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Title A Successful National and Multipartner Approach to Increase Immunization Coverage: The Democratic Republic of Congo Mashako Plan 2018-2020.
Full text https://escholarship.org/uc/item/5jv8464s
Date 2023
Author(s) Lame, Paul; Milabyo, Augustin; Tangney, Sylvia; Mbaka, Gloire O; Luhata, Christophe; Gargasson, Jean-Bernard Le; Mputu, Christelle; Hoff, Nicole A; Merritt, Sydney; Nkamba, Dalau M; Sall, Djariatou Sow; Otomba, John Samuel; Mourid, Amine El; Lusamba, Paul; Senouci, Kamel; Bor, Emmanuel; Rimoin, Anne W; Kaba, Didine; Mwamba, Guillaume; Mukamba, Elisabeth
Abstract BackgroundThe immunization system in the Democratic Republic of the Congo faces many challenges, including persistent large-scale outbreaks of polio, measles, and yellow fever; a large number of unvaccinated children for all antigens; minimal and delayed funding; and poor use of immunization data at all levels. In response, the Expanded Programme on Immunization within the Ministry of Health (MOH) collaborated with global partners to develop a revitalization strategy for the routine immunization (RI) system called the Mashako Plan.Mashako plan design and developmentThe Mashako Plan aimed to increase full immunization coverage in children aged 12-23 months by 15 percentage points overall in 9 of 26 provinces within 18 months of implementation. In 2018, we conducted a diagnostic review and identified gaps in coordination, service delivery, vaccine availability, real-time monitoring, and evaluation as key areas for intervention to improve the RI system. Five interventions were then implemented in the 9 identified provinces.DiscussionAccording to the 2020 vaccine coverage survey, full immunization coverage increased to 56.4%, and Penta3/DTP3 increased to 71.1% across the Mashako Plan provinces; the initial objective of the plan was reached and additional improvements in key service delivery indicators had been achieved. Increases in immunization sessions held per month, national stock of pentavalent vaccine, and supervision visits conducted demonstrate that simple, measurable changes at all levels can quickly improve immunization systems. Despite short-term improvements in all indicators tracked, challenges remain in vaccine availability, regular funding of immunization activities, systematic provision of immunization services, and ensuring long-term sustainability.ConclusionsStrong commitment of MOH staff combined with partner involvement enabled the improvement of the entire system. A simple set of interventions and indicators focused the energy of managers on discrete actions to improve outcomes. Further exploration of the results is necessary to determine the long-term impact and generate all-level engagement for sustainable success in all provinces.
Subject(s) Humans; Vaccines; Program Evaluation; Child; Immunization Programs; Democratic Republic of the Congo; Vaccination Coverage; Prevention; Pediatric; Vaccine Related; Infectious Diseases; Immunization; Infection; Good Health and Well Being
Coverage e2200326
Publisher eScholarship, University of California
Type of publication article
Format application/pdf
Source Global health, science and practice, vol 11, iss 2
Rights public
Identifier qt5jv8464s
Repository Berkeley - University of California
Added to C-A: 2023-09-20;11:37:55