Advocacy is about change – convincing people to seize opportunities and address gaps in delivering immunisation to ensure vaccines get to every child.
But what are those gaps and opportunities? What are the problems with the immunisation delivery system? Why are some children not receiving vaccines?
National landscape mapping
The first step on your journey to improve immunisation and ensure vaccines reach every child in your country is to get a full picture of the situation.
How many have been reached with routine immunisation
How strong is your routine immunisation delivery system?
How are vaccines funded in your country?
Once you know the situation, you can identify the gaps and the opportunities for change and improvement.
Painting a picture of the situation in your country or region is known as Landscape Mapping.
Mapping your country’s health
If you have developed a partnership for immunisation, engage the wider group in your Landscape Mapping.
The first step is to gather information about your country and your region that will help you understand the broader context of immunisation and vaccines.
Collect as much of this information as you can, including at the regional and sub-national levels (called provinces, states, districts or something else, depending on your country). You can record it in the worksheet below.
Developing an overview of health and immunisation
The health of the population
- Total numbers of women, men, children and by regions where relevant
- Any important economic indicators such as Gross National Product (GNI)
- What are the languages, religions, ethnic groups, migrants and refugees?
- What are the national birth rates and child mortality rates?
- List the burden of major diseases, including particularly the burden of vaccine-preventable communicable diseases.
- What are any notable major health issues, priorities/initiatives by the government and other health agencies/organisations?
- Gather key maternal and child health indicators, such as collected for the MDG Countdown to 2015.
Coverage and equity of immunisation
- What vaccines are currently available or planned for introduction in your country?
- What are the current coverage rates and drop-out rates for available vaccines, particularly
Diphtheria-Tetanus-Persussis (DTP) 3 doses?
- What are the national coverage targets?
- As much as possible, also explore data for sub-national, district or community levels as this is critical
for assessing coverage and equity issues.
- Are there any indicators of inequitable access to vaccines?
- These may be linked to geography (some regions or communities have lower coverage rates), wealth quintiles (groups with lower income levels, and/or ethnic, gender or community inequities).
National health and immunisation plans and policies
- What are the National health policies, strategies and plans?
- Request access to your country’s Comprehensive Multi-Year Plan (cMYP) for immunisation?
- Do any sub-national health or immunisation plans exist? Are they harmonised with the national plan?
Sustainable financing of immunisation
- Is there a national budget line for immunisation and vaccines?
- What is Gavi’s support and approved funding for your country: what is it now, what will it be in the future?
Is your country transitioning from Gavi support, and if so, when?
Other sources of sustainable financing:
- Is there bilateral support from donor countries, private sector support, or other sources? Is any planned
in the future?
Analysing the routine immunisation system
The vaccine supply chain
- Are they getting vaccines to all communities?
- Can they manage any planned new vaccines?
- Is it well managed nationally and down to the community level?
- Are there stock-outs at the national or sub-national levels?
- Are they adequate to get vaccines even to remote locations.
The immunisation delivery and health care system
- Are the health services adequate and well-functioning (including sub-national, district, community levels)
- Are there trained healthcare workers in sub-national/community settings?
Community health system:
- Does it work well for children’s caregivers and the community?
- Is the community involved and engaged in ensuring the immunisation delivery system is appropriate
and functioning well?
Reaching the unreached:
- What is being done to track and reach unvaccinated children, or those who drop-out?
Data and disease surveillance
Immunisation and disease surveillance:
- Is there timely, reliable and comprehensive data on disease surveillance and vaccine coverage, importantly at the
- What is being done to improve and strengthen the data collection system if it is weak?
- Are there data surveillance and collection tools?’