Strengthening routine immunization services and sustainable financing for immunization

Q&A About Immunization - Archives

Question:
Our health system has been significantly decentralized over the past decade. What are some good ways that we can strengthen immunization services at the district level?

Answer:
WHO, UNICEF, BASICS and other organizations have elaborated an excellent strategy for strengthening services at the district level. Reaching Every District (RED) combines attention to a number of persistent problems (such as poor data collection and use, outreach, supervision) and has the potential to improve planning, management and support for routine immunization services at the sub-national level. RED has been used successfully in countries such as the Democratic Republic of Congo, Ethiopia, Angola, Madagascar, Senegal, and Uganda to improve performance, and it is now being promoted in much of Africa and Asia. Its five components include:

• Re-establishing outreach vaccination
• Strengthening supportive supervision
• Increasing links between communities and services
• Improving monitoring for action
• Planning and managing resources more effectively

RED is designed to be integrated into ongoing immunization programs as a package of interventions; however, its components may be phased in over time and/or given different emphases to match locally defined needs and interests. An advantage of the RED approach is its potential to strengthen not only immunization, but also those other essential maternal and child health services—such as antenatal and postnatal care family planning, and growth promotion—which may be underutilized and/or inadequately supported at the community level.

A majority of the resources described in the Resources section of this website support strengthening immunization at the district and facility levels. There are tools, strategy and training guidelines, case studies, and others. See particularly Routine Immunization Resources.