Countries are using Vaccine Alliance support to strengthen their health and immunisation services at the national and sub-national levels
A health worker travels to administer vaccines in Afghanistan. Photo: UNICEF/2006/Lana Slezic.
By the end of 2013, Gavi had committed US$ 862.5 million in HSS grants from 2007 through 2017. HSS approvals from 2007-2013 total $591 million, of which 90% were already disbursed by the end of 2013.
In 2013, the $119 million disbursed to more than 25 countries represents a doubling of the 2012 disbursement level and is the highest level of disbursement since 2008.
HSS funds are used, among other activities, to support:
- service delivery, focusing for instance on infrastructure investments and vehicles;
- procurement and supply chain management;
- human resources, emphasising training and supervision for community health workers and health professionals.
Here we list four country examples of how Gavi HSS support contributes to health system performance and improves immunisation:
Afghanistan’s physical geography and security issues limit access to health services and undermine efforts to ensure vaccines reach the nomadic Kochi population.
A Vaccine Alliance HSS grant is being used to fund the mapping of the Kochi’s travelling routes and training mobile health teams, incorporating at least one female health worker and vaccinator, to deliver health services to the Kochi. Given the Government’s limited capacity, this project has been outsourced through performance-based contracting to civil society organisations.
Even in countries where there is no discrepancy between the proportion of boys and girls immunised, gender-related factors can still prove a barrier to accessing immunisation services.
Given that Bangladesh mothers, as primary caretakers, predominantly bring their children to vaccination sessions, the Health Ministry has recognised they will feel more comfortable addressing a female health worker. Thanks to Gavi HSS support, Female Welfare Assistants are being trained in 13 targeted districts to provide health services, including immunisation, and also to conduct semi-annual Health Promotion days.
Liberia has used its Gavi HSS grant to improve data quality and address bottlenecks in its monitoring & evaluation (M&E) processes.
Countries need accurate and complete data to identify issues and solutions, eg, which districts have vaccine stock-outs or which health posts lack staff trained to run vaccination sessions. Liberia drew on a Gavi HSS grant to jointly-fund a Regional District Health Information System workshop, where M&E officers from each county were trained in new web-based software allowing them to store and send information online.
By facilitating the submission of more timely and accurate reports, decision-makers can quickly understand which immunisation programmes are successful and which face challenges.
A health worker prepares to vaccinate a child in Ethiopia.
Credit: Gavi/2013/Jiro Ose.
Before Gavi’s HSS grant, Ethiopia’s cold chain was poorly equipped to deliver vaccines from the central store to health districts. The country possessed only one refrigerated truck to transport vaccines while many refrigerators at the district-level were outdated and in need of repair.
With Gavi support, Ethiopia is securing five more refrigerator trucks – one for national use and four to transport vaccines between central and regional hubs – as well as 4,000 new fridges and 10,000 spare parts. The HSS grant is also funding the installation of solar panels so that even health facilities with no direct power source will be able to store vaccines in a fully functioning refrigerator.