Linked Community News June 2024

This newsletter is available in English, Portuguese, Spanish, and Russian.

We’re kicking off June with exciting network updates and the latest evidence from the global immunisation community.

At the end of May, Linked held a two-day kickoff meeting in Jakarta for the new Indonesia Subnational Peer-to-Peer Learning Platform. Immunisation practitioners, policymakers, and partners working at the national and subnational levels came together to discuss and align on challenges and opportunities for immunisation in Indonesia and learning priorities for the platform. We’re looking forward to building on the momentum of this initial meeting as districts are paired off for monthly virtual learning engagements plus two in-person engagements that will bring together all 6 districts.

We also published an updated brief outlining all the rich, practical resources produced by Linked through the end of 2023. You can draw upon these resources to learn about how other countries are addressing critical barriers and apply them to your own programs to improve sustainable and equitable vaccine coverage.

The global immunisation community has published helpful guides, literature, and briefs to aid the journey to successful new vaccine introduction, making the case for investing in immunisation, and cost effectiveness of immunisation services.

Resources related to new vaccine introduction primarily centered on the HPV vaccine.

Other resources about cost effectiveness of immunisation services ranged from expanded investments in immunisation to investing in life course immunisation.

There are also a number of compelling country stories – from Indonesia to Jordan to Myanmar and Philippines – illustrating the innovative approaches to restore and improve vaccine coverage and reach zero-dose children in hard-to-reach areas.

Warm regards,

Astara Lubis, Program Director, Results for Development and Program Director for Linked Immunisation Action Network’s Indonesia Subnational Peer-to-Peer Learning Platform

Astara Lubis is a program development specialist with 20 years of experience in policy and organizational analysis, stakeholder engagement and management of large-scale portfolio programs in Indonesia. She has worked with international organizations such as Australia Agency for International Development (now DFAT), Australia Department of Education, Australia Department of Agriculture, APEC Business Advisory Council, UNDP and USAID, with significant experience in political economy, democratic governance, community development, health system strengthening and public health. As Indonesia Program Director, she will lead the design and implementation of Linked’s Indonesia subnational peer-to-peer learning platform, including national level stakeholder engagement.

Linked’s Indonesia Subnational Peer-to-Peer Learning Platform Holds Kickoff Meeting in Jakarta
Linked held a two-day kickoff meeting to launch its Indonesia subnational peer-to-peer, collaborative learning network in Jakarta from 29-30 May. Immunisation practitioners, policymakers, and partners working at the national and subnational levels came together to discuss and align on challenges and opportunities for immunisation in Indonesia and learning priorities for the platform. The subnational learning platform is a pilot initiative that aims to test and expand Linked’s innovative and action-oriented collaborative learning approaches to engage immunisation stakeholders at lower levels of the health system. In 2024, the initiative is designed to pair two districts in each of the three regions (East, West, and Central) for monthly virtual learning engagements and bring together all 6 districts for two in-person engagements. During the kickoff meeting, subnational participants developed their learning plans for the district, regional, and network levels.

Catch up on Relevant Linked Resources in New Brief
An updated brief of Linked resources, including those developed through the end of 2023, captures lessons learned and good practices identified through Linked learning engagements with topics ranging from increasing access to key missing vaccines, strengthening human resource capacity, and strengthening delivery of immunisation through PHC platforms, among others. We encourage immunisation stakeholders to draw upon these resources to learn about how other countries are addressing critical barriers and apply them to their own programs to work towards sustainable and equitable vaccine coverage. Explore the brief here.

An evaluation of the cost of human papilloma virus (HPV) vaccine delivery in Zambia
The focus of this evaluation was to establish the cost to administer a single dose of the HPV vaccine as well as for full immunisation of two doses. The findings show types of vaccination sites, coverage at each type of site, financial and economic costs, and cost drivers. Review the full findings here.

Evaluation of a single-dose HPV vaccine strategy for promoting vaccine, health, and gender equity
There are several compelling reasons to pursue a single-dose HPV vaccination strategy. A single-dose strategy helps to overcome barriers to vaccine procurement and distribution caused by vaccine supply and resource constraints and logistical challenges that come with the need for administration of multiple doses. Equally important, but less discussed, are the ethical reasons for pursuing a single-dose strategy. This article illustrates how a single-dose HPV vaccination strategy advances equity in three dimensions: vaccine equity, health equity, and gender equity. Read it here.

CDC Evaluates and Shares Lessons Learned from HPV Vaccine Introduction in Three Countries
In Zimbabwe, Senegal, and Tanzania, cervical cancer is a leading cause of cancer among women. To better understand the feasibility and acceptability of new vaccine strategies for nationwide implementation, each country launched a pilot program to reach adolescent girls and subsequently decided to introduce the HPV vaccine nationwide for all girls. Evaluations from the three countries highlight lessons learned in program implementation, cost, best practices, and challenges. Explore them in detail here.

Online panel discussion on how to build an investment case for immunisation – lessons learned from MENA countries
The Vaccine Procurement Practitioners Network (VPPN) held an online panel discussion focused on how to build an investment case for sustainable financing for immunisation. Government representatives from Egypt, Morocco, and Tunisia shared their experience with the process of introducing a new vaccine and highlighted key steps, challenges, and good practices, while focusing on how investment cases or other types of evidence can be useful to secure government funding. The presentations slides can be accessed here. A Q&A summary is also available in English, French, and Arabic.

