, parallel systems of data management, lack of birth registration, inaccurate population denominators | Implementation of Electronic Immunization Systems (VIMS and TimR) in 10 regions, with plans for country-wide scale-up and integration them with civil registry vital statistics (CRVS) (JA 2019) Electronic Immunization Registry system (collecting individual child immunization records, schedules and defaulter tracing) has been integrated with DHIS2 and is planned to be integrated to CRVS birth registry system in some regions, with scaling-up in progress (JA 2017) | bracelets, cards, Civil Registry Vital Statistics (CRVS), data, DHIS2, district health information system software, eHMIS, Electronic Immunization Registry (EIR), eLMIS, Health Management Information System (HMIS), home-based records, monitoring, population estimates, registers, registration | ||
| 4 Point of service | Management & Coordination | Uzbekistan | no | Improved information and data management systems 31 | missing data, inaccurate data, poor monitoring, parallel systems of data management, lack of birth registration, inaccurate population denominators | Home-based Immunization Cards are distributed during monitoring visits to improve the immunization data quality and reduce drop-outs and missed opportunities (Multi-stakeholder Dialogue Report (MSD) 2020) | bracelets, cards, Civil Registry Vital Statistics (CRVS), data, DHIS2, district health information system software, eHMIS, Electronic Immunization Registry (EIR), eLMIS, Health Management Information System (HMIS), home-based records, monitoring, population estimates, registers, registration | ||
| 4 Point of service | Management & Coordination | Vietnam | no | Improved information and data management systems 32 | missing data, inaccurate data, poor monitoring, parallel systems of data management, lack of birth registration, inaccurate population denominators | Web-based immunization registration system was rolled out nationwide in 2017 in 11000 commune health centers and 1400 hospital and private immunization centers. The system allows tracking of immunization and health information (name, gender, age, parents information, contact information, vaccination date and logistics) (JA 2017) | bracelets, cards, Civil Registry Vital Statistics (CRVS), data, DHIS2, district health information system software, eHMIS, Electronic Immunization Registry (EIR), eLMIS, Health Management Information System (HMIS), home-based records, monitoring, population estimates, registers, registration | ||
| 4 Point of service | Management & Coordination | Yemen | no | Improved information and data management systems 33 | missing data, inaccurate data, poor monitoring, parallel systems of data management, lack of birth registration, inaccurate population denominators | Use of the HeRAMS system to report on functionality of health facilities and services (JA 2019) | bracelets, cards, Civil Registry Vital Statistics (CRVS), data, DHIS2, district health information system software, eHMIS, Electronic Immunization Registry (EIR), eLMIS, Health Management Information System (HMIS), home-based records, monitoring, population estimates, registers, registration | ||
| 4 Point of service | Management & Coordination | Zambia | no | Improved information and data management systems 34 | missing data, inaccurate data, poor monitoring, parallel systems of data management, lack of birth registration, inaccurate population denominators | Immunization information is tracked through the DHIS2 and other systems such as the Zambia Electronic Immunisation System, Mvaccination and Logistimo (JA 2018) An integrated Child and Mother Follow-up Register was implemented in 2018, providing longitudinal information on events and services for children from birth to 23rd month (JA 2018) | bracelets, cards, Civil Registry Vital Statistics (CRVS), data, DHIS2, district health information system software, eHMIS, Electronic Immunization Registry (EIR), eLMIS, Health Management Information System (HMIS), home-based records, monitoring, population estimates, registers, registration | ||
| 4 Point of service | Management & Coordination | Zimbabwe | no | Improved information and data management systems 35 | missing data, inaccurate data, poor monitoring, parallel systems of data management, lack of birth registration, inaccurate population denominators | My Village My Home approach is used by trained Village Heads and Health workers. Immunization history is documented on Child Health Card (JA 2019) | bracelets, cards, Civil Registry Vital Statistics (CRVS), data, DHIS2, district health information system software, eHMIS, Electronic Immunization Registry (EIR), eLMIS, Health Management Information System (HMIS), home-based records, monitoring, population estimates, registers, registration | ||
| 4 Point of service | Workforce | Afghanistan | yes | Peer support for health providers | Providers may have limited sources of information or out of date knowledge | Leveraging Immunization Communication Network established for polio eradication initiative (JA 2017, 2018) | continuing education, health provider, peer support, training | ||
| 4 Point of service | Workforce | Guinea-Bissau | yes | Peer support for health providers | Providers may have limited sources of information or out of date knowledge | Community health worker network ensures support, training and supervision in the context of Expanded Programme on Immunization (EPI) (JA 2016) | continuing education, health provider, peer support, training | ||
| 4 Point of service | Workforce | Kenya | yes | Peer support for health providers | Providers may have limited sources of information or out of date knowledge | Health non-governmental organization (NGO) networks-HENNET provide the needed peer support for immunization service delivery (JA 2016) | continuing education, health provider, peer support, training | ||
| 4 Point of service | Workforce | Kyrgyzstan | yes | Peer support for health providers | Providers may have limited sources of information or out of date knowledge | Village Health Committees (one in each region) network receive information on COVID-19 and supportive supervision through online Whatsapp platform (groups) (Multi-stakeholder Dialogue Report (MSD) 2020) | continuing education, health provider, peer support, training | ||
| 4 Point of service | Workforce | Lao People’s Democatic Republic | yes | Peer support for health providers | Providers may have limited sources of information or out of date knowledge | Supervision and communication on data issues and surveillance (between district health office and health facilities) occur through informal means such as Whatsapp (JA 2018) | continuing education, health provider, peer support, training | ||
| 4 Point of service | Workforce | Liberia | yes | Peer support for health providers | Providers may have limited sources of information or out of date knowledge | National Community Health Asssistants (NCHA) network and mobile platform is used to conduct immunization services, defaulter tracking and provide support in communities (JA 2018) | continuing education, health provider, peer support, training | ||
| 4 Point of service | Workforce | Malawi | yes | Peer support for health providers | Providers may have limited sources of information or out of date knowledge | Remote supportive supervision of Expanded Programme on Immunization (EPI) services through Whatsapp during the COVID-19 pandemic (Multi-stakeholder Dialogue Report (MSD) 2020) | continuing education, health provider, peer support, training | ||
| 4 Point of service | Workforce | Mali | yes | Peer support for health providers | Providers may have limited sources of information or out of date knowledge | Whatsapp platform brings together Centres de Sante Communautaire (CSCOMs), Centre de Santé de Centre de Santé de Référence (CSRefs), Women and Youth to facilitate exchanges, collect testimonies and discuss difficulties and solutions (JA 2019) | continuing education, health provider, peer support, training | ||
| 4 Point of service | Workforce | Myanmar | yes | Peer support for health providers | Providers may have limited sources of information or out of date knowledge | Regional Surveillance Officer (RSO) network was established in 1999 to focus on polio eradication and has rapidly become a vital resource at the state level, including surveillance and response for VPDs and other diseases, routine immunisation and new vaccine introduction among their many supportive state duties. The 17 RSOs are government-employed medical doctors, selected by MoHS and assigned to state RSO duties for the period of one year (JA 2017) | continuing education, health provider, peer support, training | ||
| 4 Point of service | Workforce | Rwanda | yes | Peer support for health providers | Providers may have limited sources of information or out of date knowledge | Strong Community Health Worker (CHW) network coordinates immunization services and ensures access for community/demand generation (JA 2019) | continuing education, health provider, peer support, training | ||
| 4 Point of service | Workforce | Somalia | yes | Peer support for health providers | Providers may have limited sources of information or out of date knowledge | Network of Village Polio volunteers conducts surveillance on polio cases and social mobilization (JA 2019) | continuing education, health provider, peer support, training | ||
| 4 Point of service | Workforce | South Sudan | yes | Peer support for health providers | Providers may have limited sources of information or out of date knowledge | Integrated Community Mobilization Network is comprised to community-level trained mobilizers and supervisors that support their activities at the payam and county level (JA 2018) | continuing education, health provider, peer support, training | ||
| 4 Point of service | Workforce | Sudan | yes | Peer support for health providers | Providers may have limited sources of information or out of date knowledge | A network of NGOs working in health was established in 2016 (JA 2017) | continuing education, health provider, peer support, training | ||
| 4 Point of service | Workforce | Tanzania | yes | Peer support for health providers | Providers may have limited sources of information or out of date knowledge | Creation and use of WhatsApp group for health providers to communicate to identify and collaboratively resolve issues (e.g. supply shortages) (http://bidinitiative.org/blog/health-workers-successfully-use-whatsapp-to-solve-problems/) | continuing education, health provider, peer support, training | ||
| 4 Point of service | Workforce | Togo | yes | Peer support for health providers | Providers may have limited sources of information or out of date knowledge | Creation of a Whatsapp platform to follow-up on the implementation of advanced strategies (Multi-stakeholder Dialogue Report (MSD) 2020) | continuing education, health provider, peer support, training | ||
| 4 Point of service | Workforce | Bangladesh | yes | Health workers have the training they need | Health workers may need additional training to provide quality care | Virtual training was conducted at the national and district levels to avoid mass gathering (in relation to COVID-19) (Multi-stakeholder Dialogue Report (MSD) 2020) | job aids, quality improvement, training, workload | ||
| 4 Point of service | Workforce | Burundi | yes | Health workers have the training they need 2 | Health workers may need additional training to provide quality care | Healthcare worker training in the form of cascade training for the polio vaccine, and interpersonal communication training conducted (JA 2018) | job aids, quality improvement, training, workload | ||
| 4 Point of service | Workforce | Democratic Republic of Congo | yes | Health workers have the training they need 3 | Health workers may need additional training to provide quality care | 12 managers were trained in Benin, including two in health logistics and 10 in vaccinology. This cohort joins those previously trained: 16 in vaccinology and 25 in health logistics, for a total of 27 supply chain agents and 26 in vaccinology (JA 2018) | job aids, quality improvement, training, workload | ||
| 4 Point of service | Workforce | Djibouti | yes | Health workers have the training they need 4 | Health workers may need additional training to provide quality care | Expanded Programme on Immunization (EPI) training and capacity-building activities in many domains (interpersonal communication, epidemiological surveillance, cascade training, community sensitization, vaccine management and logistics, DHIS2) (JA 2018) | job aids, quality improvement, training, workload | ||
| 4 Point of service | Workforce | Eritrea | yes | Health workers have the training they need 5 | Health workers may need additional training to provide quality care | 250 health workers trained on patient safety and Adverse Effects Following Immunization (AEFI) surveillance; 416 health workers trained on health care waste management (JA 2019) | job aids, quality improvement, training, workload | ||
| 4 Point of service | Workforce | Guinea | yes | Health workers have the training they need 6 | Health workers may need additional training to provide quality care | Supplemental immunization activities and strengthening of skills for 10,053 vaccinators allowed vaccination of 70,043 zero-dose children (JA 2019) | job aids, quality improvement, training, workload | ||
| 4 Point of service | Workforce | Guinea-Bissau | yes | Health workers have the training they need 7 | Health workers may need additional training to provide quality care | Systematic training of all agents on Expanded Programme on Immunization (EPI) and effective vaccine management (JA 2016) | job aids, quality improvement, training, workload | ||
| 4 Point of service | Workforce | Lao People’s Democatic Republic | yes | Health workers have the training they need 8 | Health workers may need additional training to provide quality care | 1000 district and health center staff of 12 provinces have been trained on micro planning using updated guidelines (JA 2019) | job aids, quality improvement, training, workload | ||
| 4 Point of service | Workforce | Madagascar | yes | Health workers have the training they need 9 | Health workers may need additional training to provide quality care | Provide Expanded Programme on Immunization (EPI) managers and service providers at all levels with a Management Tool; the management tools that are being multiplied for the 114 Service de District de Santé Publique (SDSPs) are the Centre de Santé de Base (CSB) child and woman vaccination registers, infant cards, maternal cards, vaccination coverage monitoring curves, stock sheets, temperature sheets. Community immunization registers, time registers, immunization diplomas and child health records, which are also being multiplied, will be used for the 54 priority SDSPs (JA 2019) | job aids, quality improvement, training, workload | ||
| 4 Point of service | Workforce | Mali | yes | Health workers have the training they need 10 | Health workers may need additional training to provide quality care | Training and capacity-building on the expanded programme on immunization (EPI), equity for immunization, effective vaccine management conducted at the national regional and district levels (JA 2018) | job aids, quality improvement, training, workload | ||
| 4 Point of service | Workforce | Mauritania | yes | Health workers have the training they need 11 | Health workers may need additional training to provide quality care | Cascade training for healthcare workers involved at all Expanded Programme on Immunization (EPI) levels (JA 2017) Expanded Programme on Immunization (EPI) training for healthcare workers in the private sector (JA 2017) | job aids, quality improvement, training, workload | ||
| 4 Point of service | Workforce | Nicaragua | yes | Health workers have the training they need 12 | Health workers may need additional training to provide quality care | 200 health workers from the prioritized municipalities were trained in the key components of surveillance of vaccine-preventable diseases, injection safety and the monitoring of adverse effects following immunization (AEFIs) (JA 2017) | job aids, quality improvement, training, workload | ||
| 4 Point of service | Workforce | Niger | yes | Health workers have the training they need 13 | Health workers may need additional training to provide quality care | Capacity-strengthening activities on Expanded Programme on Immunization (EPI) management and vaccine delivery were organized for healthcare workers at the district and regional levels (JA 2018) | job aids, quality improvement, training, workload | ||
| 4 Point of service | Workforce | Papua New Guinea | yes | Health workers have the training they need 14 | Health workers may need additional training to provide quality care | Training of all frontline health workers on Infection Prevention and Control (IPC) and Risk Communication and Community Engagement (RCCE) and guidelines for safe conduct of immunization sessions during COVID-19 pandemic (with personal protective equipment (PPE)) (Multi-stakeholder Dialogue Report (MSD) 2020) | job aids, quality improvement, training, workload | ||
| 4 Point of service | Workforce | Rwanda | yes | Health workers have the training they need 15 | Health workers may need additional training to provide quality care | Mentorship and supervision of health facilities on geographic information system (GIS) based technologies is done at the central level (Multi-stakeholder Dialogue Report (MSD) 2020) | job aids, quality improvement, training, workload | ||
| 4 Point of service | Workforce | Sao Tome and Principe | yes | Health workers have the training they need 16 | Health workers may need additional training to provide quality care | Training of healthcare personnel and community health workers involved in Expanded Programme on Immunization (EPI) (JA 2018) Training of agents on monitoring software TomPro (for accounting and financial reporting) (JA 2018) Training on adverse effects following immunization (AEFI) for epidemiologists, statisticians and pharmacy technicians (JA 2017) Training of doctors, nurses and community health agents on polio immunization, with cascade training (JA 2017) | job aids, quality improvement, training, workload | ||
| 4 Point of service | Workforce | Senegal | yes | Health workers have the training they need 17 | Health workers may need additional training to provide quality care | Capacity strenghtening for Expanded Programme on Immunization (EPI) and epidemiological surveillance conducted for health workers (district doctors and their assistants), including the development of an online training platform for continuous updating of the knowledge of operational agents (sanctioned by a certificate automatically generated after validation of the knowledge test at the end of the training) (JA 2018) Training in Expanded Programme on Immunization (EPI) and surveillance was conducted for healthworkers (Multi-stakeholder Dialogue Report (MSD) 2020) | job aids, quality improvement, training, workload | ||
| 4 Point of service | Workforce | Sudan | yes | Health workers have the training they need 18 | Health workers may need additional training to provide quality care | Training courses (Mid-Level Management (MLM), refresher trainings) across different states for over 1200 participants and vaccinators (JA 2016) | job aids, quality improvement, training, workload | ||
| 4 Point of service | Workforce | Tanzania | yes | Health workers have the training they need 19 | Health workers may need additional training to provide quality care | A Quality Improvement Team model resulted in increased health worker motivation, productivity (likely through redistribution of workload), and strengthened teamwork (https://www.usaidassist.org/sites/default/files/tanzania_evaluation_hivhw_performance_collaborative_july2013.pdf) | job aids, quality improvement, training, workload | ||
| 4 Point of service | Workforce | Timor Leste | yes | Health workers have the training they need 20 | Health workers may need additional training to provide quality care | Training curriculum for building capacity of health workers to establish and work with mother support groups to promote key practices for immunization, maternal newborn and child health, nutrition and water and sanitation (WASH) was developed and implemented (JA 2017) | job aids, quality improvement, training, workload | ||
| 4 Point of service | Workforce | Uzbekistan | yes | Health workers have the training they need 21 | Health workers may need additional training to provide quality care | Assessment of human resources capacity generating evidence on the situation of the workforce for health and immunization supply chain management, identifying gaps and developing an action plan (JA 2019) Assessment of the adverse effects following immunization (AEFI) system (JA 2019) | job aids, quality improvement, training, workload | ||
| 4 Point of service | Workforce | Vietnam | yes | Health workers have the training they need 22 | Health workers may need additional training to provide quality care | Training on Expanded Programme on Immunization (EPI) for district health workers in 9 out of 10 provinces for about 722 students, and for commune health workers for about 3230 students (JA 2017) Training on maternal and child health (MCH) for 1596 students (who had not been previously trained under the new MOH program) (JA 2017) Training on health planning and monitoring and evaluation for 494 students at provincial and district levels (JA 2017) Training on safe immunization practices for 114 health workers at the provincial level and 114 teachers of medical schools in 63 provinces (JA 2017) | job aids, quality improvement, training, workload | ||
| 4 Point of service | Workforce | Yemen | yes | Health workers have the training they need 23 | Health workers may need additional training to provide quality care | Capacity building of Health Educators and about 12,000 Community Health Volunteers (CHVs) and 400 Community Health workers (CHWs) engaged in door to door visit to create awareness on health interventions including immunization (JA 2019) | job aids, quality improvement, training, workload | ||
| 4 Point of service | Workforce | Afghanistan | yes | Health workers are from the communities they serve | acceptability of services, community engagement, cultural appropriateness | Specific training for female vaccinators so that women due for tetanus toxoid vaccines can receive their shots since males vaccinators are a barrier in this setting (JA 2018) | representation, workforce diversity | conflict affected, Remote rural, Urban | |
| 4 Point of service | Workforce | Myanmar | yes | Health workers are from the communities they serve 2 | acceptability of services, community engagement, cultural appropriateness | Meetings with Ethnic Health Organizations (EHO) and recruitment of EHO mentors were conducted to improve the coordination of immunization services in hard to reach, migratory, peri-urban and conflict areas (Multi-stakeholder Dialogue Report (MSD) 2020) | representation, workforce diversity | conflict affected, Remote rural, Urban | |
| 4 Point of service | Workforce | Nicaragua | yes | Health workers are from the communities they serve 3 | acceptability of services, community engagement, cultural appropriateness | 200 health workers from the prioritized municipalities were trained in the key components of surveillance of vaccine-preventable diseases, injection safety and the monitoring of adverse effects following immunization (AEFIs) (JA 2017) | representation, workforce diversity | conflict affected, Remote rural, Urban | |
