STRENGTHENING IMMUNIZATION PROGRAM IMPLEMENTATION IN SUBNATIONAL CONSEQUENTIAL GEOGRAPHIES -PHILIPPINES - The Philippines is the 5th largest contributor to the 18 million zero-dose children globally, with the 7th most children unprotected for measles. Vaccine program performance has been in a steady decline, exacerbated by the COVID-19 pandemic. Over 25% of Filipino children did not receive the first dose of diphtheria, tetanus, and pertussis containing vaccine, and over 40% are not fully immunized. These data, combined with challenges to surveillance systems, explain the repeated outbreaks of vaccine-preventable diseases (VPDs) over the past decade and underscore the need to support the Department of Health (DOH) and reinforce a system-wide approach to strengthening immunization and surveillance programs. The purpose of this project is to enable the government to realize its commitments to strengthen immunization program capacity, introducing innovative evidence-based approaches, adapted to the devolved health management structure, that support the DOH and prioritized local government units to: Prevent VPDs—apply new tools to identify underserved populations and reach them effectively with tailored interventions to close immunity gaps, enhance national coordination and strengthen new vaccine introduction; Detect outbreaks—draw on global and national expertise to strengthen VPD surveillance systems, including data linkages for timely detection, response planning and progress tracking; Respond to outbreaks—strengthen planning and coordination, while including community and local stakeholders in communication, decision-making and response, to contain the spread and minimize the disruption of outbreaks; and Sustain progress—apply a system-wide, multisectoral approach to address underlying health systems challenges while enhancing collaboration and coordination between government and financial and technical partners to promote quality and sustainability of immunization programs. Core outcomes will be to dramatically reduce the number of zero-dose children, increase coverage of prioritized life-course vaccines to achieve targets, reduce the frequency and prevent major disruptive outbreaks, and strengthen the underlying Philippine health systems to sustainably maintain these achievements. Jhpiego and FETPAFI (Field Epidemiology Training Program Alumni Foundation, Inc.), in collaboration with the University of Philippines National Institutes of Health and PharmaJet, present a unique combination of global and local expertise, trusted relationships and innovative approaches. We have tailored our approach based on close discussions with the DOH, provincial and municipal health officers’ associations, and other key stakeholders to align with current priorities and anticipate their evolution over the course of the project. We will leverage our team’s intimate local knowledge and trusted relationships, together with our global experience implementing immunization programs in over 30 countries and actively participating in global technical and policy-setting bodies, to infuse new thinking and evidence-based tools into critical aspects of the Philippines program and provide effective support to the national and subnational immunization program. We will increase reach and equity by engaging civil society and community-based organizations with deep roots in prioritized communities and those that represent underserved or disadvantaged populations, and leverage relevant programs such as the Local Council for the Protection of Children, Department of Education, the National Nutrition Council’s Barangay Nutrition Scholar Program and professional associations (e.g., Philippine Pediatric Society). The achievement and long-term sustainability of improvements in equitable vaccine coverage fundamentally rely on local leadership at all levels, and our program model fosters and supports local leadership through human-centered design approaches that incorporate co-design, joint implementation and participatory monitoring processes.
