Are you interested in exploring barriers, strategies, and country experiences addressing HPV demand generation and vaccine acceptance strategies or developing national Electronic Immunisation Registries (EIR) to improve immunisation outcomes? Keep reading below to find critical resources and uncover key insights to strengthen your national immunisation program.
This blog outlines strategies for making national level information systems such as national identity systems and civil registration and vital statistics systems interoperable with national electronic immunisation registries (EIRs).
Two new learning resources summarize key takeaways from recent Linked workshops – one focused on Persistent Backsliding: Experiences implementing approaches to restore coverage and strengthen immunisation programming for the future and a second one centered on HPV demand generation and vaccine acceptance strategies.
Dafina Gexha-Bunjaku, the Deputy Minister of Health of Kosovo discusses the country’s experience introducing the HPV vaccine, generating formative evidence on perceptions of the vaccine, developing a communication intervention plan, and overcoming barriers to vaccine uptake in this new Practitioner Perspective video.
In a second Practitioner Perspective video, Hugo Catan, a Health Program Officer, Department of Health, Health Promotion Bureau of the Philippines talks about the country’s experience introducing the HPV vaccine using an effective and cost-efficient school-based immunisation strategy.
This newsletter edition also includes a special feature on Viet Nam’s National Electronic Immunisation Registry, with several articles summarizing how the country successfully designed, developed, deployed, and scaled up their EIR.
Finally, the global immunisation community published relevant literature, guides, case studies, and more to expand knowledge around HPV vaccine introduction, private sector engagement for immunisation, participatory research and human-centered design, breaking gender barriers to vaccination, and more. Keep reading below to uncover key insights!
Warm regards,
Eka Paatashvili, Senior International Consultant, Curatio International Foundation and Country Outreach Support for the Europe and Central Asia region for the Linked Immunisation Action Network
Network Updates
Blog: The Role of Citizen Identifiers in Modernizing Electronic Immunisation Systems
On October 15, Linked held a webinar to share experiences amongst countries working towards developing national Electronic Immunisation Registries (EIRs) and discuss strategies for making national level information systems such as national identity systems and civil registration and vital statistics systems interoperable with them. This blog summarizes learnings from the webinar, including the role of citizen identifiers in modernizing EIRs, the benefits of integrating EIRs with these identifiers, and insights from the experiences of Estonia and Thailand.
Brief: Persistent Backsliding: Experiences implementing approaches to restore coverage and strengthen immunisation programming for the future – Key Takeaways from the Linked Immunisation Action Network’s workshop on 3-4 July 2024
In July, national and subnational government stakeholders from Azerbaijan, Georgia, and Honduras (with Angola participating virtually) were joined by national and regional experts from the World Health Organization (WHO), Pan American Health Organization (PAHO), UNICEF, and Brazil’s national immunisation programme for a productive and engaging Linked learning engagement. This workshop was an opportunity for countries from different regions that have experienced a significant and persistent drop in immunisation coverage in recent years to come together and reflect on the drivers of persistent backsliding. This brief outlines key learnings and takeaways from the workshop.
Brief: New vaccine introduction in middle income countries: HPV demand generation and vaccine acceptance strategies – Key takeaways from Linked’s workshop held on October 22-23rd, 2024
A Linked workshop in October facilitated the sharing of approaches, good practices, and lessons to build trust, acceptance, and uptake of the HPV vaccine in communities, with special attention to religious and cultural contexts in each participating country. Country government teams from Cuba, Kosovo, Mongolia, Philippines, Tunisia, and Viet Nam participated, along with experts from partner organizations, including Gavi, WHO HQ, PAHO, CHAI, Jhpiego, UNICEF HQ, UNICEF Europe and Central Asia Regional Office, UNICEF country office to Mongolia, and WHO country office to the Philippines and Kosovo. This brief outlines key learnings and takeaways from the workshop.
Practitioner Perspective: HPV vaccine demand generation and vaccine acceptance strategies – experiences from Kosovo
During our workshop focused on HPV demand generation and vaccine acceptance strategies, we sat down with Dafina Gexha-Bunjaku, Deputy Minister, Ministry of Health, Kosovo, to discuss the country’s experience introducing the HPV vaccine, specifically generating formative evidence on perceptions of the vaccine, developing a communication intervention plan based on this evidence, and overcoming barriers to vaccine uptake. Discover Kosovo’s experiences and insights in our practitioner perspective video, available in English.