| 4 Point of service | Workforce | South Sudan | yes | Health workers are from the communities they serve 4 | acceptability of services, community engagement, cultural appropriateness | Training of interviewers and supervisors from hard to reach/inaccessible areas was conducted in Juba with support and participation from partners (national and international NGOs/CSOs) working in those locations (JA 2018) | representation, workforce diversity | conflict affected, Remote rural, Urban | |
| 4 Point of service | Workforce | Sudan | yes | Health workers are from the communities they serve 5 | acceptability of services, community engagement, cultural appropriateness | The majority of volunteer workers providing routine and supplemental immunization services are female. In some areas of Sudan where gender norms limit women from having contact with foreigners (especially men), female vaccinators are selected from local communities, ensuring the respect of social norms (JA 2018) | representation, workforce diversity | conflict affected, Remote rural, Urban | |
| 4 Point of service | Commodities | Afghanistan | no | Cold-chain functionality, sustainability and stock management | Lack of or inconsistent cold chain | Solar refrigerators temperature monitoring system with 30-day temp monitoring was installed (JA 2016, 2017, 2018) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Burkina Faso | no | Cold-chain functionality, sustainability and stock management 2 | Lack of or inconsistent cold chain | Procurement of Solar Direct Drive (SDD) refrigerators as part of the Cold Chain Equipment Optimization Platform (CCEOP) plan (2018-2020) (JA 2019) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Burundi | no | Cold-chain functionality, sustainability and stock management 3 | Lack of or inconsistent cold chain | Procurement of Solar Direct Drive (SDD) and installation is in progress (with Gavi support) (JA 2018) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Cameroon | no | Cold-chain functionality, sustainability and stock management 4 | Lack of or inconsistent cold chain | Distribution and installation of cold chain equipment (including SDD) (JA 2017) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Central Africa Republic | no | Cold-chain functionality, sustainability and stock management 5 | Lack of or inconsistent cold chain | Installation of solar refrigerators and cold chain equipment (JA 2016, 2017, 2019) Equipment (solar panels and refrigerators) will be equipped with anti-theft mechanisms due to the security context in the Central African Republic (CAR); aside from physical security for equipment, the deployment plan will include community involvement to ensure security of the facilities (JA 2018) To improve the quality and availability of vaccines at the delivery points, two lorries were purchased to aid (i) vaccine supply to the districts; (ii) the regularity of resupply of vaccines and fuel to the districts and health facilities; and (iii) cold chain maintenance at the central and peripheral levels (JA 2019) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Comoros | no | Cold-chain functionality, sustainability and stock management 6 | Lack of or inconsistent cold chain | Installation of Solar Direct Drive (SDD) refrigerators in some regions (ex: Ngazidja) (JA 2016, JA 2018) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Cote d’Ivoire | no | Cold-chain functionality, sustainability and stock management 7 | Lack of or inconsistent cold chain | Solar Direct Drive (SDD) and electric refrigerators have been acquired as part of the Cold Chain Equipment Optimization Platform (CCEOP) framework (JA 2019) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Democratic Republic of Congo | no | Cold-chain functionality, sustainability and stock management 8 | Lack of or inconsistent cold chain | Implementation of the Cold Chain Equipment Optimization Platform (CCEOP) project allowed the country to install 2,087 solar refrigerators in the context of CCEOP1 in 2018 while 1,303 solar refrigerators will be installed through CCEOP2 in immunisation facilities in the 26 provinces. This has enabled cold chain equipment coverage to increase from 30% to 51.7% with the implementation of Gavi/HSS2, and it is set to rise further to 74% after installation of CCEOP1 in the HAs. 1/3 ultra-modern storage warehouses for vaccines, medications and other dry Expanded Programme on Immunization (EPI) supplies and for other Directorates and MoH health programmes built and equipped with Gavi HSS2 funding. The Kinkole hub in Kinshasa that was completed and inaugurated on 10 October 2018. Of the construction work on the other two peripheral modern depots (Lubumbashi and Kisangani) and the expansion of the Kananga relay depot, as of the first quarter of 2018 only the expansion work on the Kananga depot was nearly completed. 7 refrigerated trucks and 7 standard trucks have arrived and have been operational since they were officially delivered on 10 October 2018 during the inauguration of the Kinkole hub (JA 2018) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Djibouti | no | Cold-chain functionality, sustainability and stock management 9 | Lack of or inconsistent cold chain | Procurement and installation of cold chain equipment (Solar Direct Drive (SDD) refridgerators and freezers), and strenghtening of team resources in the context of Gavi’s Cold Chain Equipment Optimization Platform (CCEOP) in Q3 of 2018 (JA 2019) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Eritrea | no | Cold-chain functionality, sustainability and stock management 10 | Lack of or inconsistent cold chain | Procurement of Solar Direct Drive (SDD) refrigerators and ice lined refrigerators to improve cold chain capacity (JA 2019) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Ethiopia | no | Cold-chain functionality, sustainability and stock management 11 | Lack of or inconsistent cold chain | Solar equipment (solar direct drive refrigerators) and ice-lined refrigerators with voltage regulators procured and installed (JA 2019) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Guinea | no | Cold-chain functionality, sustainability and stock management 12 | Lack of or inconsistent cold chain | Solar Direct Drive (SDD) refridgerators acquired to increase district storage capacities at health centres (JA 2019) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Guinea-Bissau | no | Cold-chain functionality, sustainability and stock management 13 | Lack of or inconsistent cold chain | Solar Direct Drive (SDD) refrigerators are running in 48% of health facilities (JA 2019) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Haiti | no | Cold-chain functionality, sustainability and stock management | Lack of or inconsistent cold chain | Solar Direct Drive (SDD) solar refrigerators installed in Expanded Programme on Immunization (EPI) facilities to improve cold chain capacity (JA 2018) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | India | no | Cold-chain functionality, sustainability and stock management | Lack of or inconsistent cold chain | GPS-enabled mobile application for the Cold Chain Points and the immunization session sites (JA 2019) The Electronic Vaccine Intelligence Network (eVIN) rolled out and hardware procured – smart phones and temperature loggers (JA 2017, 2018 & 2019) Solar Direct Drives (SDD) and more than 14,000 data loggers have been installed for real time remote temperature monitoring of cold chain equipment (JA 2017) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Kenya | no | Cold-chain functionality, sustainability and stock management | Lack of or inconsistent cold chain | Increased number of solar fridges procured and installed (JA 2016 & 2019) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Kyrgyzstan | no | Cold-chain functionality, sustainability and stock management | Lack of or inconsistent cold chain | Electronic temperature monitoring system (JA 2019) Solar direct drive (SDD) fridges procured and being used (JA 2016) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Lesotho | no | Cold-chain functionality, sustainability and stock management | Lack of or inconsistent cold chain | The Ministry of Health has a new unit called the Supply Chain Coordinating Unit which is responsible for forecasting, procurement and supply of all health commodities. The unit is also responsible for managing the Expanded Programme on Immunization (EPI) supply chain. In 2015, the program introduced electronic temperature monitoring devices in all vaccine supply chain levels. The program also conducted comprehensive cold chain inventory and developed replacement and expansion plan (JA 2016) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Liberia | no | Cold-chain functionality, sustainability and stock management | Lack of or inconsistent cold chain | Solar direct drive refrigerators and ice-lined refrigerators and ice-pack freezers installed across the whole country to expand cold chain capacity (Under the Cold Chain Equipment Optimization Platform (CCEOP) program) (Multi-stakeholder Dialogue Report (MSD) 2020) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Madagascar | no | Cold-chain functionality, sustainability and stock management | Lack of or inconsistent cold chain | Health facilities provided with solar refrigerators (JA 2019) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Malawi | no | Cold-chain functionality, sustainability and stock management | Lack of or inconsistent cold chain | Installation of over 300 Solar Direct Drive (SDD) refrigerators to expand cold-chain capacity, as part of the Gavi funded Cold Chain Equipment Optimization Platform (CCEOP) (Multi-stakeholder Dialogue Report (MSD) 2020) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Mali | no | Cold-chain functionality, sustainability and stock management | Lack of or inconsistent cold chain | Installation of Solar Direct Drives (SDDs) in Tombouctou, Gao, Mopti and Menaka regions and Training of national and regional agents on maintenance of solar cold chain (JA 2018) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Mauritania | no | Cold-chain functionality, sustainability and stock management | Lack of or inconsistent cold chain | Ministry of Health invested in an expanding the cold chain equipment by distributing Solar Direct Drive (SDD) refrigerators and electric ice lined refrigerators (JA 2018) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Myanmar | no | Cold-chain functionality, sustainability and stock management | Lack of or inconsistent cold chain | Installation of cold chain equipment during years 1 and 2 of the Cold Chain Equipment Optimization Platform (CCEOP) and training of core facilitators and web based cold chain inventory is developed for accessibility (Multi-stakeholder Dialogue Report (MSD) 2020) Solar direct drives and temperature monitors (JA 2019) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Nepal | no | Cold-chain functionality, sustainability and stock management | Lack of or inconsistent cold chain | Solar Direct Drive (SDD) and mains-powered ice lined refrigerators and freezers (ILR) installation in remote sites (subnational level) (JA 2019) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Niger | no | Cold-chain functionality, sustainability and stock management | Lack of or inconsistent cold chain | Installation of solar direct drive (SDD) refrigerators (JA 2018) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Nigeria | no | Cold-chain functionality, sustainability and stock management | Lack of or inconsistent cold chain | Solar Direct Drive (SDD) equipment procurement and installation (JA 2017) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Pakistan | no | Cold-chain functionality, sustainability and stock management | Lack of or inconsistent cold chain | Electronic and remote temperature monitoring devices deployed and being used (JA 2018) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Papua New Guinea | no | Cold-chain functionality, sustainability and stock management | Lack of or inconsistent cold chain | Installation of Solar Direct Drive (SDD) fridges, mains-powered ice lined refrigerators and freezers (ILR), and freezers as part of the Cold Chain Equipment Optimization Platform (CCEOP), in addition to providing technical support to the Project Management team for distribution, installation and commissioning of the CCEOP (Multi-stakeholder Dialogue Report (MSD) 2020) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Republic of the Congo | no | Cold-chain functionality, sustainability and stock management | Lack of or inconsistent cold chain | Acquisition of Solar Direct Drives (SDDs) and electric refrigerators (JA 2016) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Sao Tome and Principe | no | Cold-chain functionality, sustainability and stock management | Lack of or inconsistent cold chain | Installation of Solar Direct Drive (SDD) solar refrigerators in all immunization units (HSS funding) (JA 2019) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Senegal | no | Cold-chain functionality, sustainability and stock management | Lack of or inconsistent cold chain | Acquisition of electric and solar refrigerators (Multi-stakeholder Dialogue Report (MSD) 2020) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Sierra Leone | no | Cold-chain functionality, sustainability and stock management | Lack of or inconsistent cold chain | Solar Direct Drive (SDD) units were installed to expand cold chain across facilities (JA 2019) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Solomon Islands | no | Cold-chain functionality, sustainability and stock management | Lack of or inconsistent cold chain | Installing Solar Direct Drive refrigerators across 7 provinces and providing training to clinic nurses on using Cold Chain equipment, as part of the Cold Chain Equipment Optimization Platform (CCEOP) (JA 2019) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Somalia | no | Cold-chain functionality, sustainability and stock management | Lack of or inconsistent cold chain | Use of Solar Direct Drive refrigerators to increase storage capacity for vaccines (JA 2018) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Sudan | no | Cold-chain functionality, sustainability and stock management | Lack of or inconsistent cold chain | Procurement of cold chain equipment and vaccine monitoring devices in 2015. UNICEF, OFDA and Rotary international equipped 149 facilities with vaccine refrigerators, cold rooms to two states, strenghtened passive cold chain equipement in 8 states, provided pack-up generators to 14 localities in conflict affected areas and helped upgrade the temperature monitoring devices (…). and Training of technicians on cold chain equipment maintenance (JA 2016) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Tanzania | no | Cold-chain functionality, sustainability and stock management | Lack of or inconsistent cold chain | Procured Solar Direct Drive refrigerators (1190) and ice line vest-frost refrigerators (195) to expand cold chain capacity under Cold Chain Equipment Optimization Platform (CCEOP) (JA 2019) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Togo | no | Cold-chain functionality, sustainability and stock management | Lack of or inconsistent cold chain | Installation of Solar Direct Drive (SDD) and mains-powered ice lined refrigerators and freezers (ILR) as part of the Cold Chain Equipment Optimization Platform (CCEOP) phase 1 (JA 2019) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Uganda | no | Cold-chain functionality, sustainability and stock management | Lack of or inconsistent cold chain | Solar Direct Drive (SDD) fridges were procured, distributed and installed in all districts (JA 2016, 2017 & 2018) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Uzbekistan | no | Cold-chain functionality, sustainability and stock management | Lack of or inconsistent cold chain | 558 refrigerators and 2016 freezers delivered to the country and inventory list and cold chain equipment maintenance plan is in progress (JA 2019) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Yemen | no | Cold-chain functionality, sustainability and stock management | Lack of or inconsistent cold chain | Distribution and installation of Solar Direct Drive (SDD) refrigeration systems at the district level, with the support of UNICEF (JA 2019) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Zambia | no | Cold-chain functionality, sustainability and stock management | Lack of or inconsistent cold chain | All absorption fridges were replaced with Solar Direct Drive (SDD) refrigerators (JA 2016) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Commodities | Zimbabwe | no | Cold-chain functionality, sustainability and stock management | Lack of or inconsistent cold chain | Solar Direct Drive (SDD) refrigerators were installed in rural health facilities, in addition to remote temperature monitoring system, especially for rural health communities (JA 2018, JA 2019) | cold chain, equipment, solar, stock management, supply | Conflict, Remote, rural | |
| 4 Point of service | Funding and allocation of resources | Afghanistan | no | Integrated planning and implementation between government and partners | Inefficiency in financing and service delivery due to fragmented efforts and/or conflicting priorities. | Coordination between partners (GCMU, BPHS, three donors, UNICEF, WHO) to ensure implementation of mobile/outreach activities. Coordination among partners was initiated from development of the Term of Reference (ToR)of mobile/outreach. The implantation mechanism has been agreed by all partners (NEPI, UNICEF, WHO). In the pre-proposal stage all non-governmental organizations (NGOs) were oriented on the implementation mechanism. In addition to that the sustainability of mobile/outreach was discussed with the World Bank to be integrated along with the upgraded sub-centers in the SEHATMANDI project (JA, 2018) Combined Polio Eradication Initiative (PEI) and Expanded Programme on Immunization (EPI) micro plans (JA 2018) | agreements, collaboration, coordination, joint planning, Memorandum of Understanding (MoU), Sector-wide Approach (SWAp) | ||
| 4 Point of service | Funding and allocation of resources | Bangladesh | no | Integrated planning and implementation between government and partners | Inefficiency in financing and service delivery due to fragmented efforts and/or conflicting priorities. | SWAp (Health, Nutrition and Population Sector Development Programme) was implemented between 2011 and 2016, with extension in the following years. The programme focuses on governance and stewardship, strengthening the health system and providing quality health services (JA 2016) | agreements, collaboration, coordination, joint planning, Memorandum of Understanding (MoU), Sector-wide Approach (SWAp) | ||
| 4 Point of service | Funding and allocation of resources | Burundi | no | Integrated planning and implementation between government and partners | Inefficiency in financing and service delivery due to fragmented efforts and/or conflicting priorities. | Tripartite Memorandum of Understanding (MoU) between Burundi’s Ministry of Public Health, UNICEF and GAVI to finance community service organization (CSO) activities and large expenses (JA 2018) | agreements, collaboration, coordination, joint planning, Memorandum of Understanding (MoU), Sector-wide Approach (SWAp) | ||
| 4 Point of service | Funding and allocation of resources | Cameroon | no | Integrated planning and implementation between government and partners | Inefficiency in financing and service delivery due to fragmented efforts and/or conflicting priorities. | Joint technical assistance plan between WHO and UNICEF to strengthen coordination and improve leadership in immunization strategies (JA 2019) Tripartite Memorandum of Understanding (MoU) between the Ministry of Health, PROVARESSC Platform (Civil Society Organizations) and WHO contributes to demand generation and increasing utilization of immunization services via, namely, supportive supervision and community sensitization (JA 2017) | agreements, collaboration, coordination, joint planning, Memorandum of Understanding (MoU), Sector-wide Approach (SWAp) | ||
| 4 Point of service | Funding and allocation of resources | Comoros | no | Integrated planning and implementation between government and partners | Inefficiency in financing and service delivery due to fragmented efforts and/or conflicting priorities. | Memorandum of Understanding (MoU) between Ministry of Health, UNICEF and the Gavi Secretariat which ensures coordination of the health systems strengthening (HSS) funds and budget (JA 2016) | agreements, collaboration, coordination, joint planning, Memorandum of Understanding (MoU), Sector-wide Approach (SWAp) | ||
| 4 Point of service | Funding and allocation of resources | Djibouti | no | Integrated planning and implementation between government and partners | Inefficiency in financing and service delivery due to fragmented efforts and/or conflicting priorities. | UNICEF supports the Expanded Programme on Immunization (EPI) team in compiling, analysing and sharing data with stakeholders required for decision-making, collecting data from the immunisation logistics chain as an entry point (JA 2019) | agreements, collaboration, coordination, joint planning, Memorandum of Understanding (MoU), Sector-wide Approach (SWAp) | ||
| 4 Point of service | Funding and allocation of resources | Guinea | no | Integrated planning and implementation between government and partners | Inefficiency in financing and service delivery due to fragmented efforts and/or conflicting priorities. | Creation of convergence programme (for synergy and complementarity of actions) by Government and UNICEF, aimed at improving availability of vaccines, complementing support from financial partners and responsibilities of legal officials, champions of immunization and community and religious leaders, as well as organizing community dialogue sessions to promote immunization (JA 2018) | agreements, collaboration, coordination, joint planning, Memorandum of Understanding (MoU), Sector-wide Approach (SWAp) | ||
| 4 Point of service | Funding and allocation of resources | India | no | Integrated planning and implementation between government and partners | Inefficiency in financing and service delivery due to fragmented efforts and/or conflicting priorities. | Vaccines & Immunization Research Network and its “Scientific Advisory Group (SAG)†established for evidence building and to guide new research and rolled-out on vaccines and immunization (JA 2017) Joint Transition Planning Framework (Polio to Public Health, 2017-2026) developed and being implemented as approved by GoI (JA 2018) Immunization Coverage Improvement Plan (iCIP) developed following comprehensive Urban Immunization Programme (UIP) reviews in targeted states of Bihar, Madhya Pradesh, Maharashtra, Rajasthan and Uttar Pradesh (JA 2019) | agreements, collaboration, coordination, joint planning, Memorandum of Understanding (MoU), Sector-wide Approach (SWAp) | ||
| 4 Point of service | Funding and allocation of resources | Kenya | no | Integrated planning and implementation between government and partners | Inefficiency in financing and service delivery due to fragmented efforts and/or conflicting priorities. | Annual joint planning and forecasting workshops to integrate immunization and other service delivery plans (JA 2017 & 2018) | agreements, collaboration, coordination, joint planning, Memorandum of Understanding (MoU), Sector-wide Approach (SWAp) | ||
