Abstract
IntroductionImmunization program monitoring includes numerous activities, some of which include monitoring of vaccination coverage, surveillance performance and epidemiological patterns. The provision of timely, high quality and actionable feedback is an essential component of strengthening health systems. Within the African region of the WHO, various bulletins are produced and disseminated regularly to provide feedback on the performance of immunization programs and vaccine preventable disease control initiatives.MethodsThe 2019 annual national immunization program managers’ meeting for countries in the eastern and southern African subregion was held in Asmara from 18 - 20 March 2019. A survey questionnaire was administered to the participants representing the national programs and in-country partners across the 20 countries.ResultsOn average, the 75 respondents receive 1.8 e-mailed feedback bulletins monthly. Twenty-three (31%) respondents receive 3 or more written feedback bulletins per month, and 72% receive the bulletins regularly. On a scale of 1 - 5 (from lowest to highest), 87% participants rated the relevance of the bulletins they receive at 4 - 5. Only 19% of the respondents responded that the results are discussed within the national immunization program, and 14% stated that action points are generated based on the feedback received. Fifty-nine (79%) respondents want to receive more frequent feedback on routine immunization performance. Among the EPI program managers and the EPI program data managers, the access to these feedback bulletins was quite limited. Even though the primary objective of the bulletins is to initiate discussions and action based on the provided feedback, such discussions do not happen regularly at country level. The programmatic use and advocacy value of the bulletins is not optimal.ConclusionWe recommend integrating program feedback, regularly updating the distribution lists, the additional use of instant messaging platforms for distribution, as well as online posting of the bulletins for wider availability.
Highlights
The African Regional Strategic Plan for Immunization 2014 - 2020 (RSPI) maps out ambitious goals for improving access to vaccines and to eliminate targeted vaccine preventable diseases
The 41 participants from various in-county partners were from WHO, UNICEF, John Snow Inc. (JSI), Clinton Health Access Initiative (CHAI), PATH and Aspen Management Partnership for Health (AMP Health)
The 15 national immunization program managers or directors who responded to the survey indicated that they receive on average 1.8 feedback bulletins over the course of a month
Summary
The African Regional Strategic Plan for Immunization 2014 - 2020 (RSPI) maps out ambitious goals for improving access to vaccines and to eliminate targeted vaccine preventable diseases. Immunization program monitoring is done regularly by recording and tracking service data, including the number of doses of antigens provided to persons. Immunization coverage data needs to be interpreted alongside information from vaccine preventable disease surveillance systems in order to provide a more complete understanding of the performance and impact of immunization programs in the control of vaccine preventable diseases. Regular review of program and health worker performance has been recognized as one of the key drivers of improvement of routine immunization systems in the African setting [3]. One important example of monitoring from the WHO global level is the compilation of national reported data through the WHO-UNICEF joint reporting form, and subsequent generation of antigen-specific annual estimates of coverage for each country, often referred to as the WHO-UNICEF estimates of national coverage [11]
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