JSI RESOURCES: Publications

Learning from Implementation of the Reaching Every Child using Quality Improvement to Strengthen the Routine Immunization System in Uganda


MCSP has incorporated quality improvement (QI) concepts and tools into the standard Reaching Every District (RED)/Community (REC) management approach. While Uganda was one of the first countries to introduce RED in 2004 and updated it to REC in 2007, REC’s widespread use by districts and health facilities was limited by persistent operational challenges; for example, analyzing data to prioritize problems and conduct detailed planning of service delivery proved very challenging to health facility staff. The innovative application of QI concepts and tools to Reaching Every Community, referred to as REC-QI, was designed to help Uganda National Expanded Programme on Immunisation (UNEPI) achieve its own goals for implementing REC. REC-QI is comprised of mutually reinforcing actions to build health personnel capacity with the goal of improving the management, delivery, and utilization of routine immunization (RI) services at the subnational level. This brief describes the findings from two structured assessments: the REC-QI assessment and the Kapchorwa district doer/non-doer assessment. Each was conducted by MCSP to systematically examine the uptake and sustainability of REC-QI practices and their effect on the RI system. JSI/MCSP, 2019. 

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