| 4 Point of service | Funding and allocation of resources | Kyrgyzstan | no | Integrated planning and implementation between government and partners | Inefficiency in financing and service delivery due to fragmented efforts and/or conflicting priorities. | The Health Sector is supported by the Sector Wide Approach (SWAp) in Kyrgzystan. KfW, Swiss Government and the World Bank support to the health sector is pooled in the SWAp and managed by the World Bank (JA 2017). | agreements, collaboration, coordination, joint planning, Memorandum of Understanding (MoU), Sector-wide Approach (SWAp) | ||
| 4 Point of service | Funding and allocation of resources | Madagascar | no | Integrated planning and implementation between government and partners | Inefficiency in financing and service delivery due to fragmented efforts and/or conflicting priorities. | Hold advocacy meetings with the various entities concerned to facilitate the adoption of the draft law (primacy, parliament, government, etc.) and the implementation of the law (implementing decree): planned for Q2 2019, but rescheduled following the strong events in the field of vaccination that occurred during this period (JA 2019) | agreements, collaboration, coordination, joint planning, Memorandum of Understanding (MoU), Sector-wide Approach (SWAp) | ||
| 4 Point of service | Funding and allocation of resources | Malawi | no | Integrated planning and implementation between government and partners | Inefficiency in financing and service delivery due to fragmented efforts and/or conflicting priorities. | Sector Wide Approach (SWAp) used to coordinate financing of health services and interventions (JA 2018) | agreements, collaboration, coordination, joint planning, Memorandum of Understanding (MoU), Sector-wide Approach (SWAp) | ||
| 4 Point of service | Funding and allocation of resources | Mozambique | no | Integrated planning and implementation between government and partners | Inefficiency in financing and service delivery due to fragmented efforts and/or conflicting priorities. | The country has an Inter-agency Coordinating Committee (ICC) to provide oversight, mobilize resources and coordinate partner support to the program. The National Logistics Working Group addresses specifically Expanded Programme on Immunization (EPI) supply chain and logistics issues – members include VillageReach, CHAI, UNICEF, USAID, CMAM and HAI (JA 2017) Costing study is underway to inform the Ministry of Health (MoH) for planning and replication (JA 2017) | agreements, collaboration, coordination, joint planning, Memorandum of Understanding (MoU), Sector-wide Approach (SWAp) | ||
| 4 Point of service | Funding and allocation of resources | Myanmar | no | Integrated planning and implementation between government and partners | Inefficiency in financing and service delivery due to fragmented efforts and/or conflicting priorities. | Over 1000 government staff attended trainings on endorsed financial management standard operating procedures (SOPs). In addition, Finance Assistants were deployed within the Ministry, especially at central state and regional levels to improve the financial management of the Ministry (planning, budgeting, policies & standards, etc.) (Multi-stakeholder Dialogue Report (MSD) 2020) | agreements, collaboration, coordination, joint planning, Memorandum of Understanding (MoU), Sector-wide Approach (SWAp) | ||
| 4 Point of service | Funding and allocation of resources | Nepal | no | Integrated planning and implementation between government and partners | Inefficiency in financing and service delivery due to fragmented efforts and/or conflicting priorities. | Nepal Health Sector Strategy is modeled on the Sector Wide Approach (SWAp) and focuses on partnerships and multi-sectoral approaches for health development (JA 2018) | agreements, collaboration, coordination, joint planning, Memorandum of Understanding (MoU), Sector-wide Approach (SWAp) | ||
| 4 Point of service | Funding and allocation of resources | Nigeria | no | Integrated planning and implementation between government and partners | Inefficiency in financing and service delivery due to fragmented efforts and/or conflicting priorities. | Development partners and Bauchi State MoH signed an Memorandum of Understanding (MoU) in support of one state-wide plan that is coordinated through a primary healthcare technical working group (JA 2018) Bill and Melinda Gates Foundation (BMGF) and Dangote Foundation are supporting 6 states in the form of MoU to address primary health care (PHC) and routine immunization (JA 2019) (https://www.unicef.org/nigeria/media/2426/file/AAI%20Bauchi.pdf) | agreements, collaboration, coordination, joint planning, Memorandum of Understanding (MoU), Sector-wide Approach (SWAp) | ||
| 4 Point of service | Funding and allocation of resources | Senegal | no | Integrated planning and implementation between government and partners | Inefficiency in financing and service delivery due to fragmented efforts and/or conflicting priorities. | Local government operational plans (POCLs) – which take into account immunization activities and the budgets and contributions of partners, the community and local authorities (JA 2018) | agreements, collaboration, coordination, joint planning, Memorandum of Understanding (MoU), Sector-wide Approach (SWAp) | ||
| 4 Point of service | Funding and allocation of resources | Solomon Islands | no | Integrated planning and implementation between government and partners | Inefficiency in financing and service delivery due to fragmented efforts and/or conflicting priorities. | Memorandum of Understanding (MoU) between Ministry of Health and Medical Services (MHMS) and the Solomon Island Churches Association (SICA) to improve program-focused work (JA 2019) | agreements, collaboration, coordination, joint planning, Memorandum of Understanding (MoU), Sector-wide Approach (SWAp) | ||
| 4 Point of service | Funding and allocation of resources | Somalia | no | Integrated planning and implementation between government and partners | Inefficiency in financing and service delivery due to fragmented efforts and/or conflicting priorities. | Private Sector Partnership Memorandum of Understanding (MoU) was signed between the Federal Ministry of Health (FMoH) and 12 private health facilities to increase the coverage of private facilities providing Expanded Programme on Immunization (EPI) services in urban areas. Activities include monitoring of the quality of services and on-the-job training for health workers (JA 2019) | agreements, collaboration, coordination, joint planning, Memorandum of Understanding (MoU), Sector-wide Approach (SWAp) | ||
| 4 Point of service | Funding and allocation of resources | Sudan | no | Integrated planning and implementation between government and partners | Inefficiency in financing and service delivery due to fragmented efforts and/or conflicting priorities. | Federal Ministry of Health (MoH) has adopted the “One Plan, One Budget, One Report” approach to harmonize implementation of immunization strategies (JA 2018) To counter the costliness and unsustainability of the mobile strategy for immunization delivery, MoH expanded fixed immunization network as part of the primary health care (PHC) expansion project (aims at ensuring universal coverage by basic PHC immunization services) (JA 2016) | agreements, collaboration, coordination, joint planning, Memorandum of Understanding (MoU), Sector-wide Approach (SWAp) | ||
| 4 Point of service | Funding and allocation of resources | Timor Leste | no | Integrated planning and implementation between government and partners | Inefficiency in financing and service delivery due to fragmented efforts and/or conflicting priorities. | Memorandum of Understanding (MoU) between SAMES (central pharmacy) and UNICEF for the procurement of vaccines at an advantageous price (through the UNICEF procurement service) (JA 2017) | agreements, collaboration, coordination, joint planning, Memorandum of Understanding (MoU), Sector-wide Approach (SWAp) | ||
| 4 Point of service | Funding and allocation of resources | Uganda | no | Integrated planning and implementation between government and partners | Inefficiency in financing and service delivery due to fragmented efforts and/or conflicting priorities. | Joint planning and quarterly review meetings with district health stakeholders in Kalungu over the past year (JA 2018) | agreements, collaboration, coordination, joint planning, Memorandum of Understanding (MoU), Sector-wide Approach (SWAp) | ||
| 4 Point of service | Funding and allocation of resources | Zimbabwe | no | Integrated planning and implementation between government and partners | Inefficiency in financing and service delivery due to fragmented efforts and/or conflicting priorities. | National Immunization Technical Advisory Group (NITAG) was established in 2011 to provide technical guidance on immunization policies including introduction of new vaccines and operational research (JA 2016) | agreements, collaboration, coordination, joint planning, Memorandum of Understanding (MoU), Sector-wide Approach (SWAp) | ||
| 3 Preparation, cost and effort | Utilization | Bangladesh | yes | Coverage and equity assessments | Inequities in coverage across population groups and communities | Use of the EQUIST tool to perform an equity analysis around maternal, newborn, child and adolescent health (MNACH) services (JA 2019) Risk Assessment was performed to determine districts/upazilas/city corporations/municipality prioritization for unreached children (zero dose and under vaccinated children) (Multi-stakeholder Dialogue Report (MSD) 2020) | assessment, coverage and equity assessment (CEA), equity, inequality, inequity, Knowledge Attitutes and Practices (KAP), Reaching Every Community (REC), Reaching Every District (RED), targeting, unimmunized, utilization, zero dose | ||
| 3 Preparation, cost and effort | Utilization | Benin | yes | Coverage and equity assessments | Inequities in coverage across population groups and communities | Implementation of the ACE (atteindre chaque enfant- REC Reaching Every Child) approach on equity. A pool of resource persons took part in a regional training workshop on the methodology for conducting equity analyses in immunization organized by the UNICEF Regional Office for West and Central Africa. The training was the subject of a joint evaluation and the country is preparing to conduct the equity analysis in interventions integrating immunization but also nutrition and birth registration (JA 2017) | assessment, coverage and equity assessment (CEA), equity, inequality, inequity, Knowledge Attitutes and Practices (KAP), Reaching Every Community (REC), Reaching Every District (RED), targeting, unimmunized, utilization, zero dose | ||
| 3 Preparation, cost and effort | Utilization | Djibouti | yes | Coverage and equity assessments | Inequities in coverage across population groups and communities | Equity analysis of immunisation services during the development of the urban immunisation strategy (surveys planned as part of HSS and technical assistance) (JA 2019) | assessment, coverage and equity assessment (CEA), equity, inequality, inequity, Knowledge Attitutes and Practices (KAP), Reaching Every Community (REC), Reaching Every District (RED), targeting, unimmunized, utilization, zero dose | ||
| 3 Preparation, cost and effort | Utilization | Ethiopia | yes | Coverage and equity assessments | Inequities in coverage across population groups and communities | A behavioral determinants survey to assess the determinants of immunization service utilization in Ethiopia Agrarian communities (JA 2019) | assessment, coverage and equity assessment (CEA), equity, inequality, inequity, Knowledge Attitutes and Practices (KAP), Reaching Every Community (REC), Reaching Every District (RED), targeting, unimmunized, utilization, zero dose | ||
| 3 Preparation, cost and effort | Utilization | Kenya | yes | Coverage and equity assessments | Inequities in coverage across population groups and communities | Knowledge, Attitudes and Practices (KAP) studies conducted in 20 low performing counties. KAP studies informed the development of communications plans and hard-to-reach audience strategies (for Nomads, for internally displaced persons (IDPs) and Refugees, for high density urban populations and for hard to reach religious groups) (JA 2018) | assessment, coverage and equity assessment (CEA), equity, inequality, inequity, Knowledge Attitutes and Practices (KAP), Reaching Every Community (REC), Reaching Every District (RED), targeting, unimmunized, utilization, zero dose | ||
| 3 Preparation, cost and effort | Utilization | Lao People’s Democatic Republic | yes | Coverage and equity assessments | Inequities in coverage across population groups and communities | National Immunization Technical Advisory Group (NITAG) has provided suport for a number of research activities: 1) Knowledge, Attitudes and Practices (KAP) survey on influenza vaccine survey among pregnant women 2) KAP on influenza vaccine survey among health care workers (JA 2018) Research project led by WHO on immunization barriers and facilitators for people living in remote communities along border regions (JA 2019) | assessment, coverage and equity assessment (CEA), equity, inequality, inequity, Knowledge Attitutes and Practices (KAP), Reaching Every Community (REC), Reaching Every District (RED), targeting, unimmunized, utilization, zero dose | ||
| 3 Preparation, cost and effort | Utilization | Liberia | yes | Coverage and equity assessments | Inequities in coverage across population groups and communities | Knowledge, Attitudes and Practices (KAP) study was conducted to understand client perception about vaccination (quantitative and qualitative study). Findings have been used to inform the immunization communication strategy and the development of Information, Education and Communication (IEC) materials that are culturally appropriate and audience sensitive, and to increase uptake of immunization services at health facility and outreach levels (JA 2019) Immunization risk assessment and vaccine perception study conducted in Montserrado and Marghibi counties. The study was aimed at understanding myths, misinformation and rumours about vaccination services (Multi-stakeholder Dialogue Report (MSD) 2020) | assessment, coverage and equity assessment (CEA), equity, inequality, inequity, Knowledge Attitutes and Practices (KAP), Reaching Every Community (REC), Reaching Every District (RED), targeting, unimmunized, utilization, zero dose | ||
| 3 Preparation, cost and effort | Utilization | Madagascar | yes | Coverage and equity assessments | Inequities in coverage across population groups and communities | Operational research at the level of the 8 major cities to know the reason for non-vaccination (Mapping of non-vaccinated people through a study of the location and reasons). The implementation of operational research in the 8 major cities is planned for Q3 2019 (JA 2019) | assessment, coverage and equity assessment (CEA), equity, inequality, inequity, Knowledge Attitutes and Practices (KAP), Reaching Every Community (REC), Reaching Every District (RED), targeting, unimmunized, utilization, zero dose | ||
| 3 Preparation, cost and effort | Utilization | Malawi | yes | Coverage and equity assessments | Inequities in coverage across population groups and communities | Mixed method survey including focus groups and in-depth interviews was conducted to assess knowledge and practices of caregivers regarding immunization (in addition to deworming and Vitamin A supplementation) in 21 districts (JA 2019) | assessment, coverage and equity assessment (CEA), equity, inequality, inequity, Knowledge Attitutes and Practices (KAP), Reaching Every Community (REC), Reaching Every District (RED), targeting, unimmunized, utilization, zero dose | ||
| 3 Preparation, cost and effort | Utilization | Mongolia | yes | Coverage and equity assessments | Inequities in coverage across population groups and communities | Routine door-to-door visits by nurse to identify new people in the catchment area. Nurse did not provide services on these walks, but instead requested new clients to attend the health facility or the local registration office. The person(s) was registered at the health facility or at the Governor’s office, and the information was shared between the Family Group Practice and the civic authorities. (http://www.equityhealthj.com/content/11/1/15) | assessment, coverage and equity assessment (CEA), equity, inequality, inequity, Knowledge Attitutes and Practices (KAP), Reaching Every Community (REC), Reaching Every District (RED), targeting, unimmunized, utilization, zero dose | ||
| 3 Preparation, cost and effort | Utilization | Mozambique | yes | Coverage and equity assessments | Inequities in coverage across population groups and communities | Comparative qualitative study on coverage and equity was implemented in 6 districts over 3 provinces to identify the main reason for children vaccination missed opportunities. Over 780 interviews were conducted with parents, health providers and health care managers, in addition to focus groups (JA 2018) | assessment, coverage and equity assessment (CEA), equity, inequality, inequity, Knowledge Attitutes and Practices (KAP), Reaching Every Community (REC), Reaching Every District (RED), targeting, unimmunized, utilization, zero dose | ||
| 3 Preparation, cost and effort | Utilization | Nicaragua | yes | Coverage and equity assessments | Inequities in coverage across population groups and communities | Knowledge, Attitudes and Practices (KAP) study conducted to assess gaps in knowledge about immunization among communities and create adapted key messages to target populations (JA 2018) Pilot workshop on operational research into reasons for low immunisation coverage and abandonment. In 2017, the pilot workshop was extended to the managers of all SILAIS and support was given to 10 SILAIS for implementing operational research to identify the reasons for low immunisation coverage, high dropout rates, and failures to notify measles/rubella cases (JA 2017) | assessment, coverage and equity assessment (CEA), equity, inequality, inequity, Knowledge Attitutes and Practices (KAP), Reaching Every Community (REC), Reaching Every District (RED), targeting, unimmunized, utilization, zero dose | ||
| 3 Preparation, cost and effort | Utilization | Nigeria | yes | Coverage and equity assessments | Inequities in coverage across population groups and communities | A community acceptability study was conducted (JA 2017) | assessment, coverage and equity assessment (CEA), equity, inequality, inequity, Knowledge Attitutes and Practices (KAP), Reaching Every Community (REC), Reaching Every District (RED), targeting, unimmunized, utilization, zero dose | ||
| 3 Preparation, cost and effort | Utilization | Rwanda | yes | Coverage and equity assessments | Inequities in coverage across population groups and communities | Formative research aiming to understand gender barriers to acceessing services and vaccination uptake and how adolesscent girls and young women (including young mothers) make decisions regarding their health and health of children. This research will contribute to broader research on the vaccination programme and Knowledge, Attitudes and Practices (KAP) study (Multi-stakeholder Dialogue Report (MSD) 2020) As part of an evaluation, 271 mothers/caregivers were interviewed immediately after vaccinating their children (at the age of 14 weeks), to seek anecdotal evidence of vaccine acceptability (JA 2019) | assessment, coverage and equity assessment (CEA), equity, inequality, inequity, Knowledge Attitutes and Practices (KAP), Reaching Every Community (REC), Reaching Every District (RED), targeting, unimmunized, utilization, zero dose | ||
| 3 Preparation, cost and effort | Utilization | Senegal | yes | Coverage and equity assessments | Inequities in coverage across population groups and communities | Coverage survey, data collection and analysis of immunisation activities to analyse access and follow-up of children. Identified 15 priority districts (JA 2018) | assessment, coverage and equity assessment (CEA), equity, inequality, inequity, Knowledge Attitutes and Practices (KAP), Reaching Every Community (REC), Reaching Every District (RED), targeting, unimmunized, utilization, zero dose | ||
| 3 Preparation, cost and effort | Utilization | Sierra Leone | yes | Coverage and equity assessments | Inequities in coverage across population groups and communities | Operational research on demand generation for Expanded Programme on Immunization (EPI) is conducted in collaboration with several partners (Innovators for Poverty Action, ICAP) (JA 2018) | assessment, coverage and equity assessment (CEA), equity, inequality, inequity, Knowledge Attitutes and Practices (KAP), Reaching Every Community (REC), Reaching Every District (RED), targeting, unimmunized, utilization, zero dose | ||
| 3 Preparation, cost and effort | Utilization | Somalia | yes | Coverage and equity assessments | Inequities in coverage across population groups and communities | Formative research undertaken in selected areas to understand underlying causes of low vaccine uptake (JA 2019) | assessment, coverage and equity assessment (CEA), equity, inequality, inequity, Knowledge Attitutes and Practices (KAP), Reaching Every Community (REC), Reaching Every District (RED), targeting, unimmunized, utilization, zero dose | ||
| 3 Preparation, cost and effort | Utilization | Sudan | yes | Coverage and equity assessments | Inequities in coverage across population groups and communities | Study done to generate evidence on community acceptance for multiple injections to generate evidence for social mobilization plan for Inactivated Polio Vaccine (IPV) introduction (JA 2016) | assessment, coverage and equity assessment (CEA), equity, inequality, inequity, Knowledge Attitutes and Practices (KAP), Reaching Every Community (REC), Reaching Every District (RED), targeting, unimmunized, utilization, zero dose | ||
| 3 Preparation, cost and effort | Utilization | Tajikistan | yes | Coverage and equity assessments | Inequities in coverage across population groups and communities | Knowledge, Attitudes and Practices (KAP) survey initiated by UNICEF aimed to identify key audiences and messages for addressing vaccine hesitancy, and improving knowledge, attitudes, and behaviors related to vaccine adherence. It assessed awareness on the importance of timely immunization for children and their readiness for vaccination as well as identifying the existing barriers and factors contributing to vaccine hesitancy . The study also aimed at developing an immunization communication strategy. Study consisted of surveys, semi-structured interviews with halth workeers and activists, and focus groups among mothers, fathers and grandmothers of vaccinated and unvaccinated children (JA 2018 and JA 2019) Focus group discussions conducted among migrant caregivers, caregivers of children left by migrant parents, Lili (Roma) carregivers, and caregivers in urban areas and healthcare workers to inform the development of District-based Social Mobilization and Outreach Action Plans (JA 2020) | assessment, coverage and equity assessment (CEA), equity, inequality, inequity, Knowledge Attitutes and Practices (KAP), Reaching Every Community (REC), Reaching Every District (RED), targeting, unimmunized, utilization, zero dose | ||
