Search

Home-based records (HBRs) provide an effective, inexpensive mechanism for recording and tracking infant vaccinations, yet stock-outs prevent HBRs from fulfilling their intended function. We describe the annual occurrence of HBR stock-outs during 2014–2016 reported by national immunization programmes to the WHO and UNICEF on the Joint Reporting Form on Immunization. During 2014–16, 48 countries reported at least one HBR stock-out. Thirteen countries reported HBR stock-outs for two of the three years. Forty-four countries reported two or more HBR funding sources in 2016. Challenges persist in ensuring continuous availability of HBRs. HBR stock-outs have important implications as they may impact continuity-of-care, increase inefficiencies at the point-of-care and reduce the ability of caregivers to be effective health advocates. Identifying mechanisms for preventing stock-outs should be a focus of attention for programmes and development partners. Expanded efforts are required to better understand the underlying causes of HBR stock-outs and identify solutions. [ABSTRACT FROM AUTHOR]

Background There is currently a re-focus at the global level on the importance of the home-based record within vaccination service delivery as an important information resource but there are few reports of ever and current home-based record prevalence across countries. Methods We considered all Demographic and Health Surveys (starting with DHS round 3) conducted between 1993 and 2013 for which a final dataset was available in the public domain at the time of the analysis. Ever and current prevalence of home-based records for recording vaccination was estimated for children aged 12–23 months at the time of the survey through a secondary analysis of data from 180 Demographic and Health Surveys conducted in 67 countries derived from questions asked of women aged 15–49 years for their children on home-based record availability and retention. Ever home-based record prevalence is the proportion of children aged 12–23 months who have ever received a home-based record. Current home-based record prevalence is the proportion of children aged 12–23 months for whom a home-based record was available for viewing by the surveyor at the time of the survey. Results Estimated ever home-based record prevalence was ≥90% in 116 surveys from 52 countries and was <70% in 15 surveys from 7 countries. Estimated current home-based record prevalence was ≥80% in 31 surveys from 23 countries and was <50% in 51 surveys from 24 countries. Current home-based record prevalence was <80% as of the most recent survey during 2010–2013 for five (Bangladesh, Ethiopia, Nigeria, Indonesia and Pakistan) of the ten countries with the largest birth cohorts globally. Among 34 countries that conducted three or more DHS, we observed improvements in both ever and current home-based record prevalence of >10% points in six countries. Current home-based record prevalence increased >10% points in six countries where the ever prevalence was maintained at ≥90% across the period of observation. And, no meaningful change was observed in estimated ever and current home-based record prevalence in 11 countries, five of which maintained ever prevalence ≥90% across the period of observation. High home-based record loss rates were observed in many countries. Conclusions The results here show that despite improvements in the availability, utilization and retention of home-based records for recording vaccination history in some countries, opportunities remain to change the mind-set in many national immunization programmes around the importance of the home-based record, particularly in countries with large birth cohorts. Immunization programmes are encouraged to monitor ever and current home-based record prevalence. Nationally representative household surveys collecting information on immunization coverage should include ever and current home-based record prevalence in the standard survey reports and tables to better enable programme managers to identify problems and target corrective action. [ABSTRACT FROM AUTHOR]

Abstract: Home-based child vaccination records play an important role in documenting immunization services received by children. We report some of the results of a review of home-based vaccination records from 55 countries. In doing so, we categorize records into three groups (vaccination only cards, vaccination plus cards, child health books) and describe differences in characteristics related to the quality of data recorded on immunization. Moreover, we highlight areas of potential concern and areas in need of further research and investigation to improve our understanding of the home-based vaccination record form related to improved data quality from immunization service delivery. [Copyright &y& Elsevier]

The strategy to Eliminate Yellow Fever Epidemics (EYE) is a global initiative that includes all countries with risk of yellow fever (YF) virus transmission. Of these, 40 countries (27 in Africa and 13 in the Americas) are considered high-risk and targeted for interventions to increase coverage of YF vaccine. Even though the World Health Organization (WHO) recommends that YF vaccine be given concurrently with the first dose of measles-containing vaccine (MCV1) in YF-endemic settings, estimated coverage for MCV1 and YF vaccine have varied widely. The objective of this study was to review global data sources to assess discrepancies in YF vaccine and MCV1 coverage and identify plausible reasons for these discrepancies. We conducted a desk review of data from 34 countries (22 in Africa, 12 in Latin America), from 2006 to 2016, with national introduction of YF vaccine and listed as high-risk by the EYE strategy. Data reviewed included procured and administered doses, immunization schedules, routine coverage estimates and reported vaccine stock-outs. In the 30 countries included in the comparitive analysis, differences greater than 3 percentage points between YF vaccine and MCV1 coverage were considered meaningful. In America, there were meaningful differences (7–45%) in coverage of the two vaccines in 6 (67%) of the 9 countries. In Africa, there were meaningful differences (4–27%) in coverage of the two vaccines in 9 (43%) of the 21 countries. Nine countries (26%) reported MVC1 stock-outs while sixteen countries (47%) reported YF vaccine stock-outs for three or more years during 2006–2016. In countries reporting significant differences in coverage of the two vaccines, differences may be driven by different target populations and vaccine availability. However, these were not sufficient to completely explain observed differences. Further follow-up is needed to identify possible reasons for differences in coverage rates in several countries where these could not fully be explained. [ABSTRACT FROM AUTHOR]

