Immunization Tracking Tool Ensures No Child is Missed in Ethiopia

February 24th, 2020 | Story


Immunization is one of the most successful and cost-effective public health interventions ever devised. Vaccines save millions of lives every year from preventable diseases. The expanded program of immunization (EPI), a worldwide strategy launched in Ethiopia in 1980, has undoubtedly transformed the fate of many children and families in the country. The subsequent reaching every district (RED) approach has been implemented in Ethiopia since 2004 in districts that have poor immunization coverage and high dropout rates. The approach allows the health sector to address quality and equity challenges in relation to immunization and reach the most vulnerable.

USAID Transform: Primary Health Care has been supporting the public health sector to strengthen the implementation of the RED strategy by improving human and institutional capacities, providing integrated periodic outreach services, and supporting the introduction of new vaccines. To tackle under-five morbidity and mortality from vaccine-preventable diseases, the project also works with the health sector to improve vaccine supply chain management, strengthen community-based surveillance, engage in supplementary immunization activities, and improve monitoring and data quality to increase service coverage and quality.

The RED strategy involves the introduction of the categorization database, a tool used to collect and analyze core EPI performance indicator data and evaluate performances of woredas and their health facilities. To support this process, the project provides an orientation to woreda health offices and their respective service outlets to enable them to use the database and provide monthly feedback that can inform performance improvement activities.

Improving RED categorization helps to reduce EPI defaulter rates and improves service use. One of the places USAID: Transform Primary Health Care is providing this support is Tahtay Adiabo woreda in the Tigray region. The process began through an orientation and subsequent database tool installation at Tahtay Adiabo woreda health office and at the facilities it oversees.

Adi Awala health center has benefited greatly from this support. One of six health centers in Tahtay Adiabo woreda, it provides services to 8,796 people, including 260 children under-1. The center had a worryingly high average dropout rate of 10 percent in immunization. As part of the RED implementation, in 2018 the RED categorization database was installed at the health center to ensure no children were falling through the cracks in immunization efforts. Tsega Hailu, a health officer at the facility, describes the changes since these activities began saying, “The [RED categorization] tool enables us to easily map out our two health posts’ performances in EPI and prioritize our support to those who are struggling.”

Through the project’s frequent follow-up visits and technical support, the health center was able to use the tool for regular data input and analysis. Using the results to target services, the dropout rate for measles vaccines dropped in just a year from 10 to 4 percent.

The director of the health center Semere Halefom says using the tool has transformed the EPI services offered and has potentially saved lives.

Before the intervention, we were exerting a lot of efforts to manually track our service provision, which had a lot of disadvantages including with regards to timely decision making. Through this tool, we have not only improved in terms of EPI but in our general data quality usage as well.”

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