| 3 Preparation, cost and effort | Utilization | Timor Leste | yes | Coverage and equity assessments | Inequities in coverage across population groups and communities | Several rapid qualitative and quantitative studies were conducted to understand the affected communities (knowledge, attitudes and perceptions about COVID-19), population most at risk, to identify communication channels that were most effective, health seeking behaviours and perceptions in the community about COVID-19 and health services (Multi-stakeholder Dialogue Report (MSD) 2020) | assessment, coverage and equity assessment (CEA), equity, inequality, inequity, Knowledge Attitutes and Practices (KAP), Reaching Every Community (REC), Reaching Every District (RED), targeting, unimmunized, utilization, zero dose | ||
| 3 Preparation, cost and effort | Utilization | Uzbekistan | yes | Coverage and equity assessments | Inequities in coverage across population groups and communities | Ministry of Health is conducting formative research among different key informants to understand enablers, influencers and barriers that affect girls’ decisions for being vaccinated for HPV. This research helped to identify key messages that were used in communications plan to sensitize and mobiilze communities and other relevent audiences about HPV vaccination. Research was done through focus groups, individual interviews and community surveys (Multi-stakeholder Dialogue Report (MSD) 2020) Knowledge, Attitudes and Practices (KAP) study conducted among parents to understand views and behaviours towards immunization. The survey activities are supplemented by in-depth interviews and focus groups with parents (JA 2018) WHO initiated the Rapid Evaluation of HPV Vaccine Introduction, a qualitative evaluation aiming to develop lessons learned from the introduction of the vaccine, specificallly focusing on the development and delivery of communicatoin and training activities (MSD 2020) | assessment, coverage and equity assessment (CEA), equity, inequality, inequity, Knowledge Attitutes and Practices (KAP), Reaching Every Community (REC), Reaching Every District (RED), targeting, unimmunized, utilization, zero dose | ||
| 3 Preparation, cost and effort | Utilization | Vietnam | yes | Coverage and equity assessments | Inequities in coverage across population groups and communities | Conducted research to evaluate 1) health worker training/education, 2) health services utilization, 3) the need for maternal and child health care and the ability of health centres to respond (JA 2017) | assessment, coverage and equity assessment (CEA), equity, inequality, inequity, Knowledge Attitutes and Practices (KAP), Reaching Every Community (REC), Reaching Every District (RED), targeting, unimmunized, utilization, zero dose | ||
| 3 Preparation, cost and effort | Utilization | Bangladesh | yes | Reminders and strategies to reduce time, costs and opportunity barriers | Logistics of remembering, time, costs and opportunity, juggling competing priorities | E-tracker individual tracking system was developed through DHIS2-based android app. System allows online and offline immunization registration, SMS messaging to remind mothers about due vaccination and monitoring of unvaccinated, partially vaccinated and fully vaccinated children. Project was piloted in Mouvibazar district and 1 zone of Dhaka South City Corporation since May 2019 (JA 2019) Non-collateral credit loans for immunisation were found to increase uptake of various vaccines in Bangladesh. Uptake was higher in areas with a credit programme versus areas without, and for women who were credit members versus those who were not. (DOI: 10.1300/J013v25n01_05) | defaulter tracing, dropout, financial barriers, phone, recall, reminders, SMS text, tracking | ||
| 3 Preparation, cost and effort | Utilization | Burundi | yes | Reminders and strategies to reduce time, costs and opportunity barriers | Logistics of remembering, time, costs and opportunity, juggling competing priorities | RapidSMS system used for defaulter tracing (send SMS to caregivers to remind them of appointments) (JA 2018) | defaulter tracing, dropout, financial barriers, phone, recall, reminders, SMS text, tracking | ||
| 3 Preparation, cost and effort | Utilization | Cote d’Ivoire | yes | Reminders and strategies to reduce time, costs and opportunity barriers | Logistics of remembering, time, costs and opportunity, juggling competing priorities | JA 2018 and 2019: Implementation of the M-Vaccine project, in collaboration with VillageReach. This intervention improves immunization demand through SMS text reminders for vaccination appointments | defaulter tracing, dropout, financial barriers, phone, recall, reminders, SMS text, tracking | ||
| 3 Preparation, cost and effort | Utilization | DPR Korea | yes | Reminders and strategies to reduce time, costs and opportunity barriers | Logistics of remembering, time, costs and opportunity, juggling competing priorities | Registering of all children 9 months-15 years and girls 16-18 years, as well as inter-personal communication by household doctors during Measles Rubella (MR) catch-up campaign allowed tracking of defaulters in hard to reach areas (JA 2019) | defaulter tracing, dropout, financial barriers, phone, recall, reminders, SMS text, tracking | ||
| 3 Preparation, cost and effort | Utilization | Eritrea | yes | Reminders and strategies to reduce time, costs and opportunity barriers | Logistics of remembering, time, costs and opportunity, juggling competing priorities | Mothers and caregivers are encouraged by healthcare providers to bring defaulter children to sites for Vitamin A supplementation and immunization during the African Vaccination Week and Child Health & Nutrition Week activities (JA 2017) | defaulter tracing, dropout, financial barriers, phone, recall, reminders, SMS text, tracking | ||
| 3 Preparation, cost and effort | Utilization | Ethiopia | yes | Reminders and strategies to reduce time, costs and opportunity barriers | Logistics of remembering, time, costs and opportunity, juggling competing priorities | Ethio-telekom SMS texts for advocacy on Expanded Programme on Immunization (EPI) sends mobile reminders to caregivers and parents for vaccination (JA 2017 & 2019) Putting in place a project for mobile phone reminders of Expanded Programme on Immunization (EPI) appointments, linked to the national electronic immunization registry (eCHIS) to help remind caregivers to vaccinate on time and reduce drop outs (JA 2019) | defaulter tracing, dropout, financial barriers, phone, recall, reminders, SMS text, tracking | ||
| 3 Preparation, cost and effort | Utilization | Ghana | yes | Reminders and strategies to reduce time, costs and opportunity barriers | Logistics of remembering, time, costs and opportunity, juggling competing priorities | Screening of school children at entry to school and providing missed vaccinations (JA 2019) Defaulter tracking tool (Child Health Register) is distributed to all facilities and vaccination sites to keep track of defaulters (JA 2017) | defaulter tracing, dropout, financial barriers, phone, recall, reminders, SMS text, tracking | ||
| 3 Preparation, cost and effort | Utilization | Guinea | yes | Reminders and strategies to reduce time, costs and opportunity barriers | Logistics of remembering, time, costs and opportunity, juggling competing priorities | Training 190 Community Safety Assistants (CSAs) and 1855 Community Relais on essential family practices (including immunization) to support social mobilization and active research and catch-up of children not immunized, and the beginning of the process of systematically counting children under 5 years of age and pregnant women (as part of the pilot initiative “40 convergence municipalities” (JA 2019) | defaulter tracing, dropout, financial barriers, phone, recall, reminders, SMS text, tracking | ||
| 3 Preparation, cost and effort | Utilization | Indonesia | yes | Reminders and strategies to reduce time, costs and opportunity barriers | Logistics of remembering, time, costs and opportunity, juggling competing priorities | An SMS-based platform (RapidPro) was used to send automated reminders to caregivers about immunisation schedule for their children. This strategy was implemented in poor urban slum areas of Jakarta with low vaccination rates, high frquency of outbreaks and dropouts (JA 2017) Coverage surverys are conducted in low-coverage areas and the Drop-Out Follow Up (DOFU) strategy is applied to target children for immunisation (JA 2016) | defaulter tracing, dropout, financial barriers, phone, recall, reminders, SMS text, tracking | ||
| 3 Preparation, cost and effort | Utilization | Kenya | yes | Reminders and strategies to reduce time, costs and opportunity barriers | Logistics of remembering, time, costs and opportunity, juggling competing priorities | Use of SMS reminders and WhatsApp messaging for information dissemination in mass campaigns. The use of SMS text reminders in communication with clientele resulted in great penetration and demand generation during the 2016 measles rubella campaign (JA 2016 & 2017) The school health strategy of mobilizing children to reach families with key messages and for defaulter tracing during campaigns has been successful and needs to be scaled up also for routine immunization. Engagement of teachers, school children and community health volunteers in tracking children who have missed their immunization (JA 2016, 2017 & 2018). An evaluation with a large number of participants found that SMS text reminders were effective in reducing dropouts for vaccinations in the selected districts in Kenya. The vaccination coverage was significantly higher among those receiving SMS text reminders than those receiving routine reminders (DOI 10.1186/s12889-016-2823-5) | defaulter tracing, dropout, financial barriers, phone, recall, reminders, SMS text, tracking | ||
| 3 Preparation, cost and effort | Utilization | Lao People’s Democatic Republic | yes | Reminders and strategies to reduce time, costs and opportunity barriers | Logistics of remembering, time, costs and opportunity, juggling competing priorities | Quarterly community meetings are conducted by local leaders and village health volunteers to identify missed children/drop-outs (JA 2019) Pilot Interactive Voice Recording (IVR) project (in 2 provinces) allows village chiefs to report Expanded Programme on Immunization (EPI) outreach and defaulter tracking progress to a centalized helpline, allowing real-time data tracking (JA 2019) During national school-based campaign for HPV vaccination, a collaboration between health centres, schools, village heads and village health volunteers allowed tracking and vaccination of girls who are not in school (Multi-stakeholder Dialogue Report (MSD) 2020) | defaulter tracing, dropout, financial barriers, phone, recall, reminders, SMS text, tracking | ||
| 3 Preparation, cost and effort | Utilization | Liberia | yes | Reminders and strategies to reduce time, costs and opportunity barriers | Logistics of remembering, time, costs and opportunity, juggling competing priorities | Defaulter tracking through Community Health Assessment (CHA) platform and electronic real-time vaccine tracking system (Multi-stakeholder Dialogue Report (MSD) 2020) | defaulter tracing, dropout, financial barriers, phone, recall, reminders, SMS text, tracking | ||
| 3 Preparation, cost and effort | Utilization | Mali | yes | Reminders and strategies to reduce time, costs and opportunity barriers | Logistics of remembering, time, costs and opportunity, juggling competing priorities | Implementation of e-register for immunization coupled with SMS text reminders for appointments. Plans for scaling up and expanding have been proposed (JA 2018) | defaulter tracing, dropout, financial barriers, phone, recall, reminders, SMS text, tracking | ||
| 3 Preparation, cost and effort | Utilization | Mozambique | yes | Reminders and strategies to reduce time, costs and opportunity barriers | Logistics of remembering, time, costs and opportunity, juggling competing priorities | Defaulter tracking in districts implementing Reaching Every District (RED) occurs through the support of trained community health workers and community leaders via community registers that are harmonized with facility-level health registers (JA 2017) | defaulter tracing, dropout, financial barriers, phone, recall, reminders, SMS text, tracking | ||
| 3 Preparation, cost and effort | Utilization | Nigeria | yes | Reminders and strategies to reduce time, costs and opportunity barriers | Logistics of remembering, time, costs and opportunity, juggling competing priorities | Pilot SMS text reminders to the parents and caregivers on the due dates of vaccination(s) (JA 2016) Cell phone reminder/recall is associated with the highest immunization completion rates among the children in the study. The combination of cell phone reminder/recall and immunization providers training intervention was not superior to cell phone reminder/recall intervention alone while immunization providers’ training alone showed no difference with routine care in improving immunization completion. (https://doi.org/10.1007/s10900-015-0092-3) Using a reminder bracelet to improve timeliness and completeness of childhood vaccinations (JA 2017) | defaulter tracing, dropout, financial barriers, phone, recall, reminders, SMS text, tracking | ||
| 3 Preparation, cost and effort | Utilization | Pakistan | yes | Reminders and strategies to reduce time, costs and opportunity barriers | Logistics of remembering, time, costs and opportunity, juggling competing priorities | Zindagi Mehfooz (ZM) DIR includes features such as individual-level data to track each child in the community, web-based dashboard, unique QR code-based identification mechanism, interactive (2-way) SMS text reminders, a decision support system to guide vaccinators for routine and catch-up immunizations (JA 2019) A new child platform registry in Sindh expands the capacity for SMS text and voice messaging and is in contracting to provide 2-way SMS text capability (JA 2018) | defaulter tracing, dropout, financial barriers, phone, recall, reminders, SMS text, tracking | ||
| 3 Preparation, cost and effort | Utilization | Rwanda | yes | Reminders and strategies to reduce time, costs and opportunity barriers | Logistics of remembering, time, costs and opportunity, juggling competing priorities | Use of immunisation e-tracker system linked to community health workers’ (CHWs’) phones to better track the defaulters (JA 2019) | defaulter tracing, dropout, financial barriers, phone, recall, reminders, SMS text, tracking | ||
| 3 Preparation, cost and effort | Utilization | Senegal | yes | Reminders and strategies to reduce time, costs and opportunity barriers | Logistics of remembering, time, costs and opportunity, juggling competing priorities | Action plans developed with input from local civil society organizations, with a focus on specific and innovative communication for the recovery of unvaccinated children (JA 2018) | defaulter tracing, dropout, financial barriers, phone, recall, reminders, SMS text, tracking | ||
| 3 Preparation, cost and effort | Utilization | Sierra Leone | yes | Reminders and strategies to reduce time, costs and opportunity barriers | Logistics of remembering, time, costs and opportunity, juggling competing priorities | Defaulter tracing through community health workers (CHWs) (JA 2018) | defaulter tracing, dropout, financial barriers, phone, recall, reminders, SMS text, tracking | ||
| 3 Preparation, cost and effort | Utilization | Somalia | yes | Reminders and strategies to reduce time, costs and opportunity barriers | Logistics of remembering, time, costs and opportunity, juggling competing priorities | Setting up mobile strategy to register nomad groups, who represent 25% of the population. List of nomads is compiled by clan leaders and shared with health authorities for tracking (JA 2018) Defaulter tracing through community health workers, community leaders and nomadic leaders (JA 2019) | defaulter tracing, dropout, financial barriers, phone, recall, reminders, SMS text, tracking | ||
| 3 Preparation, cost and effort | Utilization | South Sudan | yes | Reminders and strategies to reduce time, costs and opportunity barriers | Logistics of remembering, time, costs and opportunity, juggling competing priorities | Defaulter tracing, tracking and registering newborns is performed by community mobilizers (JA 2018) Community mobilization and defaulter tracing training for community mobilizers and vaccinators (health workers) was performed by Community Service Organizations (CSOs) (South Sudan Red Cross, Lokh-odhi and e Hope) (JA 2018) | defaulter tracing, dropout, financial barriers, phone, recall, reminders, SMS text, tracking | ||
| 3 Preparation, cost and effort | Utilization | Tanzania | yes | Reminders and strategies to reduce time, costs and opportunity barriers | Logistics of remembering, time, costs and opportunity, juggling competing priorities | Defaulter tracking performed by community health workers (CHWs) (JA 2019) | defaulter tracing, dropout, financial barriers, phone, recall, reminders, SMS text, tracking | ||
| 3 Preparation, cost and effort | Utilization | Timor Leste | yes | Reminders and strategies to reduce time, costs and opportunity barriers | Logistics of remembering, time, costs and opportunity, juggling competing priorities | Front-line workers are provided mobile phone credits to perform contact tracing (during COVID-19) and track defaulters for routine immunization (Multi-stakeholder Dialogue Report (MSD) 2020) | defaulter tracing, dropout, financial barriers, phone, recall, reminders, SMS text, tracking | ||
| 3 Preparation, cost and effort | Utilization | Zambia | yes | Reminders and strategies to reduce time, costs and opportunity barriers | Logistics of remembering, time, costs and opportunity, juggling competing priorities | Defaulter tracing is conducted by community health workers (JA 2018) | defaulter tracing, dropout, financial barriers, phone, recall, reminders, SMS text, tracking | ||
| 3 Preparation, cost and effort | Utilization | Zimbabwe | yes | Reminders and strategies to reduce time, costs and opportunity barriers | Logistics of remembering, time, costs and opportunity, juggling competing priorities | My Village My Home initiative was implemented in Manicaland Province, to track immunization drop-outs and address hesitancy (JA 2018) Mothers or caregivers received the routine health education and also received automatic messages indicating the next appointment date on three occasions. In the non intervention group, the mothers or caregivers received the routine health education and were informed about their next scheduled visit. The first message was sent 7 days before the due date for the immunization as a reminder. The second message was sent 3 days before the due date. The last message was sent a day before immunization appointment date. The messages were sent for the 6th, 10th and 14 weeks appointments. The immunization coverage in this study at 6, 10 and 14 weeks was significantly higher in the intervention group than in the non-intervention group (p < 0.001). The significant difference in the immunization coverage can be attributed to the use of immunization short message reminders. (DOI 10.1186/s12889-015-1470-6) | defaulter tracing, dropout, financial barriers, phone, recall, reminders, SMS text, tracking | ||
| 3 Preparation, cost and effort | Management & Coordination | Afghanistan | no | Mapping populations and tracking movement | Uncertainties about population location, size and movement | Revision of micro plans through Geographic information systems (GIS) (JA 2016) Supporting micro-planning through Reaching Every District (RED) strategy using Community Health Workers (CHWs) and BASIC tools to improve the immunization services (JA 2018) Checklist to track community coverage of immunization services developed (JA 2018) Provision of 1000 tracking bags for defaulter tracking (JA 2018) | geographic information systems (GIS), mapping, mobile phone data, population movement, Reaching Every Community (REC), Reaching Every District (RED), satellite imagery, tracking | Conflict, Remote rural | |
| 3 Preparation, cost and effort | Management & Coordination | Bangladesh | no | Mapping populations and tracking movement | Uncertainties about population location, size and movement | Mapping of hard to reach populations, slums and areas without immunization coverage through Geographic information systems (GIS) mapping tool (Expanded Programme on Immunization (EPI) app) are carried out to identify unimmunized and zero-dose children (JA 2019) | geographic information systems (GIS), mapping, mobile phone data, population movement, Reaching Every Community (REC), Reaching Every District (RED), satellite imagery, tracking | Conflict, Remote rural | |
| 3 Preparation, cost and effort | Management & Coordination | Cameroon | no | Mapping populations and tracking movement | Uncertainties about population location, size and movement | Mapping of camps and routes for nomadic populations (pygmy populations) and outreach efforts for joint immunisation of children and livestock from these populations (JA 2019) | geographic information systems (GIS), mapping, mobile phone data, population movement, Reaching Every Community (REC), Reaching Every District (RED), satellite imagery, tracking | Conflict, Remote rural | |
| 3 Preparation, cost and effort | Management & Coordination | Chad | no | Mapping populations and tracking movement | Uncertainties about population location, size and movement | Carrying out population estimates with the help of satellite imagery in 3 districts (Benoyé, East N’Djamena and Yao) (JA 2019) Roadmap for the operationalization of DHIS2 (JA 2019) | geographic information systems (GIS), mapping, mobile phone data, population movement, Reaching Every Community (REC), Reaching Every District (RED), satellite imagery, tracking | Conflict, Remote rural | |
| 3 Preparation, cost and effort | Management & Coordination | Cote d’Ivoire | no | Mapping populations and tracking movement | Uncertainties about population location, size and movement | Using the ArcGIS program to monitor immunization and routine data, and strengthen Expanded Programme on Immunization (EPI) program surveillance (JA 2019) | geographic information systems (GIS), mapping, mobile phone data, population movement, Reaching Every Community (REC), Reaching Every District (RED), satellite imagery, tracking | Conflict, Remote rural | |
| 3 Preparation, cost and effort | Management & Coordination | Democratic Republic of Congo | no | Mapping populations and tracking movement | Uncertainties about population location, size and movement | Rapid convenience survey and post campaign survey (JA 2017) Population census was conducted in the 516 health zones as scheduled. This count was conducted using the village approach, with full participation by community mobilisers on a voluntary basis. It served to identify unimmunised children and those lost-to-follow-up in each village (JA 2018) | geographic information systems (GIS), mapping, mobile phone data, population movement, Reaching Every Community (REC), Reaching Every District (RED), satellite imagery, tracking | Conflict, Remote rural | |
| 3 Preparation, cost and effort | Management & Coordination | Djibouti | no | Mapping populations and tracking movement | Uncertainties about population location, size and movement | Joint effort by the Ministry of Health, World Health Organization, International Organization for Migration (OIM) and the UNHCR to map vulnerable target populations who should be immunized. Cross-border zones and migrant corridors have been considered and a polio immunization plan prioritising target populations in refugee camps was developed by the Expanded Programme on Immunization (EPI) (JA 2019) | geographic information systems (GIS), mapping, mobile phone data, population movement, Reaching Every Community (REC), Reaching Every District (RED), satellite imagery, tracking | Conflict, Remote rural | |
