Progress in routine immunization in the African Region

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Progress in routine immunization in the African
Region
Annual Measles Partnership meeting Feb
2007 Washington DC
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Immunization coverage in AFR. 2001 - 2006
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Measles vaccination coverage in the big 4. AFR.
2001 - 2006
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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

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Support to scaleup RED implementation

• 90 districts in AFR implementing all components
  of RED in 2006

RED in the Big 4
Country Total Districts RED Districts RED Districts
Country Total Districts 2005 2006
Angola 164 60 82
DRC 505 339 503
Ethiopia 85 57 65
Nigeria 774 0 475
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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

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Financing Profile for Routine EPI support. AFR.
2006
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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)

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DPT3 Coverage. AFR. 2005 Nov 2006
2006 75
2005 73
ND
ND
25
71
63
Source 2006 EPI Monthly report
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District EPI performance by block. AFR. Jan -
Nov 2006
Block of districts achieving DPT-3 coverage of districts achieving DPT-3 coverage of districts achieving DPT-3 coverage
Block gt80 50-79 lt50
Western 61 26 13
South/ Eastern 66 26 8
Central 53 26 21
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Reported district level DPT3 coverage Jan-Nov
2005 vs 2006, Big Four Countries
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Measles coverage. AFR. 2005 Nov 2006
2005 68
2006 74
ND
ND
ND No data
Source 2006 EPI Monthly report
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Changes in measles coverage between 2000 2006.
AFR

• Increase in coverage 33 countries
• Increase by gt 25 of 2000 figures 25 countries
• Decline in coverage 8 countries
• (Eq G, Angola, Tanzania, Zambia, Zimbabwe..)

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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 gt/ 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

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Challenges

• Resource limitations
• Funding, health workers, vehicles,

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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

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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?

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Thank you