This edition of the newsletter is available in English, Portuguese, Spanish, and Russian.
The Linked community is invigorated and enthusiastic following multiple opportunities over the past several weeks to connect in person and exchange insights and lessons on topics ranging from providing effective supportive supervision and management to overcoming barriers to introduce and scale up the HPV vaccine.
In mid-July, stakeholders from Mongolia, Philippines, Tunisia, and Viet Nam met in Istanbul, Turkey, and exchanged country experiences related to barriers, lessons learned, and strategies to introduce and scale-up the HPV vaccine, identified key steps and drivers of successful HPV vaccine introduction, shared demand generation approaches and tools to build trust, acceptance, and uptake of the vaccine in communities, and identified introduction and service delivery strategies, and their tradeoffs and implications for sustainable financing to support countries’ decision making. Key takeaways and country experiences from this workshop are outlined in this new brief.
Later in July, stakeholders from the Asia Pacific region participated in a study tour in Colombo, Sri Lanka, to gain a deep, nuanced understanding of how effective supportive supervision and management is emphasized and integrated within the Sri Lankan health system, reflect on how supportive supervision is approached in their own immunisation programmes, and explore how strategies and good practices that work in Sri Lanka can be adapted to strengthen programmes in their home countries.
During each of these in-person learning exchanges, Linked Network Facilitators sat down with immunisation experts in our Practitioner Perspectives interview series. We hear from Dr. Nguyen Thi Thu Huong, National Institute of Hygiene and Epidemiology, Vietnam, and Junghans Sitorus, Ministry of Health, Indonesia, on the rich lessons and strategies that emerged from our recent study tour in Sri Lanka and how these learnings will be used to improve supportive supervision and management mechanisms in their own countries. We also hear from Karine Gabrielyan, Head of the Public Health Division of the Ministry of Health, Republic of Armenia and Oxana Constantinova, Doctor Epidemiologist, Center for Public Health, Moldova, about fostering a learning culture within the immunisation programme and beyond, learnings from peer countries, and what they will take forward in their countries.
Additionally, our former Gavi country dashboards that help middle-income countries track their progress toward strong immunisation programme performance have been updated with the latest 2022 data from the WHO/UNICEF estimates of national immunisation coverage (WUENIC). Be sure to explore the dashboards of your country, as well as network peers. If you identify countries with successes or those facing similar challenges as your country that you would like to discuss, please reach out to Network Facilitators.
You don’t want to miss any of the learnings that come from these workshops and other upcoming learning exchanges. As a reminder, these resources, as well as other news, events, and network updates relevant and timely to the Linked community, can be explored on the Linked website, as well as our new Linked Immunisation Action Network page on LinkedIn. Please be sure to follow and share with your networks!
Finally, this newsletter contains many intriguing and relevant resources and stories from around the world, like key findings from the 2022 WUENIC data, studies on improving immunisation equity and equality, and a case study and podcast episode focused on HPV vaccination.
Stay tuned for more cross-country learnings in the weeks ahead!
Warm regards,
Dr. Nguyen Thi Thu Huong, National Institute of Hygiene and Epidemiology, Viet Nam
NETWORK UPDATES
Check out these Resources from our Workshop, New Vaccine Introduction in Middle Income Countries – Overcoming Barriers to Introduce and Scale the HPV Vaccine
Following COVID-19, Middle Income Countries (MICs) face increasing challenges to sustain and expand their immunisation programmes: coverage rates of traditional vaccines are backsliding, domestic vaccine financing is growing slowly, and significant inequities in access and service delivery remain. New vaccine introductions are also lagging behind, creating a missed opportunity to save lives, with MICs accounting for 14% of the total vaccine-preventable deaths. In July 2023, Linked held an in-person workshop where participants from Mongolia, Philippines, Tunisia, and Viet Nam exchanged their country experiences related to barriers, lessons learned, and strategies to introduce and scale-up the HPV vaccine. Don’t miss out on the learnings and be sure to check out the workshop presentations and country posters on our website!
Overcoming Barriers to Introduce and Scale the HPV Vaccine in Middle Income Countries: Key Takeaways from Linked’s Workshop held on July 11-12th, 2023
In addition to presentations and country posters from our recent workshop on Overcoming barriers to introduce and scale the HPV vaccine in Middle Income Countries, we developed this companion brief that outlines key learnings and takeaways that arose from the workshop. Learn from the experiences of Linked countries in this key takeaways brief and consider ways to adapt these lessons to your own context.
