EPI Management - Technical Assistance in The Gambia to increase the effectiveness of EPI Management
Project Abstract
In The Gambia, a decreasing trend in the coverage of DPT1, DPT3 and MCV1 vaccines started around 2015, and all three were below 90% during 2018-2022. The national coverage of MCV2 has followed a similar trend, reaching 70% in 2023. These public health issues urgently require sound decisions at several levels of the immunisation system, from policy decisions at high levels up to managerial decisions where healthcare services are managed and delivered. Those decisions should be based on data describing existing problems, evidence on potential solutions, and contextual knowledge to inform implementation issues.
We intend to enhance EPI decision-making to make decisions more responsive to performance issues and improve the health status of the most vulnerable populations. We understand that improving decision-making is a medium to long-term intervention that requires organisational changes, with outputs usually non-tangible. Moreover, in a complex organisation such as the immunisation program, it is decentralised and heavily relies on partners for critical activities.
The proposed intervention includes:
(a) fostering a decision-making space between traditional decision-makers (i.e. health care managers at the national and regional level) and implementers of services at the immunisation service delivery points;
(b) developing a consensus around a performance framework that allows the detection of problems when they are manageable and guides in the search for solutions across the immunisation program components and
(c) focusing on specific challenges for vulnerable populations and equity issues, as well as solutions expected to have the highest impact under operational circumstances.