Immunization Agenda 2030 brief: An in-depth review of access to immunisation in middle-income countries
This brief highlights immunisation performance in middle-income countries from 2019 to 2022, visualizing a selection of IA2030 Impact Goals and Strategic Priority indicators from the IA2030 Monitoring and Evaluation Framework and scorecard. It also reviews four bottlenecks slowing progress and highlights major initiatives supporting middle-income countries. Uncover the insights in the brief here.

Cost-benefit model estimates the socioeconomic and fiscal returns of expanded investment in immunisation in Colombia
A new study in Health Affairs Scholar uses a cost-benefit model to evaluate the inclusion of five vaccines across the life course in Colombia’s national immunisation program. The study presents an innovative approach to blending fiscal, economic, social, and health outcomes to make the case for life-course immunisation programs in other countries and highlights the value of investing in life-course immunisation beyond health outcomes. Review the findings here.

Cost-effectiveness of life course immunisation: Global discussion paper and review of the evidence
A global project, led by the International Longevity Centre, is setting out to highlight the value of immunisation across our longer lives, and how immunisation is key to the shift from curative to preventative healthcare that will be invaluable in an ageing world. This discussion paper and accompanying evidence pack set out the most recent evidence for the cost effectiveness of adult immunisation and identify where non-market value is currently missing from discussions about it. Access the global discussion paper here and the review of the evidence here.

Health impact and cost-effectiveness of expanding routine immunisation coverage in India through Intensified Mission Indradhanush
A cost-effectiveness study of the Intensified Mission Indradhanush (IMI), a large-scale periodic intensification of routine immunisation in India in 2017-2018, found that it was both impactful and cost-effective for improving vaccination coverage. Examine the full article and findings here.

Gavi MICs Approach – Considerations on access to sustainable supply and affordable pricing
As part of the MICs Approach, Gavi offers a suite of catalytic tools to help drive the sustainable and equitable introduction of PCV, rotavirus, and HPV vaccines in both former and never Gavi-eligible countries, by addressing relevant barriers, including pricing. Learn more about leveraging Gavi support for market shaping and pooled procurement mechanisms to drive access to sustainable supply and affordable pricing on the Gavi website here.

Immunization Delivery Cost Catalogue update: The state of the evidence on the cost of delivering immunisation in low- and middle-income countries
ThinkWell is pleased to present an updated version of the Immunization Delivery Cost Catalogue, or IDCC, the most comprehensive,current, and standardized database on the cost of delivering vaccines in low-and middle-income countries. Based on a systematic review of over 22,000 publications, the updated IDCC presents 1,156 unique unit costs from 119 publications, in 2022 US$. First developed in 2017 by ThinkWell under the Immunization Cost Action Network (ICAN) project, the IDCC was previously updated in 2018, 2019. This update adds 607 unit cost from 62 studies—including from 12 countries previously not represented in the IDCC.

The IDCC comes with an analysis brief which summarizes the state of the evidence on immunisation delivery cost, provides ranges for delivery cost per dose, and highlights remaining evidence gaps. Additional accompanying products include its Methodology note and the Codebook and Definitions document.

Mid-term evaluation of Gavi’s 2021–2025 strategy for middle-income countries
Gavi, the Vaccine Alliance appointed Euro Health Group (EHG) to conduct a mid-term evaluation (MTE) to provide the Gavi Board and the Gavi Secretariat with an independent, objective assessment of the implementation of Gavi’s 2021–2025 strategy in support of middle-income countries. Findings and conclusions from the evaluation, including reports, summaries, and a policy brief, can be found on the Gavi website here.

Decreasing zero-dose children threefold amidst pandemic and political unrest in Myanmar
In 2021, Myanmar faced dual crises: the COVID-19 pandemic and political instability. These crises led to a sharp decline in primary health care services, including routine immunisation for children, categorizing Myanmar among the top 20 countries with the highest number of zero-dose children. Learn how they achieved a threefold decline in the number of zero-dose children here.

Catch-up routine immunisation to restore childhood immunisation coverage following COVID-induced declines in Zamboanga Peninsula, Philippines
Even before the COVID-19 pandemic, immunisation rates were low and declining in the Philippines, where the national-level Fully-Immunised Child (FIC) coverage decreased from 70% in 2015 to only 61.5% in 2020. With the threat of disease resurgence during the COVID-19 pandemic, the Department of Health (DOH) instituted the Measles-Rubella (MR) and Oral Polio Vaccine (OPV) Supplemental Immunisation Activity (SIA) from October to November 2020 to interrupt disease transmission. Learn more about the intervention and its results here.

Mobile immunisation brings lifesaving vaccines to children living in hard-to-reach areas of Jordan
Even though vaccination in Jordan is free and available to children of all nationalities, children living in remote tented settlements like Ghadeer face multiple barriers to accessing their nearest healthcare facilities – from costs to lack of information – leaving children at risk of vaccine preventable diseases. Explore how mobile immunisation teams provide information to generate demand and combat vaccine misinformation here.

Reaching the unreachable with immunisation through Posyandu
Save the Children Indonesia is working hard to reduce the number of children under 5 years dying from preventable diseases, especially pneumonia through a plethora of different programmes, including the Fighting Against Childhood Pneumonia project, which supports Posyandu activities. Posyandu is an integrated health post that provides integrated monthly service sessions (monthly Posyandu Day) for mothers and children under the age of 5. Learn more about how these activities are increasing vaccine coverage here.

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