Linked Middle-Income Former-Gavi Country Dashboards Updated with 2022 WUENIC Data
Our former Gavi country dashboards that help middle-income countries track their progress toward strong immunisation programme performance using up-to-date evidence released from WUENIC, WHO/UNICEF Joint Reporting Form on Immunisation (JRF), and other sources, have been updated with 2022 data that was released last month. We encourage you to explore the dashboards of your network peers, which include key indicators around coverage, equity, financing, and new vaccine introductions, and identify countries with successes or those facing similar challenges as your country which you would like to discuss.
The Sri Lankan Experience of Effective Management and Supportive Supervision of EPI Delivery
Linked recently had the opportunity to sit down with immunisation experts, Dr. Nguyen Thi Thu Huong, National Institute of Hygiene and Epidemiology, Vietnam, and Junghans Sitorus, Ministry of Health, Indonesia, to learn about the rich lessons and strategies that emerged from our recent study tour in Sri Lanka focused on the role of effective management and supportive supervision in the delivery of Expanded Programme on Immunisation (EPI) services. Curious to hear how learnings from the study tour will be used to improve supportive supervision and management mechanisms in their countries? Find out in our new Practitioner Perspectives video interview.
Strengthening Health Worker Capacity to Improve Immunisation Services: Practitioner Perspective from Armenia
During our in-person learning engagement that brought together countries from the Europe-Central Asia region to discuss Strengthening Health Worker (HW) Capacity and Performance Management, Linked Network Facilitators sat down with a few immunisation experts to learn about the rich lessons from the workshop. As part of this Practitioner Perspectives series, we hear from Karine Gabrielyan, Head of Public Health Division of the Ministry of Health, Republic of Armenia, about fostering a learning culture within the immunisation programme and beyond, learnings from peer countries, and what they will take forward in their country.
Strengthening Health Worker Capacity to Improve Immunisation Services: Practitioner Perspective from Moldova
As part of this Practitioner Perspectives series from our workshop on Strengthening Health Worker (HW) Capacity and Performance Management, we hear from Oxana Constantinova, Doctor Epidemiologist, Center for Public Health, Moldova, about fostering a learning culture within the immunisation programme and beyond, learnings from peer countries, and what they will take forward in their country.
FEATURED NEWS & RESOURCES
Eight things you need to know about the state of global immunisation
The latest WHO and UNICEF immunisation estimates suggest that vaccine coverage is recovering after the pandemic hit health systems hard across the world, yet challenges remain. According to the latest data, vaccination coverage across 185 WHO and UNICEF member states has made a strong recovery after the disruption of the pandemic, with the number of children receiving no vaccine doses falling by record amounts. However, the state of global immunisation remains below pre-pandemic levels. What does this mean for the 57 countries supported by Gavi, the Vaccine Alliance? Here are 8 key takeaways.
Progress and Challenges with Achieving Universal Immunisation Coverage
This technical slidedeck illustrates key findings from the 2022 WHO/UNICEF Estimates of National Immunisation Coverage (WUENIC). The analysis includes indicators like DTP vaccination coverage, progress towards decreasing the number of zero-dose children, post-pandemic recovery and resiliency, and more.
Understanding Priorities and Needs for HPV Vaccine Advocacy
Human Papillomavirus (HPV) vaccines are highly effective in preventing HPV infection and thereby reducing the incidence of cervical cancer, though low rates of HPV vaccination are a challenge for health care systems across the world. Targeted advocacy strategies are critical for prioritizing the introduction and uptake of HPV vaccines. The International Vaccine Access Center (IVAC) led a survey to engage HPV vaccine stakeholders from around the world to explore which tools, data, and approaches may be most important to inform future advocacy initiatives. Here are the key findings.
Improving Equity in Urban Immunisation in Low- and Middle-Income Countries: A Qualitative Document Review
Large numbers of zero-dose and under-immunised children reside in urban areas, an estimated 30% of zero-dose children, globally. This recent study aimed to identify common challenges to achieving equitable coverage in urban areas and map proposed interventions.
