Health systems goal indicators

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To increase effectiveness and efficiency of immunisation delivery as an integrated part of strengthened health systems

Supply chain performance

What we measure: the average score achieved by Gavi-supported countries that have completed WHO’s effective vaccine management (EVM) assessment.

This indicator helps countries to evaluate their immunisation supply chain performance over time against best practice standards, as well as to identify and respond to shortcomings. Among the features assessed are vaccine management, storage capacity, human resources and information systems.

Data quality

What we measure: the proportion of Gavi-supported countries with a less than 10 percentage point difference between different estimates of immunisation coverage.

This indicator reflects the degree of consistency between available estimates of immunisation coverage. “Administrative coverage” refers to estimates based on national-level data reported annually by the country itself. “Survey coverage” refers to estimates based on data collected as part of household surveys, such as the demographic health survey, which is usually carried out every three to five years.

Coverage with a first dose of pentavalent vaccine and drop-out rate between the first and third dose

What we measure: coverage with the first dose of pentavalent vaccine and the drop-out rate between the first and third dose in countries we support.

Taken together, these two measures provide a good indication of the ability of the health system to deliver immunisation services. High first-dose coverage coupled with low rates of drop-out from the first to the third dose suggests a strong health system, capable of reaching and fully immunising children with the required number of doses. A weaker delivery system may succeed in reaching a child with the first dose but not the third.

Integrated health service delivery

What we measure: the percentage of countries we support meeting our benchmark for integrated delivery of antenatal care and immunisation services. A country meets this benchmark if coverage levels for four interventions – antenatal care and administration of neonatal tetanus, pentavalent and measles vaccines – are within 10 percentage points of each other, and all above 70%.

This indicator reflects the level of integration between immunisation and other interventions delivered through the routine system. If these complementary services are achieving similar levels of coverage, it generally follows that the linkages and coordination between them are strong.

Civil society engagement

What we measure: the percentage of countries we support that meet our benchmarks for civil society engagement in national immunisation programmes to improve coverage and equity.

We use three criteria to assess the level of civil society engagement:

  • inclusion of civil society organisations (CSOs) in national immunisation plans with clearly stated activities;
  • defined allocations in the EPI budget for CSO plans and activities (or justification given as to why these are not included); and
  • documented evidence that CSO plans have been completed and/or are being implemented.


41 million

Since 2007, countries have immunised 41 million children with a second dose of measles or measles-rubella vaccine with Gavi support. Gavi-funded campaigns with these two vaccines have helped vaccinate another 328 million children in countries at high risk of outbreaks.

WHO/UNICEF and Gavi, 2017

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