Health system and immunisation strengthening support framework

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A new framework guides how Gavi supports health system and immunisation strengthening

Gavi support for health system and immunisation strengthening (HSIS) aims to help Gavi-supported countries reach every child regardless of geography, socioeconomic status, or gender-related barriers.

This framework, which came into effect in January 2017, sets out the HSIS principles, funding levels and essential requirements for HSIS support.

Through this support, Gavi helps governments to achieve equitable immunisation coverage. HSIS includes long-term health system strengthening support as well as one-off grants or complementary allocations, which cover part of the operational cost of new vaccine introductions, campaigns and vaccine product switches.

WHAT IS THE PURPOSE OF HSIS SUPPORT?

HSIS support aims to improve equity in immunisation coverage in a sustainable way and includes:

  • Health system strengthening (HSS) support to address health system bottlenecks, primarily in four areas: supply chain; data availability, quality, and use; community engagement; and, in-country leadership, management, and coordination. Governments are encouraged to engage civil society organisations for the implementation of HSS activities.
  • Vaccine introduction grants (VIGs) cover a share of the cost of pre-introduction activities (such as health worker training) and are intended to facilitate the timely and effective introduction of new vaccines into routine immunisation programmes.
  • Governments may wish to change the original product and/or presentation of a Gavi-supported vaccine to a different product with the same antigen. Product or presentation switch grants are intended to facilitate a safe and effective transition.
  • Operational support for campaigns (Ops) aims to facilitate the timely and effective delivery of vaccines to communities targeted by a campaign. The same support can also be used for other campaign activities such as transportation.

Guidance on the use of HSIS investments is tailored to the different stages of transition out of Gavi support, as specified in the application guidelines.  

HOW DOES HSIS SUPPORT WORK?

HSS support is available for all Gavi-supported countries. Individual country ceilings are calculated using birth cohort size, the number of under-immunised children, and Gross National Income per capita. This methodology is detailed in the HSIS support framework. Final figures will be communicated and detailed in the application guidelines.

Other HSIS grants are awarded in conjunction with approved vaccine support for introductions, campaigns and product switches. Funding levels are determined as follows:

Vaccine introduction grants 

For routine vaccines  

Low-income countries
US$ 0.80 per infant in the birth cohort, or $100,00 lump sum minimum

Preparatory transition (Phase 1) countries
$0.70 per infant in the birth cohort, or $100,000 lump sum minimum

Accelerated transition (Phase 2) countries
$0.60 per infant in the birth cohort, or $100,000 lump sum minimum

For human papillomavirus (HPV) vaccines  

$2.40 per girl in the country’s target population for the year of introduction or $100,000 lump sum minimum

Product switch grants 

$0.25 per infant in the birth cohort or $30,000 lump sum minimum

Operational support for campaigns 

Low-income countries
$0.65 per targeted person  

Preparatory transition (Phase 1) countries
$0.55 per targeted person

Accelerated transition (Phase 2) countries
$0.45 per targeted person

HSIS support is coordinated through government-led mechanisms, in line with the principles of Gavi’s transparency and accountability policy.

WHEN WILL THE HSIS SUPPORT FRAMEWORK BE IMPLEMENTED?

The framework will apply to all new applications for Gavi support after January 2017. Changes to the processes for accessing HSIS support will be introduced gradually, aligned with countries’ planning cycles and starting with countries that apply for new HSS support in 2017.

US$ 10 billion

As of the end of November 2015, Gavi’s total commitments amount to over US$ 10 billion. This includes current commitments from year 2000 up to 2020 for both country programmes and investment cases.

Gavi

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