In 2012, Liberia conducted its last Comprehensive Expanded Programme on Immunization (EPI) review (CER). In addition, the comprehensive Multi Year Plan (cMYP) expiring in in June 2020. To provide evidence for the program’s strategic directions and priority activities, a new CER was organized between July 15-29, 2022, with 12 external reviewers from agencies including WHO, USAID and UNICEF supporting the process. 

Data collection was completed from July 15 - 29, 2022. Five out of 15 counties were considered, including Montserrado, which was purposively selected based on the population size and number of health facilities. Two districts - high and low performing - were selected from per county, with three health facilities surveyed in each. 

Seven core thematic areas of EPI were considered: programme management and financing; HR management; vaccine supply, quality and logistics; service delivery; immunization coverage and monitoring; disease surveillance and demand generation. 

The findings demonstrate that, among other things, the overall EPI performance (integrating all components and all counties), is 45.21% with no big difference between county, district and HF levels. Surveillance (63.54%) is the highest performing area, whereas Vaccines Supply Quality and Logistics (25.28%) require more attention. An urban Immunization Strategy for Montserrado County exists, and is critical to improving the vaccination uptake. Nevertheless, the Government needs to be more involved, as it contributes less than 10% to EPI’s total funds while 98% of National EPI Staff is paid by GAVI. 

The complete report will be released once it has been endorsed by Liberia. 

Author: Hilaire DADJO (WHO AFRO)

Photo: Interviewing a health facility. Credit: H.Dadjo/WHO AFRO