The aim of this guide is to help health workers to use their own data to identify problems and causes of low immunization coverage, and to plan solutions to increase immunization coverage. These guidelines can be modified to suit the local context and needs, and can be used at various levels of the health system in any country.
The Government of the Republic of Angola places great importance on the provision of sound health care services to its population. The Expanded Program on Immunization is one of the Ministry of Health priority programs.
Angola experienced one of the worst periods in its recent history, which was characterized by two phases of armed conflicts that directly affected the entire population. The social sectors, particularly basic health services were most hit by the war. The massive destruction of infrastructures and the small scale investment in the health sector have all contributed to the state of poor health of the population.
The authors use cross-national social, political, economic, and institutional data to explain why some countries have stronger immunization programs than others, as measured by diphtheria-tetanus-pertussis (DTP) and measles vaccine coverage rates and the adoption of the hepatitis B vaccine. After reveiwing the existing literature on demand- and supply-side side factors that affect immunization programs, the authors find that the elements that most affect immunization programs in low- and middle-income countries involve broad changes in the global policy environment and contact with international agencies. Democracies tend to have lower coverage rates than autocracies, perhaps because bureaucratic elites have an affinity for immunization programs and are granted more autonomy in autocracies, althought this effect is not visible in low-income countries. The authors also find that the quality of a nation's institutions and its level of development are strongly related to immunization rate coverage and vaccine adoption, and that coverage rates are in general more a function of supply-side than demand effects. there is no evidence that epidemics or polio eradication campaigns affect immunization rates one way or another, or that average immunization rates increase following outbreaks of diphtheria, pertussis, or measles.
This annual report draws on innovative and authoritative benchmarking tools developed by ITU to monitor information-society developments worldwide as well as to provide valuable information for use in formulating evidencebased policies and in effective peer learning. It presents the ICT Development Index (IDI), which ranks countries’ performance with regard to ICT infrastructure and uptake, and the ICT Price Basket (IPB), a unique metric that tracks and compares the cost and affordability of ICT services.
In 2009, the Bill & Melinda Gates Foundation created the ARISE project, managed by JSI, to assemble the evidence on what drives improvements in RI performance in Africa. To amass such evidence, ARISE conducted in-depth, mixed methods comparative case studies in Cameroon, Ethiopia, and Ghana. It employed an assets-based approach to identify common drivers of improvements in RI performance at the district level, describe the pathways by which they improve coverage, and identify contextual factors affecting performance.
This article summarizes an extensive literature review addressing the question, How can we spread and sustain innovations in health service delivery and organization? It considers both content (defining and measuring the diffusion of innovation in organizations) and process (reviewing the literature in a systematic and reproducible way). This article discusses (1) a parsimonious and evidence-based model for considering the diffusion of innovations in health service organizations, (2) clear knowledge gaps where further research should be focused, and (3) a robust and transferable methodology for systematically reviewing health service policy and management. Both the model and the method should be tested more widely in a range of contexts.