POST 00660E : IMPROVING COVERAGE
Follow-up on Posts 00642E and 00646E
8 April 2004
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The first contribution is from Khadija Msambichaka
(mailto:[email protected]) from AFRO. The second comes from Mercy Ahun
(mailto:[email protected]) from GAVI Secretariat in Geneva who provides
further information on the GAVI performance-based grants. And finally, we
attached a two-page summary of Julian Bilous (mailto:[email protected])
presentation at the Technet21 Consultation in Antalya "Reaching Every
District" as it is very relevant to this discussion. This paper will be
included in the final report and the full presentation be made available
later. But it is thought appropriate to post it at this time with Julian's
agreement.
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I cannot agree more with Gasse that for interventions in areas
with poor access we should look at delivery of a minimum life-saving
package. We have very good examples and lessons learnt form the SOS pilot
project. Uganda included curative services and this was very attractive to
the community to an extent that on a certain site the community decided to
build a health facility to bring the services closer. In Mali we found the
community taking care of some of the logistics and monitoring as well. The
outreach services in villages along the Niger River offered vaccinations,
Vitamin A, antihelminthics and ITNs.
The limiting factor for inclusion of many intervention remains the human
resources.
Maybe our colleagues from Uganda could share the presentation and it could
be posted.
Khadija Msambichaka
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This is to clear up some possible confusion regarding information about the
GAVI performance-based grants that appears in a press release on the GAVI
website.
As you know, press releases are formulated for audiences that do not have
extensive background knowledge. Therefore we took pains to describe the
somewhat complex GAVI Immunization Service Support (ISS) or 'share system',
in simple terms as performance-based grants.
As many readers of TECHNET will be aware, in addition to providing new and
under-used vaccines, GAVI provides financial support to countries to
increase immunization coverage. Three years of investment payments are
given based on the countries' coverage targets. In the fourth year
countries that have actually documented increases, and passed an
immunization data quality audit (DQA), receive continued funding. So far,
among the 19 countries that have received three years of investments under
the ISS program, eight countries have documented DTP3 increases, and 11
have not shown increases, or have not passed the DQA, or both. Once these
11 countries do eventually increase DTP3 coverage and pass the DQA, they
will be eligible for continued funding, or "rewards".
According to the rules, GAVI does not require countries to define how the
money will be spent in their proposals, nor do we require them to report in
substance on how the money was spent. However, we know that important
information and lessons can be learned ? both from countries that have been
able to increase coverage and those that were less successful. Therefore
the GAVI Secretariat on request of the GAVI Board has commissioned a study
on the use of ISS funding, results of which will be available in June.
Mercy AHUN
Principal Officer
GAVI Secretariat c/o UNICEF
Geneva
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