Meeting Report: Meeting to share lessons learnt from the roll-out of the 2015 WHO Vaccination Coverage Cluster Survey Reference Manual and to set an operational research agenda around vaccination coverage surveys


Background Since the early 1990s, the World Health Organization (WHO) has provided guidance to Member States, partner agencies and institutions on methods for measuring vaccination coverage through surveys. With the goal of improving survey precision, accuracy, and overall quality, an extensive review and revision of coverage survey methods and materials resulted in the release, in 2015, of the working draft of the WHO Vaccination Coverage Cluster Survey Reference Manual (Survey Reference Manual). Countries have started using guidance included in the 2015 Survey Reference Manual for routine immunization (RI) and tetanus surveys, as well as surveys following supplementary immunization activities (SIA) and several training activities have taken place. While rolling-out the 2015 Survey Reference Manual and working with countries to promote an increased use of survey coverage estimates and other data, it has become apparent that there is enormous variation in survey design, quality of survey implementation and reporting, as well as around the analytical uses of surveys, i.e., obtaining and using vaccination indicators beyond coverage estimates. Similarly, it is clear that more needs to be done to bridge knowledge gaps around methodological issues that may affect the accuracy of survey-based vaccination coverage estimates, particularly in the current context of the Expanded Programme on Immunization (EPI), with the addition of many new vaccines and the broadening of ages targeted for vaccination. Important experience has been gained, along with best practices and lessons learned. It is expected that consolidating this information will allow WHO to finalize the Survey Reference Manual for official publication by the end of 2017, along with accompanying material such as practical summary guides, templates, tools to calculate sample size and tools to facilitate survey analysis. To this end, WHO convened a meeting from 18 to 21 April 2017 at the WHO headquarters in Geneva, Switzerland. The meeting brought together EPI managers from countries that have recently implemented vaccination coverage surveys using one or more of the elements recommended in the Survey Reference Manual, along with survey experts, statisticians, partners, representatives from WHO regional offices and headquarters, and technical assistance providers. The agenda is in Annex A and the full list of participants is available in Annex B of this report. Meeting Objectives 1. To share experiences and lessons learned from the implementation of surveys following the 2015 draft WHO Vaccination Coverage Cluster Survey Reference Manual in order to inform finalization of the Survey Reference Manual, and a suite of accompanying tools 2. To define an operational research agenda around vaccination coverage surveys