Occurrence of home-based record stock-outs-A quiet problem for national immunization programmes continues.

Home-based records (HBRs) provide an effective, inexpensive mechanism for recording and tracking infant vaccinations, yet stock-outs prevent HBRs from fulfilling their intended function. We describe the annual occurrence of HBR stock-outs during 2014-2016 reported by national immunization programmes to the WHO and UNICEF on the Joint Reporting Form on Immunization. During 2014-16, 48 countries reported at least one HBR stock-out. Thirteen countries reported HBR stock-outs for two of the three years. Forty-four countries reported two or more HBR funding sources in 2016. Challenges persist in ensuring continuous availability of HBRs. HBR stock-outs have important implications as they may impact continuity-of-care, increase inefficiencies at the point-of-care and reduce the ability of caregivers to be effective health advocates. Identifying mechanisms for preventing stock-outs should be a focus of attention for programmes and development partners. Expanded efforts are required to better understand the underlying causes of HBR stock-outs and identify solutions.