Immunization

Globally, immunization prevents three million child deaths each year, and the World Health Organization (WHO) estimates that 20% of remaining under-five deaths—approximately 1.7 million deaths annually—could be prevented with existing vaccines. Nearly 30% of all non-neonatal, under-five deaths are still preventable through immunization.  Success in reducing vaccine-preventable mortality has been dramatic, but it cannot be taken for granted.

For example, approximately one million newborns died of tetanus 30 years ago compared to about 70,000 last year—a 93% reduction. However, this achievement must be maintained and built upon every year to further lower neonatal mortality from the disease. And while vaccination coverage in some countries now exceeds 80%, coverage is not the only metric. Before they are exposed to disease, women and newborns must be reached by both potent vaccines and high-quality services in a timely, safe, effective, acceptable and affordable manner, enabling them to return to complete all their doses.

In addition, coverage disparities continue within countries, with few countries reaching 80% or higher coverage in all districts. To prevent outbreaks, consistently high coverage is needed everywhere, year after year. Increasingly, vaccination programs are aiming to reach the hard-to-reach and marginalized groups to improve access and equity.

Strategic Approach
MCHIP is dedicated to ensuring that every infant and woman of childbearing age in the developing world is fully immunized. Working with global, regional, national and sub-national partners, MCHIP:

  • Provides practical, field-oriented, technical analysis and support;
  • Shares information and best practices in the field of immunization with countries and partners; and
  • Aims to strengthen health systems by building local capacity to offer effective and sustainable vaccination services.

MCHIP provides technical support to routine immunization (RI) systems to sustain mortality reduction gains achieved through campaigns and to serve as a platform for effective introduction of new, lifesaving vaccines. Immunization program priorities include:

  • Strengthening RI services at national and sub-national levels to identify and reach the underserved in selected countries. MCHIP works with countries to identify and prioritize under-immunized populations and operationalize the Reaching Every District (RED) approach.
  • Providing technical support to countries as they prepare for the introduction of new, lifesaving vaccines. This includes assisting them with introduction plans, applications to the GAVI Alliance, preparations for and the phasing of vaccine introduction, and monitoring and post-introduction evaluation.
  • Supporting vaccine-preventable disease interventions, including polio eradication and measles mortality reduction. Success in sustaining disease control or eradication requires matched efforts in RI—MCHIP’s niche. The Program provides technical support to leverage single-disease initiatives so that they can strengthen RI.
  • Exploring how best to link immunization services with the delivery of other interventions and with shared program functions such as monitoring and evaluation.
  • Assisting a number of countries in customizing strategies that build upon the existing immunization outreach platform to deliver multiple interventions at scale.
  • Providing technical support based on field experience to global and regional partners to formulate immunization policies, design delivery strategies, and identify investment opportunities.

MCHIP works closely with international organizations and links its country programming to important global and regional initiatives, such as the GAVI Alliance, WHO/UNICEF Global Immunization Vision and Strategy (GIVS), Decade of Vaccines, Global Vaccine Action Plan, Global Polio Eradication Initiative, Measles Initiative, and others.

Key Contributions

  • Significant contributions to global and regional policymaking and technical leadership and technical input at the global level to advance immunization programming. MCHIP has contributed to global and regional policymaking and technical leadership through engagement in global policymaking processes.
  • Advanced global program learning on immunization. MCHIP has published many articles in peer reviewed journals, given keynote presentations to global and regional immunization meetings and to professional associations, and contributed to global protocols and program learning.
  • Assistance to 10 countries for new vaccine introduction. MCHIP has provided technical assistance to DRC, India, Kenya, Malawi, Rwanda, Senegal, Tanzania, Timor-Leste, Uganda and Zimbabwe to apply for and introduce new vaccines.
  • Exploration of the use of immunization as a platform for integration of other services. MCHIP collaborated with FHI to review and document efforts to integrate FP and immunization services. MCHIP and FHI co-authored the brief “Integration of Family Planning with Immunization Services,” which highlights the potential for linking FP messages and service delivery during vaccination contacts.
  • Technical support for polio eradication. MCHIP provides focused technical assistance on the intersectino of polio eradication, communication, and routine immunization at global, regional and country levels. In addition, MCHIP advises a multiagency expert group (led by UNICEF) on refining and implementing a standard set of polio communication indicators for tracking polio coverage and PEI goals. MCHIP has focused on increasing identification and tracking of pregnant women and newborns-to begin vaccination with OPV0 3 at birth and strengthen routine OPV coverage and participation in supplementary immunization activities for children under 12 months.
  • Technical assistance for epidemic H1N1 emergency response. Under core funding for avian influenza in 2009-2010, MCHIP recruited, briefed and seconded consultants to WHO/Geneva, WHO/Regional Office for Africa (AFRO) and WHO inter-country support teams in Africa for pandemic H1N1 vaccination preparedness and response; and contributed to a paper for USAID and the White House on operationalizing the response to pandemic H1N1 flu.