Immunization Systems Support

Reach Every District (RED) Approach

Implemented since 2002, the Reach Every District (RED) approach emerged from the World Health Organization (WHO) and partners in their attempt to devise an innovative strategy to improve stagnating immunization coverage and effectiveness in Africa. The RED approach outlines five operational components that are specifically aimed at improving immunization coverage in every district.

The RED approach offer planning strategies for better management of resources, works to reach all target populations, provide supportive supervision, link communities with service delivery, and ensure monitoring for action. At every stage, RED focuses on immunizing every child and pregnant woman, which can result in lifetime protection through vaccination against life-threatening diseases. The RED approach also encourages countries to use coverage data to make an analysis of the distribution of un-immunized children, and thereby prioritizes districts with poor access and utilisation of immunization services. Simultaneously, districts are encouraged to make microplans to identify local problems and adopt corrective solutions.

Implementing the RED approach is an essential step in mitigating life-threatening diseases in WHO/AFR countries in advancing towards the objectives of both the Millennium Development Goals (MDGs) and the Global Immunization Vision and Strategy (GIVS).

RED approach components

• Effective planning and management of resources: ensuring effective management of human, financial and material resources at every governing level.
• Reaching all target populations: reach out to previously under-served, un-reached communities, in giving support and access to services.
• Supportive supervision: providing local staff with on-site training by supervisors.
• Monitoring for action: promoting the use of data for action through utilization of data quality self-assessment tools at all governing levels.
• Linking services with communities: linking communities with health services, through regular meetings between communities and health staff.

The Role of RED and the Immunization and Vaccine Development Department
The role of WHO/AFRO IVD in strengthening routine immunization in the African region includes:

• Setting norms and standards to support member states in the implementation of the RED approach;
• Mobilizing additional resources for optimal implementation of the RED approach;
• Advocating with national governments and partners for scaling up of the RED approach in all countries and in all districts;
• Monitoring and evaluating routine immunization activities in the region.

How RED is contributing to improved routine immunization

The RED approach focuses on various steps in planning, managing and monitoring health services that, if carried out appropriately, will improve immunization coverage and impact. The primary implementation level for RED is the district (or the equivalent administrative unit). Empowering districts to plan, implement and monitor their own immunization services is an important objective of the RED approach. RED also promotes partnerships between districts, health workers and communities to improve the population's access to and utilisation of services, and emphasises the continuous use of program data to monitor progress and solve problems.

IVD Goals

• Reach all target populations in the 8 AFRO countries (Nigeria, Ethiopia, DRC, Tanzania, Kenya, Uganda, Angola, and Niger) which have 80% of all un-immunized children in the Region.
• Attain 90% DTP3 coverage at national level and at least 80% DPT3 coverage in all districts in 80% of countries in the Region.
• Assist all countries in the Region to implement the 5 components of the RED approach in all districts

Our Accomplishments

• RED approach is now implemented in almost all countries in the AFR Region.
• DPT3 coverage increased from 54% in 2001 to 82% in 2007.
• 17 countries reported ≥90% DPT3 coverage nationally in 2007 compared to only 8 countries in 2002. In the same year, 15 countries reported at least 80% DPT3 coverage in all of their districts.
• 80% of countries in the region received support in 2007 for development of comprehensive multi-year immunization plans with focus on RED approach implementation.
• 96% and 83% of countries have respectively introduced Hepatitis B and Hib-containing vaccines in the Region.

Challenges

• Government collaboration: without support from governments at the national, regional and district levels, the effectiveness and success in implementation of the RED approach is compromised.
• Funding: the RED approach cannot be optimally implemented or supported without fiscal support.
• Lack of qualified staff: employing trained staff to reach and successfully execute vaccination activities in remote areas is an ongoing challenge.
• Inadequate resources: staff must be equipped with proper tools to fully execute RED activities.
• Program shortfalls: in routine immunization, completion of vaccination cycle is imperative. Shortfall either in funding, motivation or staff support can reverse initial efforts.

Our Partners

The RED approach would not be successful without support of national governments and partners. Partnerships are forged to ensure: qualified staff, materials, transportation and waste management. Key external partners include: The GAVI Alliance, UNICEF, USAID, CIDA, US CDC, UN Foundation, etc.

Contact Information

Dr. Richard Mihigo
Coordinator Routine and New Vaccines
Tel: +4179 4770453, +242 7446908, +47 241 39926
Fax: +47 241 39641
E-mail: This e-mail address is being protected from spambots. You need JavaScript enabled to view it