Adapted methodology for EPI assessment using the PAHO/WHO performance monitoring tool

1401 lectures

National Workshop for EPI Assessment Jamaica Elliot WilliamsIn September 2024, Jamaica's Ministry of Health and Wellness (MOHW) initiated an assessment of the Expanded Programme on Immunization (EPI) using the PAHO/WHO Performance Monitoring Tool. The tool comprises 13 components, each rated across five implementation levels — from “initial” to “optimized.” A team of five PAHO/WHO experts, together with an internal MOHW committee, led the process, supported by a management team and healthcare workers across Jamaica’s four Regional Health Authorities.

The EPI assessment aimed to strengthen system resilience and capacity in the post-COVID-19 context by evaluating performance, identifying gaps, and developing a targeted action plan. It will also inform the country’s reporting under the IHR-SPAR+ framework.

Despite a condensed timeline — reduced from eight to five months due to scheduling constraints — the assessment was successfully implemented using a revised and inclusive methodology, which also included a vaccination audit at selected health facilities. Following the initial situation analysis, a series of consultations were conducted over a three-week period beginning on 14 January 2025, spanning national, regional, parish, and field-site levels. Participants included a wide range of technical officers, administrative staff, and allied health workers.

Key Adaptations:

  • Broad stakeholder engagement through pre-workshop consultations enabled informed contributions and rich discussions.

  • An integrated group approach was used at the national workshop, consolidating participants into a single discussion group to reflect their multiple roles.

  • Concurrent regional assessments were conducted by split PAHO/WHO and MOHW national teams using aligned methodologies at the field level.

  • Integrated validation sessions and action planning minimized duplication and streamlined the process.

  • Clear priority-setting after finalizing the action plan enabled identification of key first-year activities.

  • A follow-up session with the IHR team fostered collaboration across regions and aligned EPI efforts with broader health system goals.

The adapted methodology proved effective in delivering a comprehensive assessment within a shortened timeframe. It facilitated meaningful engagement, generated regional and field-level insights, and enabled immediate action planning.

-----

Authors: Patrice Lawrence-Williams, PAHO, Advisor, NCD and mental health; Immunization focal point, Jamaica.

Photo: National Workshop, EPI Assessment, Jamaica (PAHO Jamaica Office/ T. White)