A Successful National and Multipartner Approach to Increase Immunization Coverage: The Democratic Republic of Congo Mashako Plan 2018–2020

Abstract

The strategy to strengthen routine immunization (RI) placed particular emphasis on service delivery, management, real-time monitoring, evaluation, and vaccine availability.n Existing RI programs can be rapidly strengthened using simple metrics and straightforward interventions.n Subnational government engagement is important to create ownership and collaboration amongst stakeholders.

Assessing the Use of Geospatial Data for Immunization Program Implementation and Associated Effects on Coverage and Equity in the Democratic Republic of Congo

“…The drastic improvements in immunization outcomes may be also explained by other factors, such as the implementation, in parallel, of some speci c immunization projects, which worked in synergy. The Province of Haut-Lomami has been a Mashako Plan site with intensi ed support of the EPI [4,23]. In addition, an intervention aiming to improve the distribution of vaccine products up to the last kilometer and using Information and Communication Technologies (ICTs) in the elds of health has intensively assisted the Province through the EPI branch o ce of Kamina [23,24].…”

“…In the Democratic Republic of the Congo (DRC), the Mashako Plan is a unique, high-level national health strategy that aims to drastically increase complete childhood immunization coverage at a national level [4]. The integration of geospatial tools, technologies and data for planning and delivery of immunization services supports the Mashako Plan through a participatory process to create geospatially accurate maps of settlements, de ne health area boundaries and generate improved population estimates.…”

Zero-Dose Childhood Vaccination Status in Rural Democratic Republic of Congo: Quantifying the Relative Impact of Geographic Accessibility and Attitudes toward Vaccination

“…The DRC government committed to strengthening routine immunization services under the Mashako Plan, launched in 2018. However, the plan in its current form does not address demand-related barriers to vaccination and primarily focuses on supply-side improvements, such as increasing the number of immunization sessions, supportive supervision, vaccination stocks, and cold chain improvement [ 11 , 45 ]. To fully address non-vaccination in the country, there will likely need to be an explicit focus on demand generation, for example by mobilizing the network of community health workers (relais communautaire, RECOs in DRC) for educational campaigns.…”

“…The Democratic Republic of the Congo (DRC) persists as one of the most vulnerable countries to vaccine-preventable diseases and has experienced several recent outbreaks, including a measles epidemic in 2019 resulting in more than 300,000 suspected cases and 6000 deaths [ 10 , 11 ]. Prior efforts to understand the drivers of persistently low coverage in DRC identified several system-side challenges, including inequities in service and vaccine availability, variable management and program monitoring, and challenges with health worker motivation [ 11 ].…”

“…The Democratic Republic of the Congo (DRC) persists as one of the most vulnerable countries to vaccine-preventable diseases and has experienced several recent outbreaks, including a measles epidemic in 2019 resulting in more than 300,000 suspected cases and 6000 deaths [ 10 , 11 ]. Prior efforts to understand the drivers of persistently low coverage in DRC identified several system-side challenges, including inequities in service and vaccine availability, variable management and program monitoring, and challenges with health worker motivation [ 11 ]. In response, the Ministry of Health developed the Mashako Plan in 2018 with the primary aim of improving coverage interventions focused on improved coordination, service delivery, vaccine availability, real-time service delivery monitoring, and more robust program evaluation.…”