Universal Immunization through Improving Family Health Services in Ethiopia (UI-FHS)



Bill & Melinda Gates Foundation



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JSI’s Universal Immunization through Improving Family Health Services (UI-FHS) project works to improve the routine immunization (RI) system in Ethiopia. The project provides support to operationalize and strengthen Ethiopia’s national routine immunization strategy, Reaching Every District (RED), to improve availability, utilization, quality and sustainability of immunization services in the country.

In 2011, JSI was awarded a learning grant from the Bill & Melinda Gates Foundation to develop an approach to strengthen routine immunization using quality improvement (QI) tools in three woredas (districts). Utilizing findings from these three woredas, UI-FHS expanded its work from 2014-2018 to over 100 woredas in six regions of Ethiopia — Afar, Benishangul-Gumuz, Gambella, Southern Nations, Nationalities and Peoples' Region (SNNPR), Somali, and Tigray. With a special focus on equity and quality, UI-FHS is concentrating its technical support to Afar, Benishangul-Gumuz, Gambella, SNNPR, and Somali from 2018 to 2020.

The RED-QI approach operationalized by UI-FHS works to support the essential components of RED: planning and management of resources, reaching all eligible populations, engaging with the community, providing supportive supervision, and the monitoring and using data for action. This is done through capacity building of health staff to sustainably strengthen the routine immunization program. To strengthen implementation of the five RED components, the RED-QI approach uses QI tools to help health personnel identify problems in immunization services and create local solutions.

UI-FHS is providing technical support to FMOH and Regional Health Bureaus (RHBs) to enhance the capability of health personnel to effectively manage and deliver routine immunization and other family health services. In line with priorities in the Ethiopia Health Transformation Plan, UI-FHS is sharpening its focus on equity issues in the Developing Regional States and SNNPR. These regions are home to some of Ethiopia’s most vulnerable populations and the circumstances in these locations present serious challenges to the reach and performance of health services, including immunization.

Efforts in this phase include:

  • Supporting capacity of RHBs for implementation of routine immunization
  • Improving the provision of equitable health services to all populations
  • Strengthening coordination and collaboration between partners
  • Exploring the integration of immunization management and immunization service delivery with other health services
  • Sustaining health system strengthening efforts


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