Increasing RI Coverage by Reducing Missed Opportunities for Vaccinatio - PDF document

1 Increasing RI Coverage by Reducing Misse
Increasing RI Coverage by Reducing Missed Opportunities for Vaccination Reducing missed opportunities for vaccination (MOV) is a strategy to increase immunization coverage simply by making better use of existing vaccination sites (at health centres, hospitals, outreach/mobile services etc.). The MOV strategy answers three important questions : 1. How many opportunities for vaccination are missed at existing vaccination sites? 2. Why are opportunities for vaccina tion being missed at the different vaccination sites? 3. What can be adjusted or done differently (e.g. policies and behaviours) so that we do not miss any opportunity to vaccinate? Beyond improving immunization coverage, reducing MOVs will also improve ti meliness of vaccination, improve health service delivery in general, and promote synergy between treatment services and preventive programmes at the health facility level. What is a missed opportunity for vaccination (MOV) ? A missed opportunity for vaccination (MOV) refers to any contact with health services by an individual (child or person of any age) who is eligible for vaccination (e.g. unvaccinated or partially vaccinated and free from any contraindications to vaccinatio n), which does not result in the person receiving one or more of the vaccine doses for which he or she is eligible. How can the MOV strategy increase immunization coverage? The MOV strategy is about establishing a system so that any child/person eligible for vaccination who comes to a health facility/mobile health service (for whatever reason), receives the needed vaccines during their visit. Missed opportunities for vaccination can occur during visits to health facilities/mobile health services for immun ization (“immunization contact” ), as well as during visits to health facilities/mobile health services for curative services (e.g. treatment of mild fever, cough, diarrhoea, bruises; “treatment contact”) or other preventive services (e.g. growth monitoring , nutrition assessments and oral rehydration training sessions, etc.). Most missed opportunities are due to failures to execute already established policies and procedures. Experience from previous MOV assessments suggests several common reasons why opportunities for vaccination were missed in health facilities, including: the failure of health providers to s creen patients for eligibility perceived contraindications to vaccination on the part of providers and parents vacci ne shortages rigid clinic schedules that separate curative s ervices from vaccination areas poor retention or limited availability of home - based records , and parental or community resistance to immunizations What are the components of the MOV strategy ? The MOV strategy is a 10 - step process that involves the assessment of the magnitude and causes of missed opportunities for vaccination, immediately followed by tai lored health systems interventions to reduce such missed opportunities,

2 leading to an increase in vaccine covera
leading to an increase in vaccine coverage and timeliness of vaccinations. In some cases, it may not be necessary to conduct the formal assessment outlined in this methodology (Steps 3 - 6). Countries districts or health facilities may already have anecdotal or documented evidence of the existence of MOVs, and ther e may already be sufficient political and programmatic support for reducing missed opportunities as a strategy to improve cov erage and equity. In such cases, the Intervention Guidebook for Reducing Missed Opportunities for Vaccination can be used as a stan d - alone guide to develop local solutions to reduce MOVs in affected districts or health facilities. For the strategy team at national and subnational level For the field team conducting and analyzing the survey For the strategy team at national and subnat ional level Step 1 Step 2 Step 3 Step 4 Step 5 Step 6 Step 7 Step 8 Step 9 Step 10 What Plan for an MOV assessment and intervention Prepare for the assessment and secure commitment for follow - up interventions Conduct field work for the rapid assessment of MOVs Analyze preliminary data and identify key themes Brainstorm on proposed interventions and develop an action plan for implementation Debrief with MOH leadership and immunization partners on proposed next steps Im plement the interventions Provide supportive supervision and monitoring Conduct rapid field evaluation of outcomes/ impact of interventions Incorporate into long term immunization plans to ensure gains are sustainable Who MOH, with support from all in - country immunization partners MOV Strategy Team, MOH and other key immunization partners Assessment coordinator, MOH and in - country immunization partners Assessment coordinator, data m anager, qualitative expert/social scientist, field teams and representatives from MOH and partner organizations Assessment coordinator, field teams, MOH - EPI leadership and partner organizations All immunization partners, with leadership by MOH Health facility staff, MOH and immunization partners MOH and MOV Strategy Team, with support from key immunization partners MOH and MOV Strategy Team, with support from key immunization partners MOH, with support from key immunization partners and MOV Strategy Team Timing and Duration 2 – 4 months before field work 1 - 2 months before field work 1 - 2 weeks duration, depending on training needs and travel distances 1 - 2 days 1 day ½ day 6 - 12 months 6 - 12 months 6 - 12 months following Step 7 - 8 Ongoing Resources Planning Guide to Reduce Missed Opportunities for Vaccination Methodology for the Assessment of Missed Opportunities for Vaccination Intervention Guidebook for R educing Missed Opportunities for Vaccination For more information visit: http://www.who.int/immunization/programmes_systems/policies_strategies/MOV/en