Journal of Public Health Advance Access published online on June 19, 2009
Journal of Public Health, doi:10.1093/pubmed/fdp048
Reaching every district (RED) approach to strengthen routine immunization services: evaluation in the African region, 2005
T. Ryman, Public Health Advisor1
R. Macauley, Immunization Officer2
D. Nshimirimana, Immunization and Vaccine Development Program Manager2
P. Taylor, Project Director3
L. Shimp, Immunization Technical Advisor3
K. Wilkins, Public Health Advisor1
1 Global Immunization Division, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, 1600 Clifton Road, MS-E05, Atlanta, GA 30333, USA
2 Division of Prevention and Control of Communicable Diseases, World Health Organization Regional Office for Africa, Boite Postale 6, Brazzaville, Congo
3 IMMUNIZATIONbasics, JSI Research and Training Institute, Inc., 1616 N, Fort Myer Drive, Ste 1100, Arlington, VA 22209, USA
Address correspondence to T. Ryman, E-mail: cnu8{at}cdc.gov
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Abstract |
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Background This evaluation was undertaken in 2005, in the African region, to better understand the reaching every district (RED) implementation process that provides a framework for strengthening immunization services at the district level.
Methods In June 2005, a convenience sample of five countries was selected to evaluate the implementation of RED. Evaluation teams consisting of key partners conducted site visits to the national, district and health facility levels using standardized qualitative questionnaires.
Results RED was implemented in a similar manner in all five countries, i.e. starting with training and micro-planning. All RED components were implemented to some degree in the countries. Common implementation factors included development of plans, expanding outreach services (defined as services provided in sites outside fixed immunization sites), planning of supervisory visits and efforts to link with communities and utilize community volunteers. Monitoring tools such as wall charts and maps were observed and reportedly used.
Conclusions Evaluation of the RED implementation process provided evidence of improvement in delivery of routine immunization services. The RED framework should continue to be used to strengthen the immunization delivery system to meet continuing new demands, such as the introduction of new vaccines and integrated delivery of other child survival interventions.
Keywords: health services, immunization
The findings and conclusions in this report are those of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention.