Increasing Immunization Coverage at the Health Facility Level

The aim of this guide is to help health workers use their own data to identify problems and causes of low immunisation coverage and to plan solutions to increase immunisation coverage. Jointly produced by the Expanded Programme on Immunization (EPI) of the World Health Organization (WHO) Department of Vaccines and Biologicals and the United Nations Children's Fund (UNICEF), these guidelines can be modified to suit the local context and needs and can be used at various levels of the health system in any country.

These guidelines focus on how to increase coverage by: reaching the unreached (improving access) and reducing drop-outs (improving utilisation). The guidelines are set out in 5 simple steps:

1. Compile data on population and immunisation coverage for your area.
2. Analyse the data you have collected - e.g., to determine the causes behind problems including supply, staffing, service (delivery and demand), and IEC (information, education and communication).
3. Prioritise according to which geographic area and what solutions you need to implement first.
4. Plan priority activities for the year, including outreach - e.g., include on the workplan some priority general activities you intend to carry out this year on the workplan, particularly the ones related to social mobilisation and community involvement.
5. Monitor the impact of the workplan.

Examples follow in the Annexes, such as one including guidelines for community feedback on immunisation services.

The objectives of this practical guide are to achieve at least 80% coverage with all vaccines in every district and to build on experiences of polio eradication. Strategies include: encouraging the analysis and using data collected by health workers at the delivery level; providing simple guidelines for microplanning at the health facility and district levels; reviving outreach; and improving interaction between health services and the community.