Uncovering the Drivers of Childhood Immunisation Inequality with Caregivers, Community Members and Health System Stakeholders: Results from a Human-Centered Design Study in DRC, Mozambique, and Nigeria
The importance of immunisation for child survival underscores the need to eliminate immunisation inequalities. Few existing studies of inequalities use approaches that view the challenges and potential solutions from the perspective of caregivers. This study aimed to identify barriers and context-appropriate solutions by engaging deeply with caregivers, community members, health workers, and other health system actors through participatory action research, intersectionality, and human-centered design lenses.
Introduction of Typhoid Conjugate Vaccine (TCV) in Nepal: Role of the Vaccination Campaign in Identifying and Reaching Zero-Dose Children
The introduction of the typhoid conjugate vaccine (TCV) in Nepal presented an opportunity to identify and reach zero-dose children during the vaccination introduction’s catch-up campaign. Based on a series of key informant interviews with stakeholders at different levels of the health system, this case study describes how Nepal used the introduction of a new vaccine to identify children who were missing other routine vaccines and provides lessons learned for how immunisation campaigns can be tailored to reach zero-dose children.
How to build an infodemic insights report in six steps
Within a noisy information environment that affects people’s perceptions, attitudes, and health decisions, there is often a gap between health guidance and the population’s behavior. In these cases, infodemic insights can help to inform an emergency response or the response of a health programme. This manual developed by WHO provides a quick overview of the steps required to develop an infodemic insights report that can be used during an emergency response or for routine health programming.
Structural Inequities in Vaccine Acceptance, Demand, Delivery, and Decision-making
Launched in 2019, Sabin’s Social and Behavioral Research Grants Program supports a global network of interdisciplinary and multisectoral researchers to investigate the social and behavioral drivers behind vaccination acceptance, demand, delivery, and decision-making. This case study report includes three of the projects from Sabin’s Grants Program, which have investigated the uptake of COVID-19 vaccines within the context of communities who have experienced – and continue to experience – marginalization in their country context.
Engaging Communities to Prevent Cervical Cancer with HPV Vaccination: Lessons from India and Uganda
Sabin Vaccine Institute’s Community Conversations on Vaccines, presented by Immunisation Advocates, explores issues related to vaccines and immunisation in low- and middle-income countries through discussions with close-to-community professionals, including health workers, journalists, and researchers. In this episode, co-hosts Vince Blaser and Francesca Montalto of the Sabin Vaccine Institute are joined by Rehana Riyawala, vice president at Self-Employed Women’s Association (SEWA), and Doreen Tuhebwe, research fellow at Makerere University School of Public Health (MakSPH). They discuss HPV vaccination efforts, the prevalence of cervical cancer, and innovative approaches to addressing public health challenges in the HPV space. Listen to the episode here.
COUNTRY SPOTLIGHTS
Going door-to-door in North Macedonia to address immunisation inequities
Thirty medical teams visited families in over 120 settlements with marginalized communities in North Macedonia as part of a door-to-door campaign to address and reduce vaccination inequities. Read more about the country’s experience tailoring service delivery to the needs of individuals and communities based on data-enabled informed decisions.
Learning to fight health infodemics: future doctors train in the Republic of Moldova
30 future medical professionals from the Republic of Moldova were trained by the WHO Regional Office for Europe to help to spot online misinformation about vaccination and counter it with facts. Learn how they’re putting their training into action by monitoring and combating misinformation online.
Community health workers in Brazil work tirelessly to reach children who missed out on vaccines
Since 2015, vaccination coverage for children in Brazil under the age of 5 has been falling, placing them at much greater risk of vaccine-preventable diseases like polio and measles. Discover how these health workers navigate rural rivers and bustling cities to reach those who need them most with immunisation services.
EXTERNAL EVENTS
Upcoming Zero-Dose Learning Hub Experience Sharing Session on Identifying and Reaching Zero-Dose and Missed Communities to be Held in September
Are you working to reach children in your community who are not receiving life-saving vaccines? Do you want to learn about successful outreach strategies being used to reach under-immunised communities in other countries? Join the Gavi Zero-Dose Learning Hub Experience Sharing (ZDLH-X) session, which will be held on September 13, 2023. This session will offer a unique opportunity to learn from the experiences, successes, and lessons learned by health professionals from Uganda and Nigeria in identifying and reaching zero-dose children and missed communities. Follow this link to register.