Highlights • All countries were asked how they conducted measles, rubella, and congenital rubella syndrome surveillance. • 86% of countries reported conducting measles surveillance in line with global recommendations. • 77% of countries reported conducting rubella surveillance in line with global recommendations. • 77% of countries report conducting congenital rubella syndrome surveillance. Abstract Background All six World Health Organization (WHO) regions have committed to eliminate measles, and three WHO regions have committed to eliminate rubella. One of the key tenets of measles and rubella elimination is to have a strong surveillance system in place. The presence of a case-based measles and rubella surveillance system that is national, population-based, provides laboratory confirmation, and directs action, is one of the requirements for elimination-standard surveillance. Methods In order to understand the global landscape for measles and rubella surveillance, a questionnaire was sent to all 194 WHO member states (herein referred to as countries) requesting information on how surveillance was conducted for measles, rubella, and congenital rubella syndrome. Data were supplemented with information provided to WHO through other reporting mechanisms and by national policy documents available to the public. Frequencies and percentages were calculated. Results Data were available to review from 164 (85%) countries, although not every country responded to every question. Case-based, population-based, national surveillance with laboratory confirmation was reported to be conducted in 136 (86%) of 158 countries for measles and 122 (77%) of 158 countries for rubella. Congenital rubella syndrome surveillance was reported to be conducted by 126 (77%) of 163 countries. Gaps were noted in the quality of measles-rubella surveillance conducted, and 26 (16%) of 158 countries reported not including all healthcare providers as mandatory reporters. Conclusions Many countries reported having some of the essential components in place to conduct elimination-standard surveillance for measles and rubella; however, in order to achieve elimination, the quality of surveillance needs to improve to detect all cases. In those countries without these essential components of elimination-standard surveillance, the first step is to implement these components. [ABSTRACT FROM AUTHOR]

Household surveys are frequently used as means of vaccination coverage measurement, but obtaining accurate survey estimates present several challenges. In 2015, the World Health Organization (WHO) released a working draft of its updated Vaccination Coverage Survey Reference Manual that moved well beyond the traditional Expanded Program on Immunization (EPI) survey design. In April 2017, WHO convened a four-day meeting, to review lessons learned using the updated manual and to define an agenda for operational research about vaccination coverage surveys. About 70 stakeholders, including EPI managers and participants from 10 countries that have used the updated Survey Manual, survey experts, statisticians, partners, representatives from WHO regional offices and headquarters, and providers of technical assistance discussed methodological issues from sampling to accurately ascertaining a person’s vaccination status, optimizing data collection and data management and conducting appropriate analyses. Participants also discussed data sharing and how to best survey data for immunization decision-making. The lessons learned from the use of the updated WHO Survey Manual related mainly to operational issues to implement better quality vaccination coverage surveys. It resulted in a list of 23 recommendations for WHO, donors and partners, immunization programs, and household surveys that collect immunization data. Similarly, 14 research topics, categorized in six themes (overall survey conduction, sampling, vaccination ascertainment, data collection, data analysis and use, and inclusion of questions on knowledge, attitudes and practices) were prioritized. Top areas of further work included improving our understanding of the accuracy of caregiver recall when documented evidence of vaccination is not available, improving engagement and coordination between immunization programs and entities conducting multi-purpose household surveys such as Demographic and Health Survey and Multiple Cluster Indicator Survey, improving mechanisms for sharing vaccination survey datasets and documentation, and making better use of survey results to translate data into knowledge for decision-making. This manuscript summarizes the meeting proceedings and provides an update of actions taken by WHO since this meeting. [ABSTRACT FROM AUTHOR]

Abstract: The majority of industrialized and some developing countries have established technical advisory bodies to guide and formulate national immunization policies and strategies. These are referred to as National Immunization Technical Advisory Groups (NITAGs), WHO and its partners have placed a high priority on assisting in the establishment or strengthening of functional, sustainable, and independent NITAGs. To enable systematic global monitoring of the existence and functionality of NITAGs, in 2010, WHO and UNICEF included related questions in the WHO–UNICEF Joint Reporting Form (JRF) that provides an official means for WHO and UNICEF to collect indicators of immunization programme performance. This paper presents the status of NITAGs based on the analysis of the 2010 JRF. Although 115 countries (64% of responders) reported having a NITAG in 2010, only 50% of countries reported the existence of a NITAG with a formal administrative or legislative basis. Despite limitations in the ability to compare 2010 JRF data with that from a 2008 global survey, it appears that substantial progress has been achieved globally over with 43 committees reporting affirmatively about six NITAG process indicators, compared with 23 in the 2008 survey. Impressive progress has been observed in the proportion of countries reporting NITAGs with formal terms of reference (24% increase), a legislative or administrative basis (10% increase), and a requirement for members to disclose their interests (14% increase). Some of the poorest developing countries now enjoy support from a NITAG which meet all six process indicators. These may serve as examples for other countries. [Copyright &y& Elsevier]