Monitoring and Evaluation

Overview

WHO and partners are supporting a number of activities to strengthen and expand surveillance for new vaccines globally as part of implementation of the Global Framework for Immunization, Monitoring, and Surveillance (GMFIS).

Sentinel surveillance for Haemophilus influenzae, Pediatric Bacterial Meningitis (PBM) and rotavirus diarhoea in under five children , were initiated in the African Region duirng 2001 and 2006 respectively, with the following goals:

To provide evidence of local Haemophilus influenzae type b (Hib), Pneumococcal and Rotavirus disease burden
To generate data on S. pneumoniae and Rotavirus serotypes/genotypes in the AFR region
To support advocacy for the introduction of Hib, Pneumococcal and Rotavirus vaccines
To evaluate impact following vaccine introduction

National Ministries of Health co-ordinate the sentinel surveillance as part of integrated disease surveillance activities.

Criteria for selecting the sentinel sites for conducting the surveillance activities:

The Ministries of Health develop a plan of action indicating the hospital (s) that are selected to be sentinel surveillance sites. An initial single hospital sentinel site, plus or minus satellite health facilities, is recommended with the scope for subsequent expansion to secondary sites, so as to achieve greater representation of geographic regions and population groups. In selecting the hospitals that will act as sentinel sites for surveillance, the following criteria should be considered:

The selected hospital should cumulatively admit at least 250 children less than five years of age per year
The selected hospital must have the laboratory capabilities required to perform sentinel surveillance as outlined in the “WHO’s Generic guidelines, Protocols and AFRO Standard Operating Procedures (SOPS)
Public Hospitals, University Teaching Hospitals, NGOs facilities or any institution that is willing to share data with the Ministry of Health and WHO should be considered.
The national plan that outlines sensitive surveillance system that allow for calculation of hospitalisations rates related to diseases targeted by new vaccines are encouraged.
Plans that also cover the cost effectiveness, economic impact, hospital utilization survey and population based surveillance are encouraged.

Countries in the African Region conducting Surveillance Pediatric Bacterial Meningitis (PBM) and Rotavirus Networks

Built on framework and experience of the regional surveillance for VPDs

Some components of rotavirus are intergrated including:
- Same sentinel site (pediatric hospital ward, lab facilities)
- Data analysis and feedback
- Program monitoring (on -site reviews and meetings
WHO provides financial and technical support to MoH sentinel sites)

In addition to sentinel surveillance, WHO and partners are supporting national and Reference Laboratories in the region to strengthen capacity for Human Papilloma Virus (HPV) prevalence studies and vaccination impact monitoring.