| 3 Preparation, cost and effort | Management & Coordination | Eritrea | no | Mapping populations and tracking movement | Uncertainties about population location, size and movement | Geographic information systems (GIS) training provided to 25 key actors at the national and zoba level offices with the goal of improving electronic surveillance of vaccine preventable diseases (JA 2017) | geographic information systems (GIS), mapping, mobile phone data, population movement, Reaching Every Community (REC), Reaching Every District (RED), satellite imagery, tracking | Conflict, Remote rural | |
| 3 Preparation, cost and effort | Management & Coordination | Ethiopia | no | Mapping populations and tracking movement | Uncertainties about population location, size and movement | Integrating community health structures/immunization program with the civil status (registration) office to improve the registration of birth events that occur out of health facility and enhance a well-functioning civil registration and vital statistics system. Pilot project is being implemented, Health Extension Workers (HEWs) and Women’s Development Army (WDAs) notify births & deaths occurring at home and at the community level to the civil society organizations (CSOs) (JA 2017) | geographic information systems (GIS), mapping, mobile phone data, population movement, Reaching Every Community (REC), Reaching Every District (RED), satellite imagery, tracking | Conflict, Remote rural | |
| 3 Preparation, cost and effort | Management & Coordination | Haiti | no | Mapping populations and tracking movement | Uncertainties about population location, size and movement | Microplanning was performed in 9 departments to guarantee geographic equity in immunisation and community participation in immunisation (JA 2016) | geographic information systems (GIS), mapping, mobile phone data, population movement, Reaching Every Community (REC), Reaching Every District (RED), satellite imagery, tracking | Conflict, Remote rural | |
| 3 Preparation, cost and effort | Management & Coordination | India | no | Mapping populations and tracking movement | Uncertainties about population location, size and movement | Geographic information systems (GIS) mapping of ward boundaries & immunization sessions tagging, helps in mapping pockets of vaccine-preventable disease (VPD) outbreaks and development of urban specific communication strategies (JA 2018) Global Positioning System (GPS)-enabled mobile application for the Cold Chain Points and the immunization session sites (JA 2019) | geographic information systems (GIS), mapping, mobile phone data, population movement, Reaching Every Community (REC), Reaching Every District (RED), satellite imagery, tracking | Conflict, Remote rural | |
| 3 Preparation, cost and effort | Management & Coordination | Kenya | no | Mapping populations and tracking movement | Uncertainties about population location, size and movement | Implementation of a nomadic strategy in Turkana to track children for vaccination (JA 2016) | geographic information systems (GIS), mapping, mobile phone data, population movement, Reaching Every Community (REC), Reaching Every District (RED), satellite imagery, tracking | Conflict, Remote rural | |
| 3 Preparation, cost and effort | Management & Coordination | Mozambique | no | Mapping populations and tracking movement | Uncertainties about population location, size and movement | Reaching Every District/ Reaching Every Community (RED/REC) Strategy Digitalisation Proposal developed (and initiated) to map populations and geographic areas with least access to immunization via Geographic information systems (GIS) with a geospatial component (Multi-stakeholder Dialogue Report (MSD) 2020) Combined microplanning and QGIS project in urban immunization commenced in Yangon region with phased national roll-out (JA 2019) | geographic information systems (GIS), mapping, mobile phone data, population movement, Reaching Every Community (REC), Reaching Every District (RED), satellite imagery, tracking | Conflict, Remote rural | |
| 3 Preparation, cost and effort | Management & Coordination | Myanmar | no | Mapping populations and tracking movement | Uncertainties about population location, size and movement | Pilot Geographic information systems (GIS) project for Expanded Programme on Immunization (EPI) microplanning and monitoring in 5 townships in Yangon region to improve immunization coverage and equity (Multi-stakeholder Dialogue Report (MSD) 2020) To ensure reaching all children especially among poorest quantile groups, GIS based micro-plans developed/updated with the community in major cities to include migratory, peri-urban and slum populations (JA 2018 & 2019) | geographic information systems (GIS), mapping, mobile phone data, population movement, Reaching Every Community (REC), Reaching Every District (RED), satellite imagery, tracking | Conflict, Remote rural | |
| 3 Preparation, cost and effort | Management & Coordination | Nigeria | no | Mapping populations and tracking movement | Uncertainties about population location, size and movement | Development of Geographic information systems (GIS)-based Reaching Every Ward (REW) micro-plan in 8 low performing states (JA 2019) Community Cluster Survey is also incorporated into the monthly routine immunization supportive supervision (RISS) exercise and reported monthly on the Open Data Kit (ODK) platform (JA 2016) | geographic information systems (GIS), mapping, mobile phone data, population movement, Reaching Every Community (REC), Reaching Every District (RED), satellite imagery, tracking | Conflict, Remote rural | |
| 3 Preparation, cost and effort | Management & Coordination | Pakistan | no | Mapping populations and tracking movement | Uncertainties about population location, size and movement | Vaccine stock tracking through Vaccine Logistics Management Information Systems (vLMIS) is available at Federal and provincial levels and 83 districts (JA 2016) | geographic information systems (GIS), mapping, mobile phone data, population movement, Reaching Every Community (REC), Reaching Every District (RED), satellite imagery, tracking | Conflict, Remote rural | |
| 3 Preparation, cost and effort | Management & Coordination | Rwanda | no | Mapping populations and tracking movement | Uncertainties about population location, size and movement | Mentorship and supervision of health facilities for Geographic information systems (GIS) based technologies is done at the central level (Multi-stakeholder Dialogue Report (MSD) 2020) | geographic information systems (GIS), mapping, mobile phone data, population movement, Reaching Every Community (REC), Reaching Every District (RED), satellite imagery, tracking | Conflict, Remote rural | |
| 3 Preparation, cost and effort | Management & Coordination | Somalia | no | Mapping populations and tracking movement | Uncertainties about population location, size and movement | Geographic information systems (GIS) mapping is used for polio surveillance and microplanning (JA 2019) | geographic information systems (GIS), mapping, mobile phone data, population movement, Reaching Every Community (REC), Reaching Every District (RED), satellite imagery, tracking | Conflict, Remote rural | |
| 3 Preparation, cost and effort | Management & Coordination | Uganda | no | Mapping populations and tracking movement | Uncertainties about population location, size and movement | Electronic registers for immunization integrated with the HIV electronic medical records (JA 2018) | geographic information systems (GIS), mapping, mobile phone data, population movement, Reaching Every Community (REC), Reaching Every District (RED), satellite imagery, tracking | Conflict, Remote rural | |
| 3 Preparation, cost and effort | Management & Coordination | Vietnam | no | Mapping populations and tracking movement | Uncertainties about population location, size and movement | Geographic information systems (GIS) mapping and tracking system for mobile populations are used to identify areas with low immunization coverage (JA 2018) | geographic information systems (GIS), mapping, mobile phone data, population movement, Reaching Every Community (REC), Reaching Every District (RED), satellite imagery, tracking | Conflict, Remote rural | |
| 2 Intent | Engagement of communities, stakeholders | Cote d’Ivoire | yes | Widen the audience for Information, Education and Communication (IEC) to strengthen and sustain social mobilization | Gender norms, intra-household dynamics, social structures, and lack of female empowerment can create barriers to decision-making and care-seeking | Vaccine hesitancy among fathers is addressed and resolved with the support of community leaders (JA 2018) | decision-making power, fathers, female autonomy, female empowerment, gender norms, intra-household dynamics, self-efficacy | ||
| 2 Intent | Engagement of communities, stakeholders | Kenya | yes | Widen the audience for Information, Education and Communication (IEC) to strengthen and sustain social mobilization | Gender norms, intra-household dynamics, social structures, and lack of female empowerment can create barriers to decision-making and care-seeking | Strategy for engaging and appealing to fathers to participate in immunization (JA 2018) | decision-making power, fathers, female autonomy, female empowerment, gender norms, intra-household dynamics, self-efficacy | ||
| 2 Intent | Engagement of communities, stakeholders | Lao People’s Democatic Republic | yes | Widen the audience for Information, Education and Communication (IEC) to strengthen and sustain social mobilization | Gender norms, intra-household dynamics, social structures, and lack of female empowerment can create barriers to decision-making and care-seeking | Community leaders and village health volunteers have been targeting mothers in known high-risk villages to engage them to understand their own personal views and potential hesitancy regarding immunization (JA 2019) | decision-making power, fathers, female autonomy, female empowerment, gender norms, intra-household dynamics, self-efficacy | ||
| 2 Intent | Engagement of communities, stakeholders | Malawi | yes | Widen the audience for Information, Education and Communication (IEC) to strengthen and sustain social mobilization | Gender norms, intra-household dynamics, social structures, and lack of female empowerment can create barriers to decision-making and care-seeking | Girl Effect supported the HPV vaccination activities through production and distribution of a mini magazine targeting 9-year old girls which provided information about cervical cancer and the vaccine. The organization also aired a radio programme targeting girls and pareents, which included a drama story about a 10-year old girl receiving the vaccine, expert interviews and other general messaging about cervical cancer and the vaccine (JA 2019) | decision-making power, fathers, female autonomy, female empowerment, gender norms, intra-household dynamics, self-efficacy | ||
| 2 Intent | Engagement of communities, stakeholders | Mozambique | yes | Widen the audience for Information, Education and Communication (IEC) to strengthen and sustain social mobilization | Gender norms, intra-household dynamics, social structures, and lack of female empowerment can create barriers to decision-making and care-seeking | Expanded Programme on Immunization (EPI) program includes specific messaging and encouragement for fathers to be involved and bring their children to immunization (Multi-stakeholder Dialogue Report (MSD) 2020) | decision-making power, fathers, female autonomy, female empowerment, gender norms, intra-household dynamics, self-efficacy | ||
| 2 Intent | Engagement of communities, stakeholders | Myanmar | yes | Widen the audience for Information, Education and Communication (IEC) to strengthen and sustain social mobilization | Gender norms, intra-household dynamics, social structures, and lack of female empowerment can create barriers to decision-making and care-seeking | Development of an HPV communication strategy including risk communication strategy for HPV vaccine introduction for adolescent girls (including the production of guidelines for volunteers and communication materials for parents and girls developed in print, video and social media) (Multi-stakeholder Dialogue Report (MSD) 2020) | decision-making power, fathers, female autonomy, female empowerment, gender norms, intra-household dynamics, self-efficacy | ||
| 2 Intent | Engagement of communities, stakeholders | Rwanda | yes | Widen the audience for Information, Education and Communication (IEC) to strengthen and sustain social mobilization | Gender norms, intra-household dynamics, social structures, and lack of female empowerment can create barriers to decision-making and care-seeking | Partnership with Girl Effect organization to create media content addressing negative attitudes, perceptions and behaviours that prevent girls from accessing the HPV vaccine (JA 2019) Partnership with Rwanda interfaith council on health (RICH) aims to implement Gavi’s Gender policy by promoting an integrated approach on gender to reach under immunised children, individuals and communities (Multi-stakeholder Dialogue Report (MSD) 2020) Promundo Program P: Working with men as fathers is a key entry point to discussing sensitive subjects around traditional gender norms, and the way in which these norms negatively impact communities. Through discussion guides, role plays, and hands-on activities (such as learning how to change diapers), men and their partners are encouraged to discuss and challenge traditional masculine and inequitable gender norms and to practice more positive social behaviors in their families and communities. ( https://promundoglobal.org/programs/program-p/# ; https://doi.org/10.1371/journal.pone.0192756) | decision-making power, fathers, female autonomy, female empowerment, gender norms, intra-household dynamics, self-efficacy | ||
| 2 Intent | Engagement of communities, stakeholders | Sao Tome and Principe | yes | Widen the audience for Information, Education and Communication (IEC) to strengthen and sustain social mobilization | Gender norms, intra-household dynamics, social structures, and lack of female empowerment can create barriers to decision-making and care-seeking | NGO activities aimed to increase information provided to mothers (Marapa region) (JA 2019) | decision-making power, fathers, female autonomy, female empowerment, gender norms, intra-household dynamics, self-efficacy | ||
| 2 Intent | Engagement of communities, stakeholders | Sudan | yes | Widen the audience for Information, Education and Communication (IEC) to strengthen and sustain social mobilization | Gender norms, intra-household dynamics, social structures, and lack of female empowerment can create barriers to decision-making and care-seeking | UNICEF Alshuffa’a Alsoghar communication initiative aims to improve mothers’ and caregiver (fathers, grandparents) knowledge and practices for childcare. This strategy introduces key household and family practices to improve decision-making in children’s health, including immunization (JA 2018) | decision-making power, fathers, female autonomy, female empowerment, gender norms, intra-household dynamics, self-efficacy | ||
| 2 Intent | Engagement of communities, stakeholders | Uganda | yes | Widen the audience for Information, Education and Communication (IEC) to strengthen and sustain social mobilization | Gender norms, intra-household dynamics, social structures, and lack of female empowerment can create barriers to decision-making and care-seeking | Men are specifically targeted through mobilisation, health education and participatory guidance thus empowering them to support their families in immunisation uptake and demand generation (JA 2017) | decision-making power, fathers, female autonomy, female empowerment, gender norms, intra-household dynamics, self-efficacy | ||
| 2 Intent | Engagement of communities, stakeholders | Zambia | yes | Widen the audience for Information, Education and Communication (IEC) to strengthen and sustain social mobilization | Gender norms, intra-household dynamics, social structures, and lack of female empowerment can create barriers to decision-making and care-seeking | Encouraging men’s involvement in immunization health education as they are the main decision-makers and providers in the households (JA 2017) | decision-making power, fathers, female autonomy, female empowerment, gender norms, intra-household dynamics, self-efficacy | ||
| 2 Intent | Workforce | Burundi | yes | Financial and non-financial incentives to improve staff motivation, performance | Healthworker turnover, poor retention, poor motivation/satisfaction | Experimenting with the MobileMoney method for transferring funds to providers (Vaccinators) (JA 2019) | digital payment, financial incentives, healthworker, motivation, non-financial incentives, payment, recognition, retention, reward, salary, satisfaction, support, supportive supervision | ||
| 2 Intent | Workforce | Cameroon | yes | Financial and non-financial incentives to improve staff motivation, performance | Healthworker turnover, poor retention, poor motivation/satisfaction | Accounting managers were trained to use new harmonised management tools, such as budgetary monitoring, financial management, and electronic payment (Orange Money and MTN Mobile Money) in an effort to monitor cash flow (JA 2018) | digital payment, financial incentives, healthworker, motivation, non-financial incentives, payment, recognition, retention, reward, salary, satisfaction, support, supportive supervision | ||
| 2 Intent | Workforce | Central Africa Republic | yes | Financial and non-financial incentives to improve staff motivation, performance | Healthworker turnover, poor retention, poor motivation/satisfaction | Integrated supervision of the central level and health regions was carried out in 19 districts of the target areas. This action helped build the capacities of actors at the operational level, identify weaknesses and plan corrective actions (JA 2019) Support was given to the implementation of outreach and mobile strategies, the organisation of monthly meetings to validate immunisation data and the supervision of health facilities by district management teams (DMTs) in the 19 health districts (JA 2019) Renovating 10 high-priority health facilities targeted by the programme (purchasing equipment for health facilities and installing or improving water sources in health facilities) (JA 2018) Capacity building of DMTs and Regional Management Teams (RMTs) through series of training on district management and priority programmes of the Ministry (JA 2019) | digital payment, financial incentives, healthworker, motivation, non-financial incentives, payment, recognition, retention, reward, salary, satisfaction, support, supportive supervision | ||
| 2 Intent | Workforce | Chad | yes | Financial and non-financial incentives to improve staff motivation, performance | Healthworker turnover, poor retention, poor motivation/satisfaction | Redeploy staff from the central level to the peripheral health facilities by granting them transport allowances with terms of reference (JA 2019) Supervision for preventive maintenance at the intermediate level carried out by sub-national depot managers (JA 2019) | digital payment, financial incentives, healthworker, motivation, non-financial incentives, payment, recognition, retention, reward, salary, satisfaction, support, supportive supervision | ||
| 2 Intent | Workforce | Cote d’Ivoire | yes | Financial and non-financial incentives to improve staff motivation, performance | Healthworker turnover, poor retention, poor motivation/satisfaction | Financial incentive system was developed for community health workers (JA 2018) | digital payment, financial incentives, healthworker, motivation, non-financial incentives, payment, recognition, retention, reward, salary, satisfaction, support, supportive supervision | ||
| 2 Intent | Workforce | Democratic Republic of Congo | yes | Financial and non-financial incentives to improve staff motivation, performance | Healthworker turnover, poor retention, poor motivation/satisfaction | Conduct supportive supervision visits targeting field actors on data management during immunisation sessions in the priority health zones (HZs) (Identification of priority HZs for data quality, assurance of financing, capacity of HZ management teams and implementation and tracking of corrective actions) (JA 2018) | digital payment, financial incentives, healthworker, motivation, non-financial incentives, payment, recognition, retention, reward, salary, satisfaction, support, supportive supervision | ||
| 2 Intent | Workforce | Eritrea | yes | Financial and non-financial incentives to improve staff motivation, performance | Healthworker turnover, poor retention, poor motivation/satisfaction | Monthly incentives provided to 900 community health workers in 2019 (JA 2019) | digital payment, financial incentives, healthworker, motivation, non-financial incentives, payment, recognition, retention, reward, salary, satisfaction, support, supportive supervision | ||
| 2 Intent | Workforce | Guinea-Bissau | yes | Financial and non-financial incentives to improve staff motivation, performance | Healthworker turnover, poor retention, poor motivation/satisfaction | Community health worker network ensures support, training and supervision in the context of Expanded Programme on Immunization (EPI) (JA 2016) | digital payment, financial incentives, healthworker, motivation, non-financial incentives, payment, recognition, retention, reward, salary, satisfaction, support, supportive supervision | ||
| 2 Intent | Workforce | Kyrgyzstan | yes | Financial and non-financial incentives to improve staff motivation, performance | Healthworker turnover, poor retention, poor motivation/satisfaction | Village Health Committees (one in each region) network receive information on COVID-19 and supportive supervision through online Whatsapp platform (groups) (Multi-stakeholder Dialogue Report (MSD) 2020) | digital payment, financial incentives, healthworker, motivation, non-financial incentives, payment, recognition, retention, reward, salary, satisfaction, support, supportive supervision | ||
| 2 Intent | Workforce | Liberia | yes | Financial and non-financial incentives to improve staff motivation, performance | Healthworker turnover, poor retention, poor motivation/satisfaction | Performance-based funding is used to promote health staff motivation (Multi-stakeholder Dialogue Report (MSD) 2020) Supportive supervision activities between national level to county level, and from county level to health facilities (to mitigate the impact of COVID-19) (MSD 2020) The Ministry introduced mobile payments for vaccinators at the faciliity level in 2020 (MSD 2020) | digital payment, financial incentives, healthworker, motivation, non-financial incentives, payment, recognition, retention, reward, salary, satisfaction, support, supportive supervision | ||
| 2 Intent | Workforce | Madagascar | yes | Financial and non-financial incentives to improve staff motivation, performance | Healthworker turnover, poor retention, poor motivation/satisfaction | Training health facility in-charge on microplanning and effective vaccine management (EVM) (JA 2018) | digital payment, financial incentives, healthworker, motivation, non-financial incentives, payment, recognition, retention, reward, salary, satisfaction, support, supportive supervision | ||
