progress in routine immunization in the african region
DESCRIPTION
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 - PowerPoint PPT PresentationTRANSCRIPT
Progress in routine immunization in the
African Region
Annual Measles Partnership meeting
Feb 2007Washington DC
2Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa
Immunization coverage in AFR. 2001 - 2006
3Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa
0
10
20
30
40
50
60
70
80
2001 2002 2003 2004 2005 2006
% c
over
age
Angola DR Congo Ethiopia Nigeria
Measles vaccination coverage in the big 4. AFR. 2001 - 2006
4Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa
• 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
Key barriers to achieving high coverage
5Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa
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
6Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa6
Support to scale–up RED implementation
• 90% districts in AFR implementing all components
of RED in 2006
Country Total Districts # RED Districts
2005 2006
Angola 164 60 82
DRC 505 339 503
Ethiopia 85 57 65
Nigeria 774 0 475
RED in the Big 4
7Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa
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
8Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa
Financing Profile for Routine EPI support. AFR. 2006
9Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa
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)
10Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa10
2005: 73%
DPT3 Coverage. AFR. 2005 – Nov 2006
2006* : 75%
*Source: 2006 EPI Monthly report
NDND
<50%
50 - 79%
>= 80%
EMRO
>= 90%
25%
71%
63%
11Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa11
District EPI performance by block. AFR. Jan - Nov 2006
Block
% of districts achieving DPT-3 coverage
>=80% 50%-79% <50%
Western 61% 26% 13%
South/ Eastern
66% 26% 8%
Central 53% 26% 21%
12Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa12
Reported district level DPT3 coverage Jan-Nov 2005 vs 2006,
Big Four Countries
13Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa
ND
Measles coverage. AFR. 2005 – Nov 2006
2005: 68%
50 - 79%
EMRO
<50%
>=80%
ND: No data
2006*: 74%
ND
* Source: 2006 EPI Monthly report
14Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa
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..)
15Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa
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…
16Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa
Challenges
• Resource limitations• Funding, health workers, vehicles, …
17Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa17
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
18Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa
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?
19Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa
Thank you