Progress in routine immunization in the African Region
description
Transcript of Progress in routine immunization in the African Region
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