| 2 Intent | Workforce | Malawi | yes | Financial and non-financial incentives to improve staff motivation, performance | Healthworker turnover, poor retention, poor motivation/satisfaction | Remote supportive supervision of Expanded Programme on Immunization (EPI) services through Whatsapp during the COVID-19 pandemic (Multi-stakeholder Dialogue Report (MSD) 2020) | digital payment, financial incentives, healthworker, motivation, non-financial incentives, payment, recognition, retention, reward, salary, satisfaction, support, supportive supervision | ||
| 2 Intent | Workforce | Mali | yes | Financial and non-financial incentives to improve staff motivation, performance | Healthworker turnover, poor retention, poor motivation/satisfaction | Results-based financing (JA 2018) | digital payment, financial incentives, healthworker, motivation, non-financial incentives, payment, recognition, retention, reward, salary, satisfaction, support, supportive supervision | ||
| 2 Intent | Workforce | Nigeria | yes | Financial and non-financial incentives to improve staff motivation, performance | Healthworker turnover, poor retention, poor motivation/satisfaction | Community Cluster Survey is also incorporated into the monthly routine immunization supportive supervision (RISS) exercise and reported monthly on the Open Data Kit (ODK) platform (JA 2016) | digital payment, financial incentives, healthworker, motivation, non-financial incentives, payment, recognition, retention, reward, salary, satisfaction, support, supportive supervision | ||
| 2 Intent | Workforce | Pakistan | yes | Financial and non-financial incentives to improve staff motivation, performance 15 | Healthworker turnover, poor retention, poor motivation/satisfaction | E-VACCS 2.0, an electronic software programme, individually tracks vaccinator attendance and greatly increased vaccination coverage in Punjab through a mapping mechanism to assure a vaccinator minimum presence rate of 80%. The tool links the performance of vaccinators to incentives (JA 2016) Global System for Mobile Communications (GSM) based geographic information systems (GIS) module explored for integration into the Zindagi Mehfooz (ZM) dashboard for real-time vaccinator tracking (JA 2019) | digital payment, financial incentives, healthworker, motivation, non-financial incentives, payment, recognition, retention, reward, salary, satisfaction, support, supportive supervision | ||
| 2 Intent | Workforce | Rwanda | yes | Financial and non-financial incentives to improve staff motivation, performance | Healthworker turnover, poor retention, poor motivation/satisfaction | Mentorship and supervision of health facilities for geographic information system (GIS) based technologies is done at the central level (Multi-stakeholder Dialogue Report (MSD) 2020) | digital payment, financial incentives, healthworker, motivation, non-financial incentives, payment, recognition, retention, reward, salary, satisfaction, support, supportive supervision | ||
| 2 Intent | Workforce | Senegal | yes | Financial and non-financial incentives to improve staff motivation, performance | Healthworker turnover, poor retention, poor motivation/satisfaction | The organization of a public recognition ceremony for the best performing structures at the operational level according to criteria defined by the Education Development Centres (EDCs) (JA 2018) | digital payment, financial incentives, healthworker, motivation, non-financial incentives, payment, recognition, retention, reward, salary, satisfaction, support, supportive supervision | ||
| 2 Intent | Workforce | Sierra Leone | yes | Financial and non-financial incentives to improve staff motivation, performance | Healthworker turnover, poor retention, poor motivation/satisfaction | Performance-based incentives for Expanded Programme on Immunization (EPI) outreach workers are distributed through the Airtel Money platform from Orange Sierra Leone. Additional incentives are provided to community health workers and district cold chain technicians (JA 2018) | digital payment, financial incentives, healthworker, motivation, non-financial incentives, payment, recognition, retention, reward, salary, satisfaction, support, supportive supervision | ||
| 2 Intent | Workforce | Somalia | yes | Financial and non-financial incentives to improve staff motivation, performance | Healthworker turnover, poor retention, poor motivation/satisfaction | Nurses are receiving monthly incentives to provide routine immunization services in fixed and outreach sites in 25 priority districts (JA 2019) Monthly incentives are paid to cold-chain staff in 3 zones (Multi-stakeholder Dialogue Report (MSD) 2020) Health workers are being trained on IPC skills in order to improve their communication skills and relations with mothers/caregivers (JA 2019) | digital payment, financial incentives, healthworker, motivation, non-financial incentives, payment, recognition, retention, reward, salary, satisfaction, support, supportive supervision | ||
| 2 Intent | Workforce | South Sudan | yes | Financial and non-financial incentives to improve staff motivation, performance | Healthworker turnover, poor retention, poor motivation/satisfaction | Incentives are provided on a monthly basis for 850 community mobilizers to partake in the following activities: list newborn and under 1 years of age children, trace defaulters and link them with immunization services (JA 2019) Incentives are provided to cold chain technicians at state and national levels (JA 2019) 465 vaccinators and 24 supervisors were trained in interpersonal communication (IPC) skills (JA 2017) Training of interviewers and supervisors from hard to reach/inaccessible areas was conducted in Juba with support and participation from partners (national and international NGOs/CSOs) working in those locations (JA 2018) 74 trainers/central/state supervisors were trained in preparation for cascade training at state level (JA 2018) Training of survey personnel that included field supervisors and data collectors in 33 states (JA 2018) | digital payment, financial incentives, healthworker, motivation, non-financial incentives, payment, recognition, retention, reward, salary, satisfaction, support, supportive supervision | ||
| 2 Intent | Workforce | Tajikistan | yes | Financial and non-financial incentives to improve staff motivation, performance | Healthworker turnover, poor retention, poor motivation/satisfaction | Incentives for retention of health workers include increasing access to land ownership for building own houses and owning land for farming (JA 2018) Feed the Future Zone program (financed by USAID) aiming to improve quality health and nutrition services for mothers, newborns and children (includes immunization, supportive supervision, mother-child passports) (Multi-stakeholder Dialogue Report (MSD) 2020) | digital payment, financial incentives, healthworker, motivation, non-financial incentives, payment, recognition, retention, reward, salary, satisfaction, support, supportive supervision | ||
| 2 Intent | Workforce | Tanzania | yes | Financial and non-financial incentives to improve staff motivation, performance | Healthworker turnover, poor retention, poor motivation/satisfaction | Engaging health workers in the testing and implementation of program changes through quality improvement teams. A model implemented resulted in increased health worker motivation, productivity (likely through redistribution of workload), and strengthened teamwork. (https://www.usaidassist.org/sites/default/files/tanzania_evaluation_hivhw_performance_collaborative_july2013.pdf) | digital payment, financial incentives, healthworker, motivation, non-financial incentives, payment, recognition, retention, reward, salary, satisfaction, support, supportive supervision | ||
| 2 Intent | Workforce | Timor Leste | yes | Financial and non-financial incentives to improve staff motivation, performance | Healthworker turnover, poor retention, poor motivation/satisfaction | Performance based reward scheme was introduced in the Dili Municipality in 2017 with the goal of improving the quality of immunization (JA 2017) | digital payment, financial incentives, healthworker, motivation, non-financial incentives, payment, recognition, retention, reward, salary, satisfaction, support, supportive supervision | ||
| 2 Intent | Workforce | Togo | yes | Financial and non-financial incentives to improve staff motivation, performance | Healthworker turnover, poor retention, poor motivation/satisfaction | Creation of a Whatsapp platform to follow-up on the implementation of advanced strategies (Multi-stakeholder Dialogue Report (MSD) 2020) | digital payment, financial incentives, healthworker, motivation, non-financial incentives, payment, recognition, retention, reward, salary, satisfaction, support, supportive supervision | ||
| 2 Intent | Workforce | Uganda | yes | Financial and non-financial incentives to improve staff motivation, performance | Healthworker turnover, poor retention, poor motivation/satisfaction | Introduced a reward system for good performers (JA 2017) | digital payment, financial incentives, healthworker, motivation, non-financial incentives, payment, recognition, retention, reward, salary, satisfaction, support, supportive supervision | ||
| 2 Intent | Workforce | Zimbabwe | yes | Financial and non-financial incentives to improve staff motivation, performance | Healthworker turnover, poor retention, poor motivation/satisfaction | Camping equipment was provided to ensure a comfortable and enabling environment to health mobile teams during outreach in Zimbabwe (Maternal and Child Integrated Programme (MCHIP) led by JSI). | digital payment, financial incentives, healthworker, motivation, non-financial incentives, payment, recognition, retention, reward, salary, satisfaction, support, supportive supervision | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Afghanistan | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Knowledge, Attitudes and Practices (KAP) survey conducted (JA 2017, 2018) Dialogue with and engagement of local community and religious leaders to create an effective bridge and link between health facilities and the community (JA 2017) Community-based outreach vaccinators and or vaccination programs are used to increase immunization service delivery in urban settings (JA 2018) Increasing awareness and promoting immunization through the mobilization & training of religious leaders and establishing a network of these leaders – Ulema (JA 2018 & 2019) Generation of demand to receive immunization services by developing Information, Education and Communication (IEC) materials and conducting seminars at district level to raise awareness about need for immunizations among religious leaders to build trust in immunizations and remove misconceptions, enlist broadcast media, support the Health Information Call Center, and build the capacity of frontline health workers and school teachers (JA 2017) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Benin | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Sensitization activities are performed for parents on the importance of immunization (JA 2017) Development of the “model mothers of the year” strategy in each district (JA 2019) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Burkina Faso | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | The Burkina Faso president was identified as a Champion of Immunization and is participating in policy & advocacy for immunization (JA 2019) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Cambodia | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Village Health Support Groups contribute to Expanded Programme on Immunization (EPI) activities, such as defaulter tracing, education (raising awareness for parents) and sustaining immunization (JA 2019) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Central Africa Republic | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | NGO platform created to promote health (JA 2017) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Chad | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Ensure the promotion of immunisation through the activities of the First Lady as champion of immunisation, the different actors and community networks, the media, the use of new information and communication technologies (NICTs), schools and health centers, and ensure their follow-up, supervision and documentation (JA 2019) Advocacy and training of 3,582 village chiefs and 3,582 Community Relais on the use of the community register for the promotion of immunisation (JA 2019) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Cote d’Ivoire | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Community mobilization performed by civil society, in the context of the project “1 parrain pour 100 enfants” (JA 2017) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Democratic Republic of Congo | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Network of parlimentarians support/advocate for immunization in specific provinces (JA 2017) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Djibouti | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Social mobilizers contribute to defaulter tracing and tracking of children lost to follow-up or unimmunized, and provide educational talks on the importance of immunization, in urban areas. Activities are conducted at community development centres and headquarters of community-based organizations (JA 2019) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Eritrea | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | National Union of Eritrean Women Association, in addition to the National Union of Eritrean Youth and Students and religious organizations work closely with the Expanded Programme on Immunization (EPI) program and contribute to commmunity mobilization and reaching unvaccinated children in less accessible areas (JA 2017) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Ethiopia | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Creating a network of informants and influencers, engagement with clan leaders and religious networks (JA 2019) Using the human centered-strategy and creating a network of informants and influencers, engagement with clan leaders and religious networks, mapping of water points and livestock markets and forming a partnership with animal health program to reach pastoralist communities with immunization services (JA 2018) Community leaders and networks will be also engaged in monitoring the vaccination status of individual children to motivate and remind households in taking the vaccine and other maternal, newborn and child health services such as the antenatal and postnatal visits. The community leaders will help as well in building trust in immunization services, especially related to the HPV vaccine and the fear of vaccines’ side effects. Furthermore, gate keepers and positive models will participate into radio debates in order to spread more quickly the newly adopted norms (2019 plans) Development of a community score-card to help in tailoring services (time, location, care, etc.) to meet the needs of caregivers through use of community outreach agents (JA 2019) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Guinea | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Training 190 CSAs and 1855 Community Relais on essential family practices (including immunizatoin) to support social mobilization and active research and catch-up of children not immunized, and the beginning of the process of systematically counting children under 5 years of age and pregnant women (as part of the pilot initiative “40 convergence municipalities” (JA 2019) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | India | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Urban Health Resource Centre (UHRC) in India trains, mentors and supports women living in slums in Agra and Indore to have a greater capacity to access government services and entitlements. Initial analyses show that engaged women and their families have better access to healthcare, children’s education, and environmental improvements Community members lead production of health education videos. PATH and its partners launched the Projecting Health project in 84 villages across 3 blocks in Uttar Pradesh, India. The model was succesfully integrated into existing community support programs, such as mothers’ group meetings and village health and nutrition days. Community members developed, acted in, and shared numerous health videos, and preliminary data suggest that these screenings have improved local health knowledge and maternal and newborn care practices. (https://path.azureedge.net/media/documents/MCHN_projecting_health_fs.pdf) SMNet targeted Information, Education and Communication (IEC) through mosque announcements and involvement of children (children’s brigades) (https://www.unicef.org/evaldatabase/files/India_2013-001_Evaluation_of_Social_Mobilization_Network_Final_Report.pdf) Social Mobilization Network (SMNet) is a community engagement strategy which has helped to conduct 123,938 number of mother meetings and 1,516,163 number of IPC sessions onroutine immunization till September 2019 in Bihar and Uttar Pradesh to raise awareness (JA 2019) Accredited Social Health Activists (or ASHA) serve as an interface between the community and public health system and receive performance-based incentives for promoting routine immunization in the community (JA 2017) Mosques and other faith-based institutions mobilized to regularly make announcements for polio and for routine immunization sessions (JA 2019) Strengthening community based multi-stakeholder partnerships (JA 2019) Urban Health Resource Centre (UHRC) in India trains, mentors and supports women living in slums in Agra and Indore to have a greater capacity to access government services and entitlements. Initial analyses show that engaged women and their families have better access to healthcare, children’s education, and environmental improvements (https://sites.google.com/view/erg4immunisation/discussion-papers) The Alliance for immunization (Aii) is a network of about 180 Community Service Organizations (CSOs) aimed at bridging the gap between government and the community to help in delivering immunization services to underserved populations (JA 2017) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Kenya | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Use of vaccine champions help reduce vaccine hesitancy and advocate for immunization including the Cabinet secretary and polio survivors (JA 2016 & 2018). Routine immunization champion featured on BBC https://www.youtube.com/watch?v=giE7641JlPY (JA 2018) Engaging religious leaders has helped reduce vaccine hesitancy (JA 2016 & 2017) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Kyrgyzstan | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | National consultant recruited to work with religious leaders (JA 2018) Round tables with religious communities were held and signing of cooperation agreement to address vaccine refusals, hesitancy and antivaccination (JA 2019) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Lao People’s Democatic Republic | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Community leaders and village health volunteers have been targeting mothers in known high-risk villages to engage them to understand their own personal views and potential hesitancy regarding immunization (JA 2019) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Lesotho | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | To address rumours, Ministry of Health engaged in intense social mobilization. High advocacy meetings were held with various non-governmental organizations (NGOs), the Christian Council of Lesotho (CCL), Media Houses, District Health Management Teams (DHMTs), Chiefs, and health Center nurses (JA 2017) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Liberia | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Meetings with community leaders, mothers, parents and women groups to address benefits associated with immunization (JA 2019) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Madagascar | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Involvement of community workers (CWs) in all immunisation activities by strengthening communication (interpersonal and mass communication); using community registers; monitoring with CWs, immunisation coverage surveys (ICS) and the general population and housing census (GPHC); use of a smaller sector administrative unit instead of fokontany; adapting the number of CWs to the new subdivision; and mapping and identification of UIC (JA 2018) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Malawi | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Creation of mother care groups (village head chiefs, women volunteers) by Malawi Health Equity Network (MHEN) in hard to reach areas, urban slums and refugee camps. The groups’ activities involve defaulter tracing (door-to-door), health education, interpersonal communiction and advocacy at the community level (JA 2018; JA 2019) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Mali | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Capacity building training for members of civil society (women and youth) for the sensitization and research of non-vaccinated children (JA 2019) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Mozambique | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Community actors participate in interventions in markets, programmes on community radios, sensitization via mobile audio units and social networks (Multi-stakeholder Dialogue Report (MSD) 2020) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Myanmar | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Advocacy and orientation workshop with village and urban administrators and community leaders to expand routine immunization coverage (JA 2016) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Nigeria | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | One on one interface between traditional barbers, community leaders and caregivers to provide key messages on immunization and refer for vaccination of new-born (JA2019) Engage religious leaders to disseminateroutine immunization messages in prayer houses heads of households and female Islamic schools (targeting caregivers) (JA 2019) Community engagement (CE) strategy for routine immunization and primary health care services includes: sensitization and training of traditional and religious leaders (Emirates, Sultanate, Chiefdoms, District, village and settlement head) and State Primary Healthcare Development Agencies (SPHCDAs) on implementation of CE strategy; production and distribution of CE tools (CE toolkit, tickler boxes, defaulter tracking registers, line list for community leaders, summary forms for CEFPs); and appointment and training of State, Local Government Authority (LGA) and Ward CE focal persons, health facility workers, and all community resource persons to drive implementation (JA 2019) Women Advocates for Vaccine Access (WAVA) is a coalition of women-focused civil society organizations in Nigeria advocating for increased routine immunization and sustainable vaccine financing (JA 2017) Community engagement strategy includes annual non-monetary rewards systems for religious and traditional leaders as recognition for good performance (JA 2019) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Pakistan | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Lasbela district: Applied a knowledge translation approach to increase vaccination uptake without requiring improvement in service delivery. A series of three community discussions