LNCT Member Newsletter May 2019

LNCT Updates

Materials from European Regional Vaccine Procurement Workshop Now Available
Last month, the Learning Network for Countries in Transition (LNCT) and the UNICEF Vaccine Procurement Practitioners Network (VPPN) co-hosted their first regional procurement workshop in Tbilisi, Georgia. LNCT members Armenia, Georgia, Moldova and Uzbekistan joined fellow VPPN members North Macedonia and Serbia for three days of focused exchange around vaccine registration and regulatory issues, forecasting and budgeting, procurement options, and conducting performance assessments. Resources used and produced from the meeting can be found on the LNCT website:

*You will need to log-in to view the meeting materials or respond to the discussion forum thread.

NEW BLOG: Takeaways from the First LNCT-VPPN Joint Regional Workshop on Vaccine Procurement: Tbilisi, Georgia
Countries who attended last month’s joint workshop appreciated the focus to address specific procurement challenges faced by countries with small populations. Our recent blog highlights two key takeaways that came out of the discussions, plus highlights of a few things that we learned from these countries that other LNCT members might like to learn about.

LNCT Network-wide Meeting 2019, Resource Mobilization: Moving Beyond Vaccines, to be Held in Indonesia this July
LNCT’s 2019 Network-wide Meeting will be held in Tangerang, Indonesia on July 3-5, with the theme of Resource Mobilization: Moving Beyond Vaccines. The agenda will feature discussions around transition plan development and implementation, resource mobilization at the national and sub-national levels, vaccine hesitancy, vaccine procurement, health insurance, and private sector engagement and will include the development of country action plans for resource mobilization for delivery costs. In addition, participants will have the opportunity to visit Indonesia’s national health insurance agency or a district health office and providers to learn more about the Indonesia experience.

LNCT Transition Dashboards Provide Helpful Overview of Transitioning Countries’ Progress and Challenges 
In March 2019, LNCT rolled out a set of transition dashboards that help countries track their progress toward immunization sustainability and compare themselves to their peers. We encourage you to look at your country’s data and see how it compares to the rest of LNCT. Please share with us your comments, experiences, or questions on our discussion forum*You will need to log-in to respond in the discussion forum.

REMINDER: Interest in Private Sector Engagement at the LNCT 2019 Network-wide Meeting
Many LNCT member countries have expressed an interest in learning and knowledge sharing around private sector engagement for immunization. We are planning to feature this topic at the 2019 LNCT Network-wide Meeting. To help us shape this session, please remember to take four minutes to answer our short survey by May 31, 2019 to tell us about your interest in this topic.

Update for Countries and Regional Partners Requesting Gavi Post-transition Support
In November 2017, the Gavi Board approved continued Gavi Alliance engagement with transitioned countries and a budget allocation of up to US$30m to support these countries until 2020. Support is being provided for technical assistance in key programmatic areas, including supply chain, LMC and data, paying special attention to innovative approaches and government commitment to their long-term sustainability. Since then, Gavi has updated the guidance incorporating feedback from partners, as well as including examples and lessons learnt following the first round of reviews of PTE support requests. The timeframe for submission of support requests is also now flexible.

8 out of 14 eligible countries have seen their post-transition support requests approved: Armenia, Bhutan, Bolivia, Georgia, Guyana, Indonesia, Kiribati and Moldova. The Alliance’s support will be catalytic as the government is co-investing in the supported activities and has committed to provide the necessary resources that will be needed to sustain them. In the coming weeks, Gavi expects further support requests from 6 countries and 4 regional requests. Please contact the Secretariat if you need further information or guidance on the post-transition engagement process: jwisniewska@gavi.org. More information about the type of support requests that have been approved are available on the LNCT website.

Country Spotlight

Nigeria Uses Community Engagement Strategy to Consolidate Efforts to Curtail Vaccine Hesitancy
This article was originally published in the WHO AFRO updateVaccine hesitancy is one of the major challenges facing the immunization program in Nigeria. The National Primary Healthcare Development Agency (NPHCDA), WHO and its partners have been working with traditional leaders in communities using their recently developed Community Engagement Framework (CEF) to combat vaccine hesitancy. The framework is implemented in stages:

  1. Line Listing’, which involves recording and registration of all children, aged 0-12 months in the community
  2. Reconciliation’, which engages traditional leaders to visit health facilities or outreach session sites to compare his line list with the child immunization register for identification of children not immunized
  3. Defaulter Tracking’ identifies children that did not attend immunization session, and refer them to the community health facility or outreach center for immunization

WHO is supporting the implementation of the CEF in 9 states: Jigawa, Gombe, Sokoto, Borno, Yobe, Kaduna, Kano, Bayelsa, and Bauchi. The general aim of implementing the framework is to ensure that people are fully informed about the importance of vaccines and are not dissuaded by rumors on social media or other platforms.

