By Skye Gilbert, Program Officer, Bill and Melinda Gates Foundation
Nov 5, 2014
In 2012, when Bill and Melinda Gates approved the creation of an explicit Routine Immunization strategy, we noted to them that improved immunization data is a fundamental driver of improved immunization systems overall. However, at the time, we did not have a comprehensive, strategic approach to investing in data systems. Rather than conduct a series of small, academic studies on this topic, we made a large investment to PATH—the Better Immunization Data (BID) Initiative—with the belief that systems change, and improving data, would require a complex, holistic approach and that based in part of the BID Initiative’s progress, we’d figure out our own strategy along the way.
In the last 18 months, the BID Initiative community has played a pivotal role in informing the Gates Foundation’s approach. The insights have not just been from PATH, but from country representatives attending the BID Initiative meetings, the initiative advisory board and the deep, game-changing engagement from the governments in our first two demonstration countries, Tanzania and Zambia.
We’ve learned that co-creating solutions with country representatives results in solutions that are more context-appropriate, sustainable and relevant to local needs. We’ve learned that it’s difficult to balance rigorous assessments of impact with the need for flexibility, adaptability and speed of implementation. While we haven’t found the perfect balance yet, I’m excited to see us getting closer to an answer that will yield strong solutions and the evidence of their effectiveness. Finally, we’ve learned that the most important resource for improving data is not a phone, or an internet connection, or a sophisticated analytical system. That in fact, the people in the system are the agents of change, and data that empowers them can open endless possibility for improving systems.
So I want to take this opportunity to thank the BID Initiative community for your engagement and your wisdom. You’ve helped us shape an investment philosophy that has greater country involvement in intervention design, greater sensitivity to balancing rigorous evaluation with flexible implementation, and increased focus on people within the health system and how they can be empowered to be agents of change. We look forward to continuing to learn from you, and to seeing the BID Initiative solutions come to life in health facilities and districts in the coming year!
Join my colleague, Jenny Sequiera, and three other doctors for the next BLN webinar on Reaching Every District incorporating Quality Improvement approaches (RED-QI). The speakers will discuss practical information on setting up quality improvement systems that support better implementation of immunization programs, tying into the essential need for change management with the BID Initiative.