was conducted on the following topics: vaccine uptake; costs and benefits of childhood vaccination; and local action plans. Group participants were encouraged to spread the dialogue to households in their communities. Discussions were lead by men and women from the district, and involved community members who were trusted within their community and able to convince others about important issues. (http://www.biomedcentral.com/1472-698X/9/S1/S8) A prototype on immunization in slums of one union council in Lahore is being developed and implemented through a local community service organization, CHIP. 12 slum health committees are established with participation from local community notables, religious leaders, teachers, and local government representatives for advocacy and social mobilization among slum communities (JA 2019) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Rwanda | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Partnership with Rwanda interfaith council on health (RICH) aims to implement Gavi’s Gender policy by promoting an integrated approach on gender to reach under immunised children, individuals and communities (Multi-stakeholder Dialogue Report (MSD) 2020) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Sao Tome and Principe | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Community sensitization about immunization for measles and rubella is performed through radio and TV messages and SMS (via UNITEL) (JA 2017) Social mobilization activities are performed by community mobilizers and community leaders, in addition to involvement of President in launch of Expanded Programme on Immunization (EPI) campaign (JA 2017) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Senegal | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Risk communication and community engagement activities were performed by community mobilizers and volunteers to promote continuity of health services during COVID-19 (Multi-stakeholder Dialogue Report (MSD) 2020) Support in implementation of demand creation/promotional activities by civil society organizations (JA 2018) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Solomon Islands | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Memorandum of Understanding (MoU) between Ministry of Health and Medical Services (MHMS) and the Solomon Island Churches Association (SICA) to improve program-focused work (JA 2019) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Somalia | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | 2-days training session for Regional Social Mobilization Coordinators (RSMCs) and District Social Mobilization Coordinators (DSMC) from 8 priority districts was conducted in early May. House to house social mobilization was organised in outreach form by 38 MCHs where Expanded Programme on Immunization (EPI) outreach vaccination was happening. Health education sessions including Expanded Programme on Immunization (EPI) organised in 38 MCHs in 8 priority districts (JA 2018) Advocacy meetings have been going on a quarterly basis with influential religious and administrative leaders at the district level (JA 2019) DSMCs and social mobilisers also conduct monthly meetings with women groups, community and religious leaders in their catchment areas, in order to advocate for routine immunisation (JA 2019) Ongoing community meetings with women groups to increase demand for immunisation services (Multi-stakeholder Dialogue Report (MSD) 2020) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | South Sudan | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | A total of 8,481 youth and mothers forum meetings were conducted in 56 counties to support mobilization for immunization (JA 2019) Community mobillization and education around immunization (demand generation) through integrated community mobiilization networks, youth clubs and drama groups (JA 2018) Community sensitization conducted via distribution of key messages on immunization through megaphone announcements. Sensitization occured in community groups, churches and market places (JA 2018) Community mobilizers are equipped with data collection tool, flip book and routine immunization flyers to disseminate immunization messages during house visits and group meetings, with the goal of improving community knowledge, attitudes and practices for immunization (JA 2018) House to house visits for community mobilization for immunization (JA 2017) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Sudan | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Focal person from the community who is familiar with the customs, traditions and language is chosen and trained to promote immunization activities (JA 2018). Study done to generate evidence on community acceptance for multiple injections to generate evidence for social mobilization plan for IPV introduction (JA 2016) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Timor Leste | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Video message on handwashing and COVID-19 prevention was created by MoH, Unicef and WHO, in addition to other resources (distribution posters, communication materials to raise awareness and prevent stigmatization related to COVID-19) (Multi-stakeholder Dialogue Report (MSD) 2020) Mother support groups established in 5 municipalities. MoH has developed an integrated communication package including interpersonal communication (IPC) curricula and guidelines and audio-visual material for mother support groups to promote favorable behaviours and practices in immunization (JA 2017) Expanded Programme on Immunization (EPI) is supported by school teachers, religious leaders, community-based organizations, mother support groups and local community leaders (JA 2017) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Togo | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Community mobilization for immunization through the “Papa Champion” initiative, which recruits local volunteers to assist and promote Expanded Programme on Immunization (EPI) activities (JA 2019) Communication strategies for COVID-19 were developed with the involvement of administrative and religious authorities (meetings with prefects and mayors, community dialogues in areas with vaccine hesitancy, social media use for sensitization, communication for immunization conducted in marketplaces and public spaces) (Multi-stakeholder Dialogue Report (MSD) 2020) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Uganda | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Trained and equipped religious, political, and community leaders to be vocal champions of immunization (JA 2018) Dialogue with district community development officers and use of community structures to generate demand for Expanded Programme on Immunization (EPI) services (JA 2017 & 2018) The Ugandan Civil Society Immunization Platform (UCSIP) is intended to help Community Service Organizations (CSOs) have a unified voice, as well as work closely and harmoniously with the Government of Uganda, Development Partners and other immunization stakeholders taking part in the country’s immunization and health system strengthening processes. The civil society platform is hosted by the Malaria and Childhood Illness NGO Network Secretariat (MACIS) drawing on its networksat National, Regional, District, Health Sub-district and Sub-County levels,to align CSO activities with national Expanded Programme on Immunization (EPI) structures (JA 2017) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Uzbekistan | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Starting August 2019, representatives of women’s councils are involved in field work, in the context of the HPV vaccine (JA 2019) Face to face meetings with MoH, UN personnel and SES organized in schools in Tashkent to address parental refusal to vaccinate daughters (Multi-stakeholder Dialogue Report (MSD) 2020) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Vietnam | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | 322 village health staff in low coverage areas were trained in immunization and communication strategies for immunization (JA 2017) Information, Education and Communication (IEC) materials were developed for health workers, parents and caregivers and are being distributed across health facilities. Package includes informational leaflets and posters on MR, routine immunization, vaccination schedule (JA 2018) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Yemen | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Community based communication-related activities geared towards combating vaccine hesitancy in 2018 included focused group discussions with men and women groups, engagement of religious and community leaders (JA 2019) Community Health Volunteers participate in outreach activities and community mobilization for immunization (examples: identifying missed children, encourage referrals to health facilities, etc.) (JA 2016) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Zambia | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Community Service Organizations (CSOs) are leading community education activities through drama performances (JA 2018) The Churches Health Association of Zambia (who is part of the Zambia Civil Society Immunization Platform), conducted community mobilisation to increase uptake of HPV vaccine in boys and girls (JA 2016) The Churches Health Association of Zambia trained 19 civil society organisations on resource mobilization governance and communication for immunization, resulting in activities promoting demand generation and defaulter tracing (JA 2018) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Zimbabwe | yes | Engage local leaders to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Key messages for African vaccination week and HPV campaign were broadcasted through national television, radio, media and stationary posts, as well as through health workers and community leaders (JA 2019) Engaging and involving religious leaders in planning and implementation of immunisation activities at all levels, to combat vaccine hesitancy (JA 2018) Lead mothers and fathers mobilize other caregivers from the community to bring their children for immunization (JA 2016) | awareness, beliefs, community engagement, community leaders, community mobilisation, hesitancy, misinformation, norms and values, practical knowledge, religious leaders, social mobilisation, trust, women’s groups | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Afghanistan | yes | Use of communication strategies to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Generation of demand to receive immunization services by developing information, education and communication (IEC) materials and conducting seminars at district level to raise awareness about need for immunizations among religious leaders to build trust in immunizations and remove misconceptions, enlist broadcast media, support the Health Information Call Center, and build the capacity of frontline health workers and school teachers (JA 2017). | awareness, beliefs, communication, community radio, journalism, knowledge, low-literacy, misinformation, rumours | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Bangladesh | yes | Use of communication strategies to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Communication activities converted to print, electronic and social media as compared to community engagement. Community volunteer was hired to support campaign activities (Multi-stakeholder Dialogue Report (MSD) 2020) Smiling sun campaign – delivery media included signboards, television drama series, television advertisements, radio spots, newspaper ads, and local publicity. (http://www.biomedcentral.com/1472-698X/9/S1/S5) | awareness, beliefs, communication, community radio, journalism, knowledge, low-literacy, misinformation, rumours | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Benin | yes | Use of communication strategies to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Contracts were developed with radio stations for the diffusion of micro programs and segments on immunisation in the districts participating in the Initiative Vaccination Décentralisée (JA 2017) | awareness, beliefs, communication, community radio, journalism, knowledge, low-literacy, misinformation, rumours | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Cameroon | yes | Use of communication strategies to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Diffusion of advertisments for immunization in local languages on community radio stations in rural areas (JA 2017) Development of a crisis communication plan to respond to the rumours and misinformation surrounding HPV vaccination (JA 2019) | awareness, beliefs, communication, community radio, journalism, knowledge, low-literacy, misinformation, rumours | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Chad | yes | Use of communication strategies to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Communication component of the CDA has been strengthened by the Community Based Approach to Promote Immunisation (CBAPI). This new approach has been implemented in 15 pilot districts and will be extended to 31 districts in 2017. However, in 2018, only 28 health districts will continue to be funded for the implementation of this approach (JA 2019) Production of communication materials (posters, stickers on the immunisation schedule and community-based surveillance of acute flaccid paralysis (AFP) cases and timetables) in support of the promotion of routine immunisation in the provinces of Lac, Hadjer Lamis and Kanem (JA 2019) | awareness, beliefs, communication, community radio, journalism, knowledge, low-literacy, misinformation, rumours | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Djibouti | yes | Use of communication strategies to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Communication strategy was developed (in partnership with UNICEF) specifically to target nomadic and migrant populations (JA 2018) Activities to promote and raise awareness completed by Community Relais and social mobilizers; educational talks on the importance of immunization; promotion and awareness-raising activities conducted in community development centres & community-based organizations (JA 2019) All media channels, including social media strategies were useful to boost immunisation programmes during campaigns against polio and measles (JA 2019) | awareness, beliefs, communication, community radio, journalism, knowledge, low-literacy, misinformation, rumours | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Ethiopia | yes | Use of communication strategies to address misinformation and raise awareness | Mistrust, misinformation and disinformation | The social mobilization network is used in pastoralist regions and communities to raise awareness and generate demand for immunization. Furthermore, digital communication strategy developed using social media platforms for delivery and using digital means to track rumours and misonceptions (JA 2016) | awareness, beliefs, communication, community radio, journalism, knowledge, low-literacy, misinformation, rumours | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Ghana | yes | Use of communication strategies to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Various essential services and educational sessions on available interventions were provided to mothers and caregivers in the context of the Child Health Promotion Week (topics include immunization against childhood diseases, Vitamin A supplementation, nutrition counseling, growth monitoring, among others) (JA 2017) | awareness, beliefs, communication, community radio, journalism, knowledge, low-literacy, misinformation, rumours | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | India | yes | Use of communication strategies to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Critical Appraisal Skills (CAS) is a pilot programme aimed at building the capacities of key media professionals and students; 40 journalism students from the Indian Institute of Mass Communication (IIMC) and 40 mid-level journalists were engaged in the process. In 2017 60 key media influencers (journalists and academicians) trained as trainers to deliver the public health module (JA 2017) Social Mobilization Network (SMNet) is a community engagement strategy which has helped to conduct 123,938 number of mother meetings and 1,516,163 number of interpersonal communication (IPC) sessions on routine immunization until September 2019 in Bihar and Uttar Pradesh to raise awareness (JA 2019) A focused approach to information, education and communication (IEC) material development was critical in SMNet for successful mobilization. For an instance, the ‘green booklet’ designed for a community with followers of Islam, contains an appeal from the local imam along with quotations from Hadith, which enumerates the role of health and responsibility of parents for the same (https://www.unicef.org/evaldatabase/files/India_2013-001_Evaluation_of_Social_Mobilization_Network_Final_Report.pdf) | awareness, beliefs, communication, community radio, journalism, knowledge, low-literacy, misinformation, rumours | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Indonesia | yes | Use of communication strategies to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Communication campaign was developed to advocate for measles and rubella immunization through short films, SMS text blast messages, art/graphic design, and communication channels (Facebook, Twitter, Whatsapp, etc.) (JA 2017) | awareness, beliefs, communication, community radio, journalism, knowledge, low-literacy, misinformation, rumours | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Kenya | yes | Use of communication strategies to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Engagement of journalists in immunization helped reduce hesitancy; plus a consultative forum with health journalists to raise awareness on immunization (JA 2018 & 2019) | awareness, beliefs, communication, community radio, journalism, knowledge, low-literacy, misinformation, rumours | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Kyrgyzstan | yes | Use of communication strategies to address misinformation and raise awareness | Mistrust, misinformation and disinformation | A team of 50 popular journalists was built and trained (with incentives) to support immunization promotion, through multiple web platforms housing audio and video information for caregivers and communities (Multi-stakeholder Dialogue Report (MSD) 2020) Community mobilization during COVID-19 and immunization communication was done through social media and discussion platforms such as Whatsapp (MSD 2020) A module for journalists’ training was developed and training of journalists conducted (JA 2019) Design a comprehensive communication strategy to address vaccination hesitancy in Kyrgyzstan to address vaccine refusals, vaccine hesitancy, rumors and misconceptions that affect routine immunization uptake in the country. The strategy will include the plan for an integrated health communication campaign on routine immunization reaching out to all audiences, including internal migrants. Prior to the development of the strategy, the Ministry of Health and UNICEF have been implementing quantitative and qualitative nationally representative surveys to assess knowledge, attitudes and practices of the audiences as well as gain a better understanding on reasons behind refusals and immunization associated behaviors, and also to collect insights about approaches and actions to generate demand for immunization services (JA 2017) | awareness, beliefs, communication, community radio, journalism, knowledge, low-literacy, misinformation, rumours | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Lao People’s Democatic Republic | yes | Use of communication strategies to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Project aimed at supporting antenatal care (ANC) counseling for women and promoting facility births (financed by the World Health Organization) allows women to receive information on birth and essential services such as immunization, specifically increasing coverage of Hepatitis B. The program also adresses gender-related barriers to facility delivery such as transportation (JA 2019) | awareness, beliefs, communication, community radio, journalism, knowledge, low-literacy, misinformation, rumours | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Liberia | yes | Use of communication strategies to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Routine immunization messages are being aired on 7 FM and 30 community radio stations (JA 2018) Media campaigns over the radio to dispel rumours about the COVID-19 vaccination and to educate on the importance of routine immunization (Multi-stakeholder Dialogue Report (MSD) 2020) House to house visits in some counties by community health assistants (CHAs) to discuss the benefits of vaccination and register under 5 children (JA 2019) 1350 information, education and communication (IEC) materials were printed and distributed to all 15 counties and all 599 health facilities providing immunization services (JA 2018) | awareness, beliefs, communication, community radio, journalism, knowledge, low-literacy, misinformation, rumours | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Madagascar | yes | Use of communication strategies to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Support the performances of local artists in terms of traditional folklore for mass communication in priority Poverty Reduction Strategy (PRSP) areas: Anosy, Atsimo Andrefana, Diana, Sava, Vakinankaratra, Amoron’I Mania (JA 2019) Conduct innovative community awareness strategies including Communication for Development (C4D) and social mobilization activities (JA 2019) | awareness, beliefs, communication, community radio, journalism, knowledge, low-literacy, misinformation, rumours | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Malawi | yes | Use of communication strategies to address misinformation and raise awareness | Mistrust, misinformation and disinformation | The Malawi Institute of Journalism, in collaboration with UNICEF, developed innovative and creative materials to mobilize communities for Second Year of Life (2YL) vaccination and HPV vaccination. Messages were broadcasted usng multiple communications channels (programs and radio spots) on community and nation radio stations (JA 2019) Training on reporting of HPV vaccination issues was given to 20 journalists from print and electronic media (JA 2018) Girl Effect supported the HPV vaccination activities through production and distribution of a mini magazine targeting 9-year old girls which provided information about cervical cancer and the vaccine. The organization also aired a radio programme targeting girls and parents, which included a drama story about a 10-year old girl receiving the vaccine, expert interviews and other general messaging about cervical cancer and the vaccine (JA 2019) | awareness, beliefs, communication, community radio, journalism, knowledge, low-literacy, misinformation, rumours | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Mali | yes | Use of communication strategies to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Training and capacity building for media representatives on communication for immunization (JA 2019) Mass media sensititization messages were diffused in local languages (JA 2018) Film projections, home visits, interpersonal communication activities and counseling was performed in 55 health areas in the Tombouctou and Taoudénit regions (JA 2018) | awareness, beliefs, communication, community