The immunisation review report by the World Health Organization (WHO) summarises findings and recommendations made during a joint review of Bangladesh’s Expanded Programme on Immunization (EPI) in 2018 to assess the programme’s progress and challenges, as well as share lessons learned for preventing and controlling vaccine-preventable diseases (VPDs).
The review was initiated by the WHO Regional Office for South-East Asia in collaboration with the Ministry of Health & Family Welfare (MOHFW) of Bangladesh. The joint review team also included representatives from UNICEF, Gavi and the U.S. Centers for Disease Control and Prevention (CDC). The reviewers’ areas of focus included among others: government support for immunisation; equity of immunisation coverage; data quality and effectiveness of surveillance.
The team collected information through a desk review of relevant policies and guidelines; secondary analysis of available data; interviews with key stakeholders and policymakers; field visits and direct observations. Findings and recommendations are presented in a structured way, both on national and field levels.
In brief, the review concludes that Bangladesh EPI is a flagship for the country and the region. The country has successfully maintained high immunisation coverage as well as VPD surveillance and successfully introduced new vaccines. Nonetheless, the country faces important challenges that need to be met to maintain and build on its existing programme. The challenges include a shortage of human resources; a high dependence on donors in the face of anticipated declines in donor support; inequities in vaccine coverage between urban and rural areas, indicating the fragmented provision of vaccination services in urban areas; lack of clarity regarding target populations results in unreliable administrative coverage figures and difficulties in ensuring adequate supplies without wastage.
Overall, the review offers an in-depth overview of the immunisation and surveillance situation in Bangladesh. The analysis of the challenges provides not only insights into specific hurdles in the field and at the policy level but also looks at potential solutions and interesting interventions that are planned or already being implemented in several regions.
World Health Organisation Regional Office for South-East Asia (2019) Joint National/International Expanded Programme on Immunisation and Vaccine Preventable Diseases Surveillance Review, Bangladesh 28 July- 6 August 2018. Available from: https://apps.who.int/iris/bitstream/handle/10665/339888/sea-immun-127-eng.pdf?sequence=3&isAllowed=y