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Globally, immunization prevents 2-3 million deaths each year. The World Health Organization (WHO) estimates that the remaining under-5 deaths — approximately 1.5 million deaths annually — could be prevented with existing vaccines. Success in reducing vaccine-preventable mortality has been dramatic, but it cannot be taken for granted.

MCSP worked to operationalize USAID’s longstanding commitment to strengthen routine immunization (RI). By increasing capacity to achieve and sustain high and equitable immunization coverage levels with all appropriate vaccines, we reached the unreached and reduced child mortality.

Our approach:

  • Provided the foundation for timely vaccination;
  • Supported and sustains new vaccine introduction;
  • Contributed to the achievement of disease control initiatives; and
  • Advanced other health interventions.

MCSP was a global leader in the arena of immunization, helping to shape policies and strategies in close partnership with ministries of health, the WHO, UNICEF, Gavi, and in-country partners. Our participation in selected global working groups and committees amplified the Program’s learning while infusing the strategic and operational plans of key partners with pragmatic, operational considerations based on field realities.

We worked to strengthen country-level capability to manage the delivery of immunization services and promote their acceptance and utilization by tailoring immunization strengthening approaches to each country’s context. By strengthening key neglected program components of the RI system — such as the supply chain and community partnerships — and improving the generation, quality and local use of data, we helped to ensure timely childhood vaccination.

Our team applied a variety of strategies to improve immunization management in-country through in-service training, supportive supervision, on-the job training and mentoring, and pre-service education. MCSP also partnered with WHO to develop, review and adapt capacity-building materials and guidelines to be used at the country level.

Fostering strong partnerships between the health system and communities, including caregivers, was critical to achieving our global goals. These partnerships improved the shared planning, delivery, utilization and monitoring of immunization services, and gave particular attention to reaching underserved populations and reducing drop-out rates.

Key Results

  • MCSP contributed to at least 17 global and five regional working groups for immunization on topics such as addressing missed opportunities for vaccination, improving immunization coverage in urban poor areas, and improving routine immunization data quality. The Program’s work in these groups contributed to the development of global and regional guidelines to inform country immunization policy and programs, including: the 2017 revision to the WHO AFRO Reaching Every District (RED) guide; the 2016 Addis Declaration on Immunization; a series of WHO modules on strengthening the cold chain; and Global Routine Immunization Strategies and Practices, a report that outlines transformative investments to achieving better immunization outcomes and a comprehensive framework of strategies and practices for RI as a companion to the Global Vaccine Action Plan.
  • From inception to pilot testing, MCSP played a key role in the WHO African Regional Office’s 2017 revision of the RED guidelines for immunization to include a greater focus on integration, equity and the community. The Program supported AFRO’s regional orientation workshops for the new guidelines, as well as the guidelines’ adaptation in seven MCSP immunization focal countries, furthering the Program’s goal of vaccinating every child while ensuring that children who receive vaccines also have access to other critical health services.
  • The Program supported the rapid scale-up of 25 national lifesaving vaccine introductions — including measles-rubella, measles second dose, inactivated poliovirus, rotavirus, and pneumococcal conjugate vaccine — in 10 countries. MCSP took advantage of the vaccine introduction process to build capacity and strengthen RI systems, building towards a “life-course” approach to vaccination.
  • MCSP’s efforts contributed substantially alongside the WHO, the African Union, UNICEF, the Bill & Melinda Gates Foundation, and other partners to the passage of the Addis Declaration on Immunization (ADI) in February 2016. The Declaration, which calls for making immunization services a national priority and a cornerstone of development, was endorsed by 53 African Union heads of state. In June 2017, the Program contributed to the development of a Roadmap, which guided implementation of ADI. MCSP provided careful input into the three main strategies, directed the partnership to a more inclusive approach, and used a pragmatic lens based on field realities to achieve the ADI’s objectives. MCSP continued to support advocacy efforts and monitoring and evaluation around this historic achievement for immunization.
  • The Program contributed to global polio eradication and legacy planning through: its communications support to polio endemic countries; its technical assistance to polio outbreak response assessments and community surveillance; and its work with partners to consolidate, document and disseminate lessons learned from polio eradication over the last three decades that may provide useful insight into RI and other health interventions. Through our collaboration with partners, 11 countries completed the historic WHO-led global polio vaccine switch in April 2016, successfully removing all trivalent oral polio vaccines nationwide and replacing them with the bivalent oral polio vaccine. MCSP’s efforts resulted in effective planning and ensured that health care workers were trained and supervised to administer the new vaccine.
  • In support of USAID’s $1 billion investment in Gavi, MCSP staff in 12 countries engaged in annual Joint Appraisals (JA) or Country Engagement Framework (CEF) assessments to review progress related to Gavi’s portfolio of support. In 2016 and 2017, MCSP reported on our country programs’ experience with the JA and CEF processes to: provide feedback to Gavi to strengthen these processes; support countries and ensure greater inclusion of all partners’ inputs in country; and better leverage and complement the significant investment of USAID in Gavi and benefit country EPIs and, by extension, children and families.