Key guidance on (S)NLWGs

Olamide Folorunso

This page contains guidance on establishing and strengthening (SN)NLWGs and is organised into the following sections:

Key resources

The document below provides guidance for establishing, strengthening, and monitoring NLWGs, detailing their mandate, structure, key functions, and performance indicators.

Why set up (S)NLWGs?

Since the launch of the Expanded Programme on Immunization (EPI) in 1974, immunization schedules have expanded from a few vaccines to multi-antigen schedules targeting all age groups. This growth, coupled with contextual challenges and complex delivery requirements, has introduced new challenges in ensuring optimal performance and sustainability. NLWGs and SNLWGs are positioned to address these challenges through improving efficiency, resilience, and equity. They ensure vaccine availability, potency, and equitable access, while coordinating partner investments and national priorities.

Mandate and governance

NLWGs should be formally recognized through ministerial decrees or other administrative processes, granting them authority within the MoH structure. Governance is led by a Chair, supported by a secretary, and operates via Sub-working groups to address specific technical areas, such as cold chain management or forecasting. Recommendations are developed by these sub-groups and submitted to the ICC for endorsement. NLWGs are often positioned under the ICC or as subcommittees of national supply chain coordination platforms, ensuring their recommendations feed into higher-level policymaking.

NLWG Maturity Framework and key performance indicators

A new (S)NLWG Maturity Framework measures working group’s presence and functionality, across five levels: Ad hoc, Iterative, Defined, Managed, and Best Practice, offering a guide to countries’ NLWGs’ strengthening efforts. The NLWG’s effectiveness is measured through three categories of key performance indicator (KPI):

  1. KPIs related to NLWG as a body: Existence of a formal ToR, regular meetings, inclusive membership, conflict-of-interest declarations, and issuance of recommendations.
  2. KPIs related to NIP: Vaccine availability, reduction in stock-outs, cold chain functionality, efficiency of last-mile distribution, waste management, forecasting accuracy, financing sustainability, and improvements in Effective Vaccine Management (EVM) scores.
  3. KPIs related to SNLWGs: Establishment, functionality, capacity-building, and technical support provided to lower levels of the health system.

These KPIs are aligned with Gavi Alliance’s Performance Action Framework, which require NLWGs to review continuous improvement plans (cIPs), track vaccine stock, manage cold chain equipment, and mobilize resources.

Contextual application

Guidance contains nuanced implementation considerations based on country size and supply chain complexity with case studies from countries such as Ghana, Kenya, Nigeria, Indonesia, and Vanuatu illustrate different stages of maturity, highlighting needs for technical assistance, formalization, or advocacy.