Abstract
IntroductionAlthough systematic program review meetings are common practice in many health and immunization programs, there is little documentation on their implementation and role. Adult education principles espouse opportunities for peer exchange to build capacity and cross-learning, for which review meetings have been a forum utilized in immunization programs for many years. This study describes the process and use of review meetings to build immunization technical capacity in four African countries since 2011.MethodsA longitudinal case study providing retrospective descriptive analysis and qualitative data collected on immunization program implementation and review meetings conducted within the years of 2011-2016 with district and facility health staff and technical partners from Ethiopia, Kenya, Tanzania and Uganda.ResultsBased on summarized findings and analyses from over 200 review meetings conducted in the four countries within the time period of 2011-2016, these meetings have been shown to be effective tools for improving immunization program performance and the capacity of health staff.ConclusionReview meetings (ideally conducted quarterly) provide health workers with beneficial and low cost opportunities for adult learning, including building skills in data analysis and review, which can be sustained at district and health facility levels. In combination with other performance improvement approaches implemented and supported in countries (such as supportive supervision, training, and on-the-job learning and assessment), review meetings can also contribute to achievement of immunization and health outcomes.
Highlights
Regular review of immunization data is essential for countries to monitor and improve their immunization program performance, and to strengthen accountability, especially for countries whose programs are mainly funded by large donor initiatives such as Gavi, the Vaccine Alliance [1]
This study describes the process and use of review meetings to build immunization technical capacity in four African countries since 2011
Key elements that each country's QRMs include are noted below (Figure 1, review meeting key elements) and described subsequently in the county summaries: the content and structure of QRMs are based on initial rapid assessments of the routine immunization program conducted with district and facility staff at the facilities themselves, sometimes incorporating on-site corrections
Summary
Regular review of immunization data is essential for countries to monitor and improve their immunization program performance, and to strengthen accountability, especially for countries whose programs are mainly funded by large donor initiatives such as Gavi, the Vaccine Alliance [1]. The systematic review of performance by peers can be one strategy to mitigate incentives to over report and to improve data quality. This experience exchange has been found to be a highly effective method of learning. Many health programsincluding immunization-have incorporated regular (e.g. quarterly or biannual) review meetings with participation by peers as a means for knowledge sharing and performance improvement. There is little documentation on the quality of these review meetings, notably on their role vis-à-vis the various other reporting and feedback processes and tools used in immunization programs for improving services, data monitoring and use, and towards promoting a culture of utilizing data for decision-making
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