Practitioner Perspective: HPV vaccine demand generation and vaccine acceptance strategies – experiences from the Philippines
Also during our workshop focused on HPV demand generation and vaccine acceptance strategies, we sat down with Hugo Catan, Health Program Officer, Department of Health, Health Promotion Bureau, Philippines to discuss the country’s experience introducing the HPV vaccine using a school-based immunisation strategy. Discover the Philippine’s experiences and insights in our practitioner perspective video, available in English.
Special Feature on Viet Nam’s National Electronic Immunisation Registry
Determinants of Scale-up From a Small Pilot to a National Electronic Immunisation Registry in Viet Nam
Digital health innovations can improve health system performance, yet previous experience has shown that many innovations do not advance beyond the pilot stage to achieve scale. Vietnam’s National Immunisation Information System (NIIS) began as a series of digital health pilots, first initiated in 2010, and was officially launched nationwide in 2017. The NIIS is one of the few examples of an electronic immunisation registry (EIR) at national scale in low- and middle-income countries. This study outlines the determinants of scale-up of the national EIR in Viet Nam, contributing to the evidence on how and why digital interventions can successfully achieve scale. Read the findings here.
The Transition to an Entirely Digital Immunisation Registry in Ha Noi Province and Son La Province, Viet Nam
Since its launch, Viet Nam’s NIIS has resulted in drastically improved immunisation coverage and timeliness of vaccinations, as well as more accurate and effective vaccination planning and reporting. During rollout, end users were tasked with managing both NIIS and paper-based systems in parallel until a formal assessment on the readiness to fully transition to the NIIS was conducted. This study evaluated and compared the readiness of 2 provinces in Viet Nam in moving entirely from a paper-based to paperless system for immunisation records, with an emphasis on accuracy, completeness, consistency, timeliness, and data quality. Discover the results here.
Design, Development, and Deployment of an Electronic Immunisation Registry: Experiences from Viet Nam, Tanzania, and Zambia
Electronic immunisation registries have been shown to strengthen immunisation practices in low-and middle-income countries by saving health worker time with automated reporting, improving data quality and use, reducing stock-outs,and improving immunisation coverage. Practitioners and researchers have called for more implementation research to understand the “how” and “why” of digital health implementations. This article documents the practical experience of scaling an EIR across 3 country contexts: Viet Nam, Tanzania, and Zambia, aiming to provide practical, operational insights to country decision-makers and partners who are considering or are in the process of implementing an EIR. Uncover the insights here.
Outcomes and Costs of the Transition from a Paper-Based Immunisation System to a Digital Immunisation System in Viet Nam
There is limited evidence on the costs of development and implementation of a national digital immunisation system, recurrent costs of the system, and cost implications of eliminating a parallel paper system at the service delivery level. The Vietnamese experience of introducing and scaling digital tools for immunisation presents an opportunity to help fill these evidence gaps. This study aimed to evaluate the short-term outcomes and costs associated with Viet Nam’s transition to a paperless system. Analyze the key findings here.
Featured News & Resources
Private sector engagement for immunisation programmes: a pragmatic scoping review of 25 years of evidence on good practice in low-income and middle-income countries
Many National Immunisation Programmes attempt to leverage the private sector; however, there is limited consolidated and synthesized documentation on good practices, gaps and lessons learnt. This recent scoping review identifies gaps, updates, and consolidate evidence on promising practices in private sector engagement for vaccination. Examine the review here.
HPV Vaccine Introduction: Technical Resources
This toolbox serves as a reference for all aspects of HPV vaccine introduction (decision-making, Gavi applications, planning, communication, implementation, and monitoring and evaluation, etc.) This toolbox contains practical tools developed by EPI programmes, partners, and global organizations and complements the global guidance and tools in the WHO HPV Vaccine Introduction Clearing House. Explore the tools here.
Co-Creating Health Solutions: Participatory Research and Human-Centered Design for Immunisation Programs
This technical paper offers a comprehensive and practical guide to conducting participatory research and design within global health immunisation initiatives, drawing on the experiences of VillageReach, the Sabin Vaccine Institute and partners. The focus is on principles that center community engagement, inclusivity and leveraging local knowledge, with examples and case studies from countries. View the paper here.
