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Progress in routine immunization in the African Region

Progress in routine immunization in the African Region. Annual Measles Partnership meeting Feb 2007 Washington DC. Immunization coverage in AFR. 2001 - 2006. Measles vaccination coverage in the big 4. AFR. 2001 - 2006. Key barriers to achieving high coverage. Low quality of service

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Progress in routine immunization in the African Region

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  1. Progress in routine immunization in the African Region Annual Measles Partnership meeting Feb 2007 Washington DC

  2. Immunization coverage in AFR. 2001 - 2006

  3. Measles vaccination coverage in the big 4. AFR. 2001 - 2006

  4. Key barriers to achieving high coverage • Low quality of service • Inadequate training and supervision • little or no outreach services, • links with the community not systematic • Inadequate monitoring system • district disparities not reflected in national coverage data • Lack of district micro-planning

  5. Reaching Every District Strategy: operational components • Re-establishment of outreach services • Supportive supervision • Community links with service delivery • Monitoring and use of data for action • Planning and management of resources

  6. Support to scale–up RED implementation 90% districts in AFR implementing all components of RED in 2006 REDin the Big 4 6

  7. Immunization financing • Increasing immunization self- financing • More countries have line item in the national budget for vaccine purchase • More partner support and better utilisation of funding • Important funding gaps still remain

  8. Financing Profile for Routine EPI support. AFR. 2006

  9. MP support for Routine EPI • Measles Partnership support for routine EPI amounting to 10% of operational costs coming through the WHO • Supporting the implementation of RED strategy • Micro-planning process • Re-establishment/ scaling up of outreach activities • Training of health workers • Monitoring (monthly/ quarterly meetings)

  10. EMRO >= 80% >= 90% 50 - 79% <50% DPT3 Coverage. AFR. 2005 – Nov 2006 2006* : 75% 2005: 73% ND ND 25% 71% 63% *Source: 2006 EPI Monthly report 10

  11. District EPI performance by block. AFR. Jan - Nov 2006 11

  12. Reported district level DPT3 coverage Jan-Nov 2005 vs 2006, Big Four Countries 12

  13. EMRO <50% 50 - 79% >=80% Measles coverage. AFR. 2005 – Nov 2006 2005: 68% 2006*: 74% ND ND ND: No data * Source: 2006 EPI Monthly report

  14. Changes in measles coverage between 2000 – 2006. AFR • Increase in coverage; 33 countries • Increase by > 25% of 2000 figures: 25 countries • Decline in coverage; 8 countries • (Eq G, Angola, Tanzania, Zambia, Zimbabwe..)

  15. 5 country RED evaluation (2005)Key findings • In 4 of 5 countries, RED was initiated using available data to prioritize districts • In 4 countries, immunization coverage increased by >/= 10% points • In MAD, a decline in national coverage. However, RED had a protective effect in the target districts • Successful introduction of RED; contingent on availability of funds for training,micro-planning…

  16. Challenges • Resource limitations • Funding, health workers, vehicles, …

  17. Way forward Continue to focus on the Big 4 (particularly Nigeria and Angola), and the central block Support member states to scale up the implementation of all 5 components of the RED in all districts Support countries to improve the quality of routine immunization data through the DQS Continue to encourage governments to invest in EPI 17

  18. Issues for discussion • Recognizing the role of the routine immunization (“keep-up”) in sustaining the gains in measles mortality reduction: • Can MP help bring in more donor support for routine EPI? • How can countries be supported to focus activities in high risk districts?

  19. Thank you

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