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Dear colleagues, I was recently asked the above question. After some consideration, my response was:
"Countries should only conduct a national EVM assessment when they plan to create and implement a continuous improvement plan (cIP) or other strategic national immunization strategy based on the assessment findings."
If countries are unable to do this, they should consider conducting a targetted or subnational EVM assessment that is more aligned to their needs, or delaying the assessment until they are in a better position to implement a cIP. Based on this guidance, it could be said that countries should probably NOT conduct an EVM assessment in the following situations:
1. In conflict situations where a large amount of facilities are inaccessible, for example where a government is not in control of the entire country. In this situation, a national immunization programme would be unable to implement a cIP for the entire country and therefore a targetted or subnational assessment would be a more appropriate use of resources. Furthermore, if a large number of facilities must be excluded from the random sample (for example, if they are not in government control), then any random sampling methodology that is used will not be representative of the entire country, only the area that is included.
2. In emergency situations (conflict, natural disaster, epidemic, etc.) where implementing systematic improvements to the provision of routine immunization services will be difficult.
I wonder what others think of the above? Does it make sense? Are there situations where exceptions should be made? If so, how we establish the ground rules for such exceptions?
Have a great weekend,
Dan
"Countries should only conduct a national EVM assessment when they plan to create and implement a continuous improvement plan (cIP) or other strategic national immunization strategy based on the assessment findings."
If countries are unable to do this, they should consider conducting a targetted or subnational EVM assessment that is more aligned to their needs, or delaying the assessment until they are in a better position to implement a cIP. Based on this guidance, it could be said that countries should probably NOT conduct an EVM assessment in the following situations:
1. In conflict situations where a large amount of facilities are inaccessible, for example where a government is not in control of the entire country. In this situation, a national immunization programme would be unable to implement a cIP for the entire country and therefore a targetted or subnational assessment would be a more appropriate use of resources. Furthermore, if a large number of facilities must be excluded from the random sample (for example, if they are not in government control), then any random sampling methodology that is used will not be representative of the entire country, only the area that is included.
2. In emergency situations (conflict, natural disaster, epidemic, etc.) where implementing systematic improvements to the provision of routine immunization services will be difficult.
I wonder what others think of the above? Does it make sense? Are there situations where exceptions should be made? If so, how we establish the ground rules for such exceptions?
Have a great weekend,
Dan
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Hi Dan,
Good day. I agree with the two points you made. However, I would like to make another point here. I found the EVM assessment and cIP development extremely important for any country to ensure a robust isc. But prior to these, the countries must understand the importance of these works. The policy makers, immunization headquarters and development agencies must come to a consensus and be committed to not only do these but also implement the cIP. Because the ultimate goal is visible improvement. I believe there are many countries out there with remarkable cIPs waiting for ages to be implemented. Therefore, political commitment and allocation of resources are undeniable aspects of a successful EVM assessment followed by development and implementation of cIPs
Dr. Md. Tanvir Hossen
Consultant, Urban Immunization
IVD, WHO, Bangladesh.
M: +8801717572284
Good day. I agree with the two points you made. However, I would like to make another point here. I found the EVM assessment and cIP development extremely important for any country to ensure a robust isc. But prior to these, the countries must understand the importance of these works. The policy makers, immunization headquarters and development agencies must come to a consensus and be committed to not only do these but also implement the cIP. Because the ultimate goal is visible improvement. I believe there are many countries out there with remarkable cIPs waiting for ages to be implemented. Therefore, political commitment and allocation of resources are undeniable aspects of a successful EVM assessment followed by development and implementation of cIPs
Dr. Md. Tanvir Hossen
Consultant, Urban Immunization
IVD, WHO, Bangladesh.
M: +8801717572284