RT Journal Article
SR Electronic
T1 A Successful National and Multipartner Approach to Increase Immunization Coverage: The Democratic Republic of Congo Mashako Plan 2018–2020
JF Global Health: Science and Practice
JO GLOB HEALTH SCI PRACT
FD Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs
SP e2200326
DO 10.9745/GHSP-D-22-00326
VO 11
IS 2
A1 Lame, Paul
A1 Milabyo, Augustin
A1 Tangney, Sylvia
A1 Mbaka, Gloire O.
A1 Luhata, Christophe
A1 Gargasson, Jean-Bernard Le
A1 Mputu, Christelle
A1 Hoff, Nicole A.
A1 Merritt, Sydney
A1 Nkamba, Dalau M.
A1 Sall, Djariatou Sow
A1 Otomba, John Samuel
A1 Mourid, Amine El
A1 Lusamba, Paul
A1 Senouci, Kamel
A1 Bor, Emmanuel
A1 Rimoin, Anne W.
A1 Kaba, Didine
A1 Mwamba, Guillaume
A1 Mukamba, Elisabeth
YR 2023
UL http://www.ghspjournal.org/content/11/2/e2200326.abstract
AB Key FindingsThe strategy to strengthen routine immunization (RI) placed particular emphasis on service delivery, management, real-time monitoring, evaluation, and vaccine availability.Existing RI programs can be rapidly strengthened using simple metrics and straightforward interventions.Subnational government engagement is important to create ownership and collaboration amongst stakeholders.Key ImplicationAs new vaccines are added to RI schedules, the processes identified during the Mashako Plan implementation will continue to inform practices that ensure the strength of immunization systems in the DRC and may be useful to other low-and-middle income countries.Background:The immunization system in the Democratic Republic of the Congo faces many challenges, including persistent large-scale outbreaks of polio, measles, and yellow fever; a large number of unvaccinated children for all antigens; minimal and delayed funding; and poor use of immunization data at all levels. In response, the Expanded Programme on Immunization within the Ministry of Health (MOH) collaborated with global partners to develop a revitalization strategy for the routine immunization (RI) system called the Mashako Plan.Mashako Plan Design and Development:The Mashako Plan aimed to increase full immunization coverage in children aged 12–23 months by 15 percentage points overall in 9 of 26 provinces within 18 months of implementation. In 2018, we conducted a diagnostic review and identified gaps in coordination, service delivery, vaccine availability, real-time monitoring, and evaluation as key areas for intervention to improve the RI system. Five interventions were then implemented in the 9 identified provinces.Discussion:According to the 2020 vaccine coverage survey, full immunization coverage increased to 56.4%, and Penta3/DTP3 increased to 71.1% across the Mashako Plan provinces; the initial objective of the plan was reached and additional improvements in key service delivery indicators had been achieved. Increases in immunization sessions held per month, national stock of pentavalent vaccine, and supervision visits conducted demonstrate that simple, measurable changes at all levels can quickly improve immunization systems. Despite short-term improvements in all indicators tracked, challenges remain in vaccine availability, regular funding of immunization activities, systematic provision of immunization services, and ensuring long-term sustainability.Conclusions:Strong commitment of MOH staff combined with partner involvement enabled the improvement of the entire system. A simple set of interventions and indicators focused the energy of managers on discrete actions to improve outcomes. Further exploration of the results is necessary to determine the long-term impact and generate all-level engagement for sustainable success in all provinces.