Centers for Disease Control and Prevention, 1600 Clifton Rd, MS A-04, Atlanta, GA 30333, USA.
Public Health Foundation of India, Plot No. 47, Sector 44, Institutional Area, Gurugram 122002, India.
Vaccine. 2019 Mar 7;37(11):1428-1435. doi: 10.1016/j.vaccine.2019.01.047. Epub 2019 Feb 11.
Despite global support for immunization as a core component of the human right to health and the maturity of immunization programs in low- and middle-income countries throughout the world, there is no comprehensive description of the standardized competencies needed for immunization programs at the national, multiple sub-national, and community levels. The lack of defined and standardized competencies means countries have few guidelines to help them address immunization workforce planning, program management, and performance monitoring. Potential consequences resulting from the lack of defined competencies include inadequate or inefficient distribution of resources to support the required functions and difficulties in adequately managing the health workforce. In 2015, an international multi-agency working group convened to define standardized competencies that national immunization programs could adapt for their own workforce planning needs. The working group used a stepwise approach to ensure that the competencies would align with immunization programs' objectives. The first step defined the attributes of a successful immunization program. The group then defined the work functions needed to achieve those attributes. Based on the work functions, the working group defined specific competencies. This process resulted in three products: (1) Attributes of an immunization program described within eight technical domains at four levels within a health system: National, Provincial, District/Local, and Community; (2) 229 distinct functions within those eight domains at each of the four levels; and (3) 242 competencies, representing eight technical domains and two foundational domains (Management and Leadership and Vaccine Preventable Diseases and Program). Currently available as a working draft and being tested with immunization projects in several countries, the final document will be published by WHO as normative guidelines. Vertical immunization programs as well as integrated systems can customize the framework to suit their needs. Standardized competencies can support immunization program improvements and help strengthen effective health systems.
尽管全球支持将免疫接种作为健康权的核心组成部分，并且世界各地的中低收入国家的免疫规划已经成熟，但对于国家、多个次国家和社区各级免疫规划所需的标准化能力，还没有全面的描述。缺乏明确和标准化的能力意味着各国几乎没有指导方针来帮助他们解决免疫工作人员规划、规划管理和绩效监测问题。由于缺乏明确的能力而可能产生的后果包括资源分配不足或效率低下，无法支持所需的功能，以及难以充分管理卫生人力。2015 年，一个国际多机构工作组召开会议，定义国家免疫规划可以为自己的工作人员规划需求而采用的标准化能力。该工作组采用逐步方法确保这些能力与免疫规划的目标保持一致。第一步定义了成功的免疫规划的属性。然后，该小组定义了实现这些属性所需的工作职能。基于工作职能，工作组定义了具体的能力。这一过程产生了三个产品：（1）在卫生系统的四个层面（国家、省、地区/地方和社区）的八个技术领域内描述的免疫规划属性；（2）在这四个层面的八个领域中的每个领域都有 229 个不同的功能；（3）242 项能力，代表八个技术领域和两个基础领域（管理和领导以及疫苗可预防疾病和规划）。目前，该框架作为一份工作草案提供，并正在一些国家的免疫项目中进行测试，最终文件将由世卫组织作为规范指南发布。垂直免疫规划和综合系统都可以定制该框架以满足其需求。标准化能力可以支持免疫规划的改进，并有助于加强有效的卫生系统。