radio, journalism, knowledge, low-literacy, misinformation, rumours | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Mauritania | yes | Use of communication strategies to address misinformation and raise awareness | Mistrust, misinformation and disinformation | 15 journalists from Nouadhibou were trained on immunization topics (and the treatment of public health emergencies), in an effort to generate demand for immunization (JA 2018) | awareness, beliefs, communication, community radio, journalism, knowledge, low-literacy, misinformation, rumours | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Mozambique | yes | Use of communication strategies to address misinformation and raise awareness | Mistrust, misinformation and disinformation | COVID-19 messages on immunization and prevention were disseminated via digital posters on Whatsapp and Facebook (Multi-stakeholder Dialogue Report (MSD) 2020) Community actors participate in interventions in markets, programmes on community radios, sensitization via mobile audio units and social networks (MSD 2020) Dissemination of health promotion messages (including SMS) to encourage community engagement and participation, and complement the interpersonal communication and community engagement activities (JA 2017) Development of an interpersonal communication (IPC) guide, and usage of multiple channels of communication to improve interpersonal communication between caregivers/communities and health system, dissemination of health promotion messages and to encourage community engagement and participation (JA 2017) messages through radio have been used to complement the interpersonal communication and community engagement activities (JA 2017) | awareness, beliefs, communication, community radio, journalism, knowledge, low-literacy, misinformation, rumours | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Myanmar | yes | Use of communication strategies to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Sharing of COVID-19 information through Ministry of Health Services (MoHS) and the Central Expanded Programme on Immunization’s (cEPI’s) Facebook pages has resulted in an observance of no rumours among communities negatively impacting service uptakes (Multi-stakeholder Dialogue (MSD) Report 2020) A creative agency was deployed for two months to support MoHS for development of communication materials during onset of COVID outbreak (MSD 2020) Development of an HPV communication strategy including risk communication strategy for HPV vaccine introduction for adolescent girls (including the production of guidelines for volunteers and communication materials for parents and girls developed in print, video and social media) (MSD 2020) | awareness, beliefs, communication, community radio, journalism, knowledge, low-literacy, misinformation, rumours | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Nicaragua | yes | Use of communication strategies to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Knowledge, Attitudes and Practices (KAP) study conducted to assess gaps in knowledge about immunization among communities and create adapted key messages to target populations (JA 2018) | awareness, beliefs, communication, community radio, journalism, knowledge, low-literacy, misinformation, rumours | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Pakistan | yes | Use of communication strategies to address misinformation and raise awareness | Mistrust, misinformation and disinformation | The national Expanded Programme on Immunization (EPI) and UNICEF’s social media platforms and mass media were used to create awareness and interact with parents. The exclusive hashtag for the World Immunization Week (WIW) campaign in 2019 #TeekuVsDisease reached 589,209 people with 1.75 million impressions. 48,896 people were reached through Facebook ads out of which 4,091 new people started following the EPI Facebook page and 57% of these were women. Targeted messages were shared in 150 WhatsApp groups with a total of 17,318 members (JA 2019) Community-based trial in Karachi, Pakistan: “To address the needs of low literacy populations, easy-to-understand pictorial cards, using very simple language, to convey three key messages as part of the educational intervention were designed. The first key message highlighted how vaccines save children’s lives. The second message provided logistic information about the address and location of the local vaccination centers. The third key message emphasized the significance of retaining immunization cards, and the role they could play at the time of the child’s school admissions. A copy of these pictorial messages was left with the mother. These messages took about 5 minutes to impart, and were given by the trained CHWs to each participant at their household.” (https://doi.org/10.1186/1471-2458-11-239) Center-based trial in Karachi, Pakistan: center-based education session for mothers, “emphasizing the importance of immunization schedule completion. The education session also included the information about potential adverse impact on child’s health if the schedule was not completed. The education session was in simple local language and of short duration (2-3 minutes)” (doi:10.1016/j.vaccine.2008.10.048) Card was redesigned to be larger, using simple language for low literacy, and to prominently display date of next visit. Card was stored in a plastic jacket with a hanging string. (doi:10.1016/j.vaccine.2008.10.048) | awareness, beliefs, communication, community radio, journalism, knowledge, low-literacy, misinformation, rumours | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Papua New Guinea | yes | Use of communication strategies to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Development of a national Immunization Advocacy Communication and Social Mobilization strategy endorsed by the National Department of Health – advocacy and social mobilization activities that include messages and information, education and communication (IEC) materials for advocacy and community mobilization developed in 2020 (Multi-stakeholder Dialogue Report (MSD) 2020) | awareness, beliefs, communication, community radio, journalism, knowledge, low-literacy, misinformation, rumours | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Philippines | yes | Use of communication strategies to address misinformation and raise awareness | Mistrust, misinformation and disinformation | A national intervention leveraged both mass media and face-to-face communication between the healthcare worker and mother. The proportion of infants starting their immunisation schedules on time (at less than four months of ages) and completing on time (nine to eleven months old) increased. The campaign emphasised logistical information (where, when, cost) and focused on urban areas, which had lower coverage on average versus rural areas (http://www.popline.org/node/378743). | awareness, beliefs, communication, community radio, journalism, knowledge, low-literacy, misinformation, rumours | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Republic of the Congo | yes | Use of communication strategies to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Immunisation awareness messages sent through SMS texts during immunization campaigns (JA 2017) | awareness, beliefs, communication, community radio, journalism, knowledge, low-literacy, misinformation, rumours | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Rwanda | yes | Use of communication strategies to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Community mobilization through spots radio and TV talk show and community outreach (Multi-stakeholder Dialogue Report (MSD) 2020) Partnership with “Girl Effect” organization to create media content addressing negative attitudes, perceptions and behaviours that prevent girls from accessing the HPV vaccine (JA 2019) | awareness, beliefs, communication, community radio, journalism, knowledge, low-literacy, misinformation, rumours | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Sao Tome and Principe | yes | Use of communication strategies to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Journalists (radio and TV) received training on immunization and its importance for communities (JA 2017) | awareness, beliefs, communication, community radio, journalism, knowledge, low-literacy, misinformation, rumours | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Senegal | yes | Use of communication strategies to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Journalists participated in discussions on addressing rumours about the HPV vaccine (JA 2019) Creation of a documentary film on the HPV vaccine to address the rumours and misinformation, in the context of African Immunisation Week (JA 2019) Development of a media plan including institutional communication and operational level activities including the production of TV and radio programs and a social media campaign (JA 2018) Implementation of communication and social mobilization activities for the RR monitoring campaign, financially and logistically supported by UNICEF and Gavi (JA 2018) | awareness, beliefs, communication, community radio, journalism, knowledge, low-literacy, misinformation, rumours | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | South Sudan | yes | Use of communication strategies to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Collaboration with 32 radio stations in 9 local languages (JA 2017) | awareness, beliefs, communication, community radio, journalism, knowledge, low-literacy, misinformation, rumours | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Tajikistan | yes | Use of communication strategies to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Journalists were trained on immunization-related topics to address the public’s perception of immunization. Additionally, journalists were trained on COVID-19 information (Multi-stakeholder Dialogue Report (MSD) 2020) | awareness, beliefs, communication, community radio, journalism, knowledge, low-literacy, misinformation, rumours | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Togo | yes | Use of communication strategies to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Contract with 28 community radios to sensitize population on COVID-19 issues (Multi-stakeholder Dialogue Report (MSD) 2020) | awareness, beliefs, communication, community radio, journalism, knowledge, low-literacy, misinformation, rumours | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Uganda | yes | Use of communication strategies to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Trained health workers and journalists how to respond appropriately to potential rumours about vaccines and vaccination (JA 2017) Short message service (SMS text) campaigns and engagement with adolescent health programs to improve uptake of HPV (JA 2017) Social media platforms (WhatsApp, Face book, SMS) are being used to transmit information to parents and caregivers (JA 2019) Multimedia HPV campaign (radio, TV, social media, Ureport, mTRAC) | awareness, beliefs, communication, community radio, journalism, knowledge, low-literacy, misinformation, rumours | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Uzbekistan | yes | Use of communication strategies to address misinformation and raise awareness | Mistrust, misinformation and disinformation | As part of the WHO/UNICEF Joint immunization plan with the Ministry of Health, seminar meetings and activities were organized with bloggers and journalists, to support the introduction of HPV vaccine for 9-year-old girls (JA 2019) Global Immunization Week was conducted, which includes key messages to reduce the spread of myths/misconceptions about immunization, video clips involving celebrities broadcasted on TV, campaigns on social networks, TV and radio shows and more (JA 2019) Consultative meeting with managers of major media companies to improve coverage of immunization (JA 2019) Crisis communication plan implemented to address misconceptions and concerns of families regarding the HPV vaccine in girls (Multi-stakeholder Dialogue Report (MSD) 2020) Social media and mass media channels used to inform the public about the HPV vaccine (MSD 2020) | awareness, beliefs, communication, community radio, journalism, knowledge, low-literacy, misinformation, rumours | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Vietnam | yes | Use of communication strategies to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Organized trips for reporters/ journalists to visit and write news on immunization in various area (in Quảng Ninh, Bắc Ninh, Äắc lắc provinces) (JA 2018) The Expanded Programme on Immunization (EPI) organized 2 national level workshops for journalists on risk communication in immunization (JA 2017) | awareness, beliefs, communication, community radio, journalism, knowledge, low-literacy, misinformation, rumours | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Yemen | yes | Use of communication strategies to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Information, Education and Communication (IEC) materials were developed and distributed nationwide. Mass media including TV, Radio programs were conducted and messages through social media to the population (JA 2019) NGO partners were also engaged in social mobilization activities including theatres and concerts (JA 2019) | awareness, beliefs, communication, community radio, journalism, knowledge, low-literacy, misinformation, rumours | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Zambia | yes | Use of communication strategies to address misinformation and raise awareness | Mistrust, misinformation and disinformation | Expanded Programme on Immunization (EPI) communication strategy is used to address myths and misconceptions about immunisation, particularly during Child Health Week (JA 2017) Journalists from 22 districts received training in communication for immunisation (JA 2017) | awareness, beliefs, communication, community radio, journalism, knowledge, low-literacy, misinformation, rumours | ||
| 1 Knowledge, awareness and belief | Engagement of communities, stakeholders | Zimbabwe | yes | Use of communication strategies to address misinformation and raise awareness | Mistrust, misinformation and disinformation | In order to address vaccine hesitancy, the government has continued to pursue a persuasive approach through interpersonal communication, media briefings, community dialogues, and effective responses to adverse effects following immunization (AEFIs) (JA 2018) | awareness, beliefs, communication, community radio, journalism, knowledge, low-literacy, misinformation, rumours | ||
| 1 Knowledge, awareness and belief | Workforce | Burundi | no | Health managers and workers have strengthened ability to design and deliver equitable services | Health workers may need additional training to provide quality care | Healthcare worker training in the form of cascade training for the polio vaccine, and interpersonal communication training conducted (JA 2018) | equity training, healthworker, management | ||
| 1 Knowledge, awareness and belief | Workforce | Djibouti | no | Health managers and workers have strengthened ability to design and deliver equitable services | Health workers may need additional training to provide quality care | Expanded Programme on Immunization (EPI) training and capacity-building activities in many domains (interpersonal communication, epidemiological surveillance, cascade training, community sensitization, vaccine management and logistics, DHIS2) (JA 2018) | equity training, healthworker, management | ||
| 1 Knowledge, awareness and belief | Workforce | Guinea | no | Health managers and workers have strengthened ability to design and deliver equitable services | Health workers may need additional training to provide quality care | Supplemental immunization activities and strengthening of skills for 10,053 vaccinators allowed vaccination of 70,043 zero-dose children (JA 2019) | equity training, healthworker, management | ||
| 1 Knowledge, awareness and belief | Workforce | Guinea-Bissau | no | Health managers and workers have strengthened ability to design and deliver equitable services | Health workers may need additional training to provide quality care | Systematic training of all agents on the Expanded Programme on Immunization (EPI) and effective vaccine management (JA 2016) | equity training, healthworker, management | ||
| 1 Knowledge, awareness and belief | Workforce | Lao People’s Democatic Republic | no | Health managers and workers have strengthened ability to design and deliver equitable services | Health workers may need additional training to provide quality care | 1000 district and health center staff of 12 provinces have been trained on micro planning using updated guidelines (JA 2019) | equity training, healthworker, management | ||
| 1 Knowledge, awareness and belief | Workforce | Madagascar | no | Health managers and workers have strengthened ability to design and deliver equitable services | Health workers may need additional training to provide quality care | Provide Expanded Programme on Immunization (EPI) managers and service providers at all levels with a Management Tool; the management tools that are being multiplied for the 114 Service de District de la Santé Publique (SDSPs) are the Centre de Santé de Base (CSB) child and woman vaccination registers, infant cards, maternal cards, vaccination coverage monitoring curves, stock sheets, temperature sheets. Community immunization registers, time registers, immunization diplomas and child health records, which are also being multiplied, will be used for the 54 priority SDSPs (JA 2019) | equity training, healthworker, management | ||
| 1 Knowledge, awareness and belief | Workforce | Mali | no | Health managers and workers have strengthened ability to design and deliver equitable services | Health workers may need additional training to provide quality care | Training and capacity-building on Expanded Programme on Immunization (EPI), equity for immunization, effective vaccine management conducted at the national regional and district levels (JA 2018) | equity training, healthworker, management | ||
| 1 Knowledge, awareness and belief | Workforce | Mauritania | no | Health managers and workers have strengthened ability to design and deliver equitable services | Health workers may need additional training to provide quality care | Cascade training for healthcare workers involved at all Expanded Programme on Immunization (EPI) levels (JA 2017) Expanded Programme on Immunization (EPI) training for healthcare workers in the private sector (JA 2017) | equity training, healthworker, management | ||
| 1 Knowledge, awareness and belief | Workforce | Mozambique | no | Health managers and workers have strengthened ability to design and deliver equitable services | Health workers may need additional training to provide quality care | Development of an Interpersonal Communication (IPC) guide, and usage of multiple channels of communication to improve interpersonal communication between caregivers/communities and health system, dissemination of health promotion messages and to encourage community engagement and participation (JA 2017) Increased adverse effects following immunization (AEFI) training, update of materials with engagement of pharmacovigilance (JA 2017) | equity training, healthworker, management | ||
| 1 Knowledge, awareness and belief | Workforce | Nicaragua | no | Health managers and workers have strengthened ability to design and deliver equitable services | Health workers may need additional training to provide quality care | 200 health workers from the prioritized municipalities were trained in the key components of surveillance of vaccine-preventable diseases, injection safety and the monitoring of adverse events following immunization (AEFIs) (JA 2017) | equity training, healthworker, management | ||
| 1 Knowledge, awareness and belief | Workforce | Niger | no | Health managers and workers have strengthened ability to design and deliver equitable services | Health workers may need additional training to provide quality care | Capacity-strengthening activities on immunization management and vaccine delivery were organized for healthcare workers at the district and regional levels (JA 2018) | equity training, healthworker, management | ||
| 1 Knowledge, awareness and belief | Workforce | Papua New Guinea | no | Health managers and workers have strengthened ability to design and deliver equitable services | Health workers may need additional training to provide quality care | Training of all frontline health workers on Infection Prevention and Control and Risk Communication and Community Engagement (RCCE) and guidelines for safe conduct of immunization sessions during COVID-19 pandemic with personal protective equipment (PPE) (Multi-stakeholder Dialogue Report (MSD) 2020) | equity training, healthworker, management | ||
| 1 Knowledge, awareness and belief | Workforce | Somalia | no | Health managers and workers have strengthened ability to design and deliver equitable services | Health workers may need additional training to provide quality care | Healthcare workers were trained on interpersonal communication (IPC) to improve communication skills with mothers and caregivers (JA 2019) Enhanced use of women community health workers (i.e., DFID-funded pilot in 8 districts across the country) (JA 2019) | equity training, healthworker, management | ||
| 1 Knowledge, awareness and belief | Workforce | Tajikistan | no | Health managers and workers have strengthened ability to design and deliver equitable services | Health workers may need additional training to provide quality care | Interpersonal communication module developed for training and capacity development of health workers on effective immunization communication (JA 2019) | equity training, healthworker, management | ||
| 1 Knowledge, awareness and belief | Workforce | Tanzania | no | Health managers and workers have strengthened ability to design and deliver equitable services | Health workers may need additional training to provide quality care | A Quality Improvement Team model resulted in increased health worker motivation, productivity (likely through redistribution of workload), and strengthened teamwork (https://www.usaidassist.org/sites/default/files/tanzania_evaluation_hivhw_performance_collaborative_july2013.pdf) | equity training, healthworker, management | ||
| 1 Knowledge, awareness and belief | Workforce | Timor Leste | no | Health managers and workers have strengthened ability to design and deliver equitable services | Health workers may need additional training to provide quality care | Training curriculum for building capacity of health workers to establish and work with mother support groups to promote key practices for immunization, maternal newborn and child health, nutrition and water and sanitation (WASH) was developed and implemented (JA 2017) Over 400 primary health care workers within 5 municipalities have been trained on Interpersonal Communication (IPC) (JA 2017) | equity training, healthworker, management | ||
| 1 Knowledge, awareness and belief | Workforce | Yemen | no | Health managers and workers have strengthened ability to design and deliver equitable services 17 | Health workers may need additional training to provide quality care | Capacity building of Health Educators and about 12,000 Community Health Volunteers (CHVs) and 400 Community Health Workers (CHWs) engaged in door to door visits to create awareness on health interventions including immunization (JA 2019) | equity training, healthworker, management |
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