Reaching every district (RED) approach to strengthen routine immunization services: evaluation in the African region, 2005

Ryman, Tove K.; Macauley, Rose; Nshimirimana, Deo; Taylor, Patricia E.; Shimp, Lora; Wilkins, Karen

doi:10.1093/pubmed/fdp048

Cited by 67 publications

(75 citation statements)

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“…The overall management of the GMP+ and provision of other basic health services including growth monitoring, health education, nutrition counselling and other services were carried out by trained health volunteers. The Reaching Every District strategy initiated in the African region in 2002 emphasises the full involvement of target communities and the utilisation of available local resources for well-planned outreach services 20 21. Our results suggest that, as a model of routine outreach services, the GMP+ has a potential for improving immunisation coverage.…”

Section: Discussionmentioning

confidence: 78%

The impact of community-based outreach immunisation services on immunisation coverage with GIS network accessibility analysis in peri-urban areas, Zambia

Sasaki

Igarashi

Fujino

et al. 2010

Journal of Epidemiology & Community Health

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Background Accessibility to health services is a critical determinant for health outcome. Objectives To examine the association between immunisation coverage and distance to an immunisation service as well as socio-demographic and economic factors before and after the introduction of outreach immunisation services, and to identify optimal locations for outreach immunisation service points in a peri-urban area in Zambia. Methods Repeated cross-sectional surveys were conducted for two groups of children born between 1999 and 2001, and between 2003 and 2005.The association between immunisation coverage for DPT3 and measles, and access distance, child sex, female headed households, and monthly household income were assessed using logistic regression analysis. Optimal locations for outreach service points were identified using GIS network analysis and genetic algorithms. Results Before the introduction of outreach services, longer distances to the service points were associated with lower DPT3 and measles immunisation coverage (OR¼0.24, 95% CI 0.10 to 0.56, p<0.01 for DPT3; and OR¼0.38, 95% CI 0.17 to 0.83, p<0.05 for measles). However, access distances were not an impediment to immunisation coverage once the outreach services were introduced. The average distance to immunisation services could be decreased from 232.3 to 168.4 metres if the current 12 outreach service points were repositioned at optimal locations. Conclusion Access distance to immunisation services was a critical determinant of immunisation coverage in a peri-urban area. Intervention via outreach services played an important role in averting the risk of missing out on immunisation. Optimal location analysis has the potential to contribute to efficient decision making regarding the delivery of immunisation services.

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Section: Discussionmentioning

confidence: 78%

The impact of community-based outreach immunisation services on immunisation coverage with GIS network accessibility analysis in peri-urban areas, Zambia

Sasaki

Igarashi

Fujino

et al. 2010

Journal of Epidemiology & Community Health

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“…Studies 33 show that increasing the number of locations (eg, health posts and schools) off ering immunisation services can lead to moderate-tohigh gains in coverage.…”

Section: Increased Use Of Outreach Servicesmentioning

confidence: 99%

Strategies to improve health coverage and narrow the equity gap in child survival, health, and nutrition

et al. 2012

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Implementation of innovative strategies to improve coverage of evidence-based interventions, especially in the most marginalised populations, is a key focus of policy makers and planners aiming to improve child survival, health, and nutrition. We present a three-step approach to improvement of the eff ective coverage of essential interventions. First, we identify four diff erent intervention delivery channels-ie, clinical or curative, outreach, community-based preventive or promotional, and legislative or mass media. Second, we classify which interventions' deliveries can be improved or changed within their channel or by switching to another channel. Finally, we do a meta-review of both published and unpublished reviews to examine the evidence for a range of strategies designed to overcome supply and demand bottlenecks to eff ective coverage of interventions that improve child survival, health, and nutrition. Although knowledge gaps exist, several strategies show promise for improving coverage of eff ective interventionsand, in some cases, health outcomes in children-including expanded roles for lay health workers, task shifting, reduction of fi nancial barriers, increases in human-resource availability and geographical access, and use of the private sector. Policy makers and planners should be informed of this evidence as they choose strategies in which to invest their scarce resources.

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“…Based on the components above, every year the IMG-RI sub-group members rated the country Annual EPI Plans after review of available operational planning materials, including Annual EPI Plans and Coverage Improvement Plans (CIPs) [5]. …”

Section: Methodsmentioning

confidence: 99%

Monitoring Results in Routine Immunization: Development of Routine Immunization Dashboard in Selected African Countries in the Context of the Polio Eradication Endgame Strategic Plan

Poy

Ent

Sosler

et al. 2017

The Journal of Infectious Diseases

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BackgroundTo monitor immunization-system strengthening in the Polio Eradication Endgame Strategic Plan 2013–2018 (PEESP), the Global Polio Eradication Initiative identified 1 indicator: 10% annual improvement in third dose of diphtheria-tetanus-pertussis–containing vaccine (DTP3) coverage in polio high-risk districts of 10 polio focus countries.MethodsA multiagency team, including staff from the African Region, developed a comprehensive list of outcome and process indicators measuring various aspects of the performance of an immunization system.ResultsThe development and implementation of the dashboard to assess immunization system performance allowed national program managers to monitor the key immunization indicators and stratify by high-risk and non–high-risk districts.DiscussionAlthough only a single outcome indicator goal (at least 10% annual increase in DTP3 coverage achieved in 80% of high-risk districts) initially existed in the endgame strategy, we successfully added additional outcome indicators (eg, decreasing the number of DTP3-unvaccinated children) as well as program process indicators focusing on cold chain, stock availability, and vaccination sessions to better describe progress on the pathway to raising immunization coverage.ConclusionWhen measuring progress toward improving immunization systems, it is helpful to use a comprehensive approach that allows for measuring multiple dimensions of the system.

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Reaching every district (RED) approach to strengthen routine immunization services: evaluation in the African region, 2005

Cited by 67 publications

References 0 publications

The impact of community-based outreach immunisation services on immunisation coverage with GIS network accessibility analysis in peri-urban areas, Zambia

The impact of community-based outreach immunisation services on immunisation coverage with GIS network accessibility analysis in peri-urban areas, Zambia

Strategies to improve health coverage and narrow the equity gap in child survival, health, and nutrition

Monitoring Results in Routine Immunization: Development of Routine Immunization Dashboard in Selected African Countries in the Context of the Polio Eradication Endgame Strategic Plan

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