10 Ways USAID Supports Routine Immunization Around the World

This is how our work extends equitable access to lifesaving vaccines

At a maternal and child clinic at La Fossette, one of the largest in Cap-Haitian, Haiti, patients arrive for regular check-ups as well as vaccinations. Four health workers work at the site, either vaccinating or weighing children. The clinic is held in a building in the process of being built.
/ Karen Kasmauski, MCSP and Jhpiego

Every April, World Immunization Week is commemorated throughout the world to raise awareness and increase rates of immunization against vaccine-preventable diseases. This year, we’re raising awareness by encouraging people at every level, from the general public to the private sector, to go further in their efforts to increase immunization coverage for the greater good.

Immunization is among the most cost-effective health interventions, and has been long recognized by USAID and our partners as a cornerstone for child health and survival. When considering broader economic and social benefits, the return on investment for immunization is up to 44 times the vaccination costs, averting an estimated 2 to 3 million child deaths each year.

Despite the cost-effectiveness of immunization, an estimated 19.5 million infants worldwide, including 12.2 million infants in USAID’s focus countries, are without basic vaccinations. Additionally, global vaccination coverage has stalled at 86 percent, with no significant changes during the past year. This estimate highlights the deep coverage inequalities both between and within countries.

Keep reading for 10 specific ways USAID supports expanding access to life-saving vaccines:

1. Support to Gavi to Expand Access to Vaccines

Ketcia Orilius is a community health worker in Robin, Haiti. Her focus is on women and children, and her duties include administering vaccines and immunizations. She was also trained to use a USAID-provided tablet, made by a Haitian company, which easily allows her to register new patients and track immunizations. / David Rochkind, USAID

USAID’s support to Gavi brings together the public and private sectors to champion and expand equal access to new and underutilized vaccines in lower-income countries. USAID supports the accelerated introduction of new and underutilized vaccines in 73 countries, including post-introduction evaluations and assessments. In 2016 alone, Gavi immunized 62 million children, often with more than one Gavi-supported vaccine.

2. National Vaccine Introductions

Left to right: District immunization coordinator Gina Biteny, community health volunteer Jeno and Dr. Jimi Rakotoarimanana provide immunizations in the Analalava district of Madagascar, which once had a childhood immunization rate below 70 percent — now it hovers around 90 percent. / JSI

USAID provides technical assistance to partner Governments to support a smooth and effective introduction of new and underused vaccines into national immunization programs.

3. RED/REC Implementation

Ketcia Orilius, 37, a community health worker in Robin, Haiti, gives 3-month-old Orelus Kerlens Melus multiple vaccines. Ketcia’s house visits like this one are helping to make health services accessible in Robin, where many families can’t easily get to clinics or hospitals. / David Rochkind, USAID

USAID supports the reaching every district/community strategy (RED/REC). This strategy focuses on building national capacity from the health facility and district level upward to maximize access to all vaccines — old and new — and reach hard-to-reach communities and populations.

4. Human Resource Capacity

The Smiling Sun Clinic in Tongi, Bangladesh, provides free vaccinations to poor residents. Here, Raja brings her baby in for a measles vaccination. / Amy Fowler, USAID

USAID supports both in-service and pre-service training activities for front line and mid-level health workers to deliver vaccinations.

5. Data Quality and Data Use

Simprints is a Saving Lives at Birth grant recipient that uses a fingerprint scanner to identify patients and link them to their health record. Simprints is partnering with VaxTrac to design better biometric hardware and software for NGOs and Ministries of Health fighting to save lives through better vaccination coverage. / Simprints Biometric System

USAID provides support for improving data quality and data use within health facilities and at the district-level. Also, USAID supports national efforts to transition to electronic health information systems, which help track vaccination efforts.

6. Cold Chain, Logistics and Vaccine Management

Sanyu Kigondu, hands over vaccine container to management of a health facility in Migori County, Kenya. / Allan Gichigi, MCSP

USAID provides technical and financial support for effective management of temperature-controlled vaccine supply chains with a focus on rural communities. Many vaccines need to stay cold to remain effective, so the ability to transport and store them in a temperature controlled environment is crucial to overall immunization efforts.

7. Demand and Community Engagement

A network of Smiling Sun clinics throughout Bangladesh, supported by USAID, provides essential services to individuals and communities across the country. The Smiling Sun Clinic in Tongi, Bangladesh, now in its twenty-first year of operation, provides services, like immunization, free of charge to the ultra-poor through funds paid by other clients, ensuring the clinic’s sustainability. / Amy Fowler, USAID

USAID provides support to engage community health workers, community and faith leaders and organizations to generate and sustain demand for vaccines, as well as mobilize communities for immunization sessions.

8. Advisory Bodies, Coordination Mechanisms and Ad-hoc Committee

Even though poorer countries bear a disproportionate burden of diseases prevented by vaccines, the introduction of new life-saving vaccines in developing countries has generally lagged behind coverage in developed countries. Here, community health volunteers, Fitiavana Andriatiarinaina and Marie-Jeanne Mbiavy, explain immunization advantages and related side effects to a group of mothers in Madagascar. / JSI

USAID advances vaccine and immunization priority issues by participating in and supporting different advisory bodies and coordinating mechanisms. USAID also serves in different working groups, ad-hoc committees and task forces at global, regional and country levels to ensure coordination and alignment of activities.

9. Immunization Policy, Guidelines and Strategy

USAID works closely with national governments to develop immunization plans and strategies. Here, nurses discuss the Ministry of Health immunization chart in Kisumu, Kenya. / Allan Gichigi, MCSP

USAID participates and provides technical and financial support for various activities around the development of immunization policies, best practices, guidelines, plans and strategies at global, regional and country levels.

10. National Reviews and Assessments

In Kenya, USAID assists district-level civil authorities in monitoring vaccination efforts and allocating the necessary resources for effective immunization strategies. These feedback mechanisms, overseen by key district-level decision-makers, have helped to build grassroots support for the effective application of local resources. / Allan Gichigi, MCSP

USAID provides technical and financial support for immunization reviews and assessments to ensure immunization efforts are constantly improving. USAID also supports the dissemination of key immunization program learning questions on best practices and other areas of interest.

Immunization is a central strategy to end preventable child deaths. By addressing immunization inequities to better reach the left outs and drop outs, USAID invests in the well-being of communities and societies around the globe. As a result of these efforts, we can advance American security and prosperity in an increasingly globalized world.

About the Author

Endale Beyene is a senior immunization adviser in USAID’s Maternal and Child Health and Nutrition Office.