The health systems goal

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Contribute to strengthening the capacity of integrated health systems to deliver immunisation

Health systems goal

From a scarcity of midwives and health facilities to poorly equipped hospitals, weak health systems represent a critical barrier to Gavi's mission to increase access to immunisation.

Without the people and equipment to deliver vaccines, no immunisation programme will be sustainable over the long term.

Through its first strategy, the Vaccine Alliance has boosted the capacity of health and immunisation services through health system strengthening (HSS) support; funding to support civil society involvement in immunisation planning and delivery; and, immunisation services support (ISS), which has used reward payments to encourage developing countries to increase the number of children immunised with three doses of the diphtheria, tetanus and pertussis vaccine (DTP3).

Goal-level indicators

  • Drop-out rate: % drop out between DTP1 and DTP3 coverage.
  • DTP3 coverage: % of surviving infants receiving three doses of DTP-containing vaccine.
  • Equity in immunisation coverage: % of Gavi supported countries where DTP3 coverage in the lowest wealth quintile is not more than 20% points of the coverage in the highest wealth quintile.
  • View Gavi's targets for its health systems goal  

Strategic Objectives


Performance based funding for HSS

With the new five-year strategic plan for 2011-2015, the Gavi Board made a decision to refocus HSS on immunisation to “contribute to strengthening the capacity of integrated health systems to deliver immunisation by resolving health systems constraints, increasing the level of equity in access to services and strengthening civil society engagement in the health sector.” The Board decided to strengthen the focus on performance and results, highlighting the importance of examining outputs rather than inputs. Performance based funding (PBF) was approved by the Board in November 2011 and was rolled out starting with 2012 approved grants.

CSO engagement

Under the new strategy, Gavi will look to strengthen its support for civil society organisations (CSO), in particular, focusing on:

  • positioning CSOs in the national planning and implementation processes;
  • maintaining a country-by-country approach to CSO engagement;
  • raising awareness in developing countries about the critical role CSO's play in immunisation and child health.
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