Highlights from our Partners

NEW BLOG: Key Considerations for Joint Appraisals
The annual Gavi Joint Appraisal (JA) can be a useful tool for countries as they plan for their transition from Gavi support, serving to highlight challenges that require additional attention. Gavi and other partners have published a wide array of guidance to help countries maximize the usefulness of the JA process. We recently asked our colleagues at the Clinton Health Access Initiative (CHAI), who have participated in six recent JAs, to provide observations about how countries have effectively put this guidance into practice and to share lessons learned. Please find their responses in our new blog.

CALL FOR INPUTS: “Draft Zero” of Immunization Agenda 2030
Draft Zero” of the Immunization Agenda 2030, is aimed at setting a new vision and strategy for vaccines and immunization for the next decade (2021-2030). The draft document is a step along the way in co-creating the future of immunization together – one that reflects the collective inputs of many people, coming from different organizations including from governments, communities, health professions, academia, development agencies, civil society and the private sector. Inside the document are instructions on how to provide and share feedback to this draft zero by June 14, 2019. For any questions, please don’t hesitate to reach out to immunizationagenda2030@who.int

Updated ThinkWell Analyses on Immunization Delivery Costs Now Available 
In May 2018, ThinkWell released findings from a systematic review of the evidence base on immunization delivery costs (IDC) in low- and middle-income countries (LMICs). Across these resources, the team has recently added new data, addressed feedback obtained from user research, and considered new approaches to analyzing the data. The changes are meant to better equip you — whether you’re a policymaker, researcher, or international partner —with evidence to guide country and global immunization and health system policy, planning, advocacy, etc.

Understanding Vaccine Confidence: Insights from Social Science Research
As part of the London School of Hygiene & Tropical Medicine (LSHTM) Vaccine Centre, a podcast series was launched to celebrate World Immunization Week. Professor Heidi Larson recorded an episode about the work of the Vaccine Confidence Project, where she speaks out about vaccine hesitancy, some of the reasons why people think twice about vaccinations and the importance of technology to stop the spread of misinformation.

Featured Resources

Sustaining Pneumococcal Vaccination After Transitioning from Gavi Support: A Modelling and Cost-effectiveness Study in Kenya
Co-led by the London School of Hygiene & Tropical Medicine and the KEMRI-Wellcome Trust Research Program, with support from UNICEF and Kenya Ministry of Health, this vaccine impact study estimated that continuing the vaccine beyond 2022 would prevent – in the first ten years – more than 100,000 children and adults from contracting pneumococcal disease and save the lives of 14,000 children and adults who would otherwise have died.

Mapping diphtheria-pertussis-tetanus Vaccine Coverage in Africa, 2000-2016: A Spatial and Temporal Modelling Study

While many African nations have made substantial progress in vaccinating children against life-threatening diseases, wide discrepancies remain within countries, according to a new scientific study conducted by the Institute for Health Metrics and Evaluation at the University of Washington. The study maps nations in fine-scale, 5×5 kilometer increments in this interactive data visualization, so that health officials nationally and locally can identify gaps in vaccine coverage and target interventions with precision, tailoring health policy decisions at local levels.

Aggregating Demand for Pharmaceuticals is Appealing, but Pooling is not a Panacea

This recent note from Center for Global Development (CGD) reviews the rationale and functions of pooled procurement initiatives, notes their potential benefits and barriers, and draws lessons regarding how best to incorporate pooled pharmaceutical purchasing models into the design and implementation of health financing reforms in countries in transition.

Private Sector Engagement and Contributions to Immunization Service Delivery and Coverage in Sudan
For more than two decades, the private sector in Sudan, including non-governmental organizations and for-profit providers, has played a key role in delivering immunization services. These private providers are well integrated into the states’ immunization programs as they take part in the Ministry of Health immunization trainings and district review meetings and they are incorporated into annual district immunization microplans. This article describes Sudan’s private sector contributions to equitable access to immunization services and coverage, as well as key challenges, lessons learned and future considerations.

Looking Ahead

WHO Six-Part Webinar Series on Leveraging Public Financial Management (PFM)
WHO is conducting a six- part webinar series from May to November 2019 on how to reform budgets and make them work better for UHC. The series aims to enhance technical knowledge and capacity among key sector stakeholders and stimulate peer exchange on the implementation of budget reforms in health. It will consist of six webinars. You can find more details, including information on how to register and the specific topics that will be covered,  on the LNCT website.

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