World Health Organisation, Inter-Country Support Team for East and Southern Africa, Harare, Zimbabwe.
World Health Organisation, Regional Office for Africa, Brazzaville, Congo.
Pan Afr Med J. 2020 Dec 30;37:385. doi: 10.11604/pamj.2020.37.385.27140. eCollection 2020.
World Health Organisation (WHO) recommends that countries conduct comprehensive national immunisation programme reviews regularly to help them identify systems wide-barriers or gaps and monitor performance against the set targets.
we reviewed reports from the latest national immunisation program reviews conducted in the 20 countries in the subregion in the course of 2012-2018. We generated descriptive analysis of the findings across the subregion.
the 20 program reviews included field observations to the subnational levels as well as interviews with program staff and stakeholders. At the time of the reviews, only 11 countries had functional National Immunisation Technical Advisory Groups. Operational funding was inadequate in half of the countries. The reviews documented the cancellation of outreach services, supportive supervision visits and maintenance of cold chain equipment due to the lack of fuel or operational funding. Immunisation programs in 10 countries had major human resource gaps. Vaccine stock management tools were not effectively used in 10 countries, and stockout of vaccines and supplies was documented in 9 countries during the review. The full components of the Reaching Every District (RED) Strategy were implemented in only 3 of the 20 countries. Twelve countries reported challenges with the availability and accuracy of target populations. Four countries had documented the presence of vaccine hesitant groups at the time of the reviews.
the reviews demonstrated challenges in various aspects of the programs in different countries. The implementation of the review recommendations should be built into the annual program plans, as well as into costed multi-year plans, in order to address the gaps and helps the program to attain the set targets. With the rapid evolution of the scope and complexity of the immunisation programs in recent years, countries should invest their efforts in building the capacity of their human resources as well as updating their logistics and data systems.
世界卫生组织（WHO）建议各国定期进行全面的国家免疫规划审查，以帮助其发现全系统障碍或差距，并监测针对既定目标的实施情况。
我们审查了 2012 年至 2018 年期间该次区域 20 个国家最近进行的国家免疫规划审查报告。我们对次区域的调查结果进行了描述性分析。
20 次规划审查包括对国家以下各级的实地考察，以及对规划工作人员和利益攸关方的访谈。在审查时，只有 11 个国家拥有功能齐全的国家免疫技术咨询小组。一半的国家运营资金不足。审查记录了由于缺乏燃料或运营资金，外联服务、支持性监督访问和冷链设备维护被取消的情况。10 个国家的免疫规划存在重大人力资源缺口。10 个国家没有有效地使用疫苗库存管理工具，在审查期间，9 个国家记录了疫苗和用品短缺的情况。20 个国家中只有 3 个国家全面实施了普及接种每个地区（REACH EVERY DISTRICT，RED）战略。12 个国家报告了目标人群的可得性和准确性方面存在挑战。4 个国家在审查时记录了存在疫苗犹豫群体。
审查表明，不同国家的规划在各个方面都存在挑战。应将审查建议的实施纳入年度规划计划以及成本核算的多年计划，以解决差距问题，帮助规划实现既定目标。近年来，免疫规划的范围和复杂性迅速演变，各国应努力建设人力资源能力，并更新其后勤和数据系统。