Sustainable Immunisation Financing in Indonesia
While Indonesia’s National Immunization Program (NIP) has achieved consistently high national vaccination coverage rates in the past, the COVID-19 pandemic and Gavi’s transition have created new pressures on immunization financing and delivery. This brief, developed by ThinkWell, examines how Indonesia’s decentralized health system affects immunisation financing and identifies key bottlenecks. Read the report here.
Leadership of frontline health workers in breaking gender barriers to vaccination: A case study from India
Focusing on the experiences of female frontline health workers known as Accredited Social Health Activists (ASHAs), this case study shows how they used innovative tools in an emerging digital ecosystem to overcome gender-related barriers and expand vaccine rollout across India during the COVID-19 pandemic. Explore the case study here.
The costs of improving the last mile delivery of vaccines through an informed push model study in Uganda
A pilot study in Uganda showed a significant improvement in vaccine delivery efficiency and quality through implementing an informed push model. The informed push model was found to be a cost-effective strategy for improving last-mile vaccine delivery by reducing lead times, enhancing cold chain management, and decreasing stock-outs. Review the full article here.
How do you reach the urban hard-to-reach? Ask these health workers
Reaching unvaccinated children in urban settings presents unique challenges. In a session organized by The Geneva Learning Foundation, in partnership with UNICEF, at Teach to Reach, a peer-learning platform, health workers have been sharing practical insights into what works – and what doesn’t – in identifying and vaccinating unvaccinated children in urban slums and informal settlements. Examine their lessons here.
Charting the unprotected: an illustrated guide to the zero-dose child
Although zero-dose children are found in many places, they often have certain things in common that mean they are less likely to be able to access vaccination. Understanding these barriers is key to designing innovative strategies to reach them. This article outlines eight things we know about the average zero-dose child today. Read it here.
Country Spotlights
Reaching Angola’s zero-dose children with lifesaving vaccination
In 2023, the Angola Ministry of Health launched the Middle-Income Countries (MICs) Zero-Dose project to boost routine vaccination coverage and integrate zero dose children into vaccination programmes. Since its implementation, there has been an increase in vaccination coverage due to enhanced community social mobilisation activities through local media, engagement of traditional and community leadership, use of community health leaders involved in the mapping of local organisations supporting health activities, clear identification of zero dose children, and implementing targeted intensification with mobile/outreach vaccination activities. Read more about the project and its successes here.
Changing Lives: Vaccinations in Timor-Leste
Timor-Leste introduced the HPV vaccine in July 2024, marking a significant achievement in public health. Three weeks into the rollout, health care workers had vaccinated 90% of the target population of school-aged girls, totaling 56,350 out of the 62,000 targeted. Learn more about their successful introduction here.
HPV vaccines reach remote Mongolia
Mongolia has just introduced the life-saving HPV vaccine, aiming to protect 90% of its children against cancer. Gavi VaccinesWork visited a school in Töv Province to see how the rollout was going. Explore the photo story here.
Six things we’ve learned from Nigeria’s efforts to reach the unimmunised
Nigeria is home to an estimated 2.1 million of these zero-dose children, making it the largest population of unvaccinated children in Africa. The country has made progress over the last two decades, but there is a long way to go still to reach Nigeria’s national target of achieving an average national coverage of all routine antigens of 80% by 2028. Learn six things the Nigeria Learning Hub has uncovered in their work to generate evidence-based insights into barriers and enablers for reaching zero-dose children here.
External Events
Materials from webinar on the Immunization Cost Catalogue: What it is, what it tells us, and how you can use it
In November, Immunization Economics hosted a webinar on the updated Immunization Delivery Cost Catalogue (IDCC), the most comprehensive, current, and standardized dataset on the cost of delivering vaccines in low- and middle-income countries. Participants learned what the IDCC is, what it tells us about the cost of delivering vaccines in LMICs, and how it can be used for budgeting and planning, resource mobilization, advocacy and further research. View the webinar materials here.
Materials from VPPN webinar on How can market intelligence help with understanding vaccine markets to inform a procurement strategy?
Earlier this month, the Vaccine Procurement Practitioners Network (VPPN) held a webinar focused on how market intelligence can help with understanding vaccine markets to inform a procurement strategy. The webinar included a presentation that summarized what considerations to take when changing the procurement strategy, what steps allow the decision to be made, and what stakeholders should be involved. It also featured country experiences from Macedonia and Uzbekistan.