2. National level considerations

2.1. Context

Routine immunization refers to the process of offering a set of vaccines to infants in the months and years after birth, providing a protection from a multitude of diseases. This set of vaccines has been very successful, such that the regions where they have been best applied no longer remember the diseases the vaccines protect against. However, routine immunization does not work well in weak health systems. Thus, while global coverage of childhood vaccines has improved, an estimated 12.4 million children remain unvaccinated. Gavi estimates that about 50% of zero-dose children live in three key geographic contexts: urban areas, remote communities and populations in conflict settings. There are substantial variations between and within countries, for example DRC and Ethiopia have the largest number of zero-dose children in remote rural areas, while Nigeria has the largest number of zero-dose children impacted by conflict. Recent advances in remote sensing and geographic information systems allow a new approach to help reaching these children.

2.2. What is the GMT?

The Geospatial Microplanning Toolkit (GMT) is a software application that aims to improve routine immunization service delivery by providing the ministry of health with a tool that allows the creation and modification of a geospatial microplan, including the monitoring of the microplanning process on sub-district, district and national level and against which implementation can be measured.

2.3. How does it work?

The GMT is used on sub-district level and allows the field staff using the application to map all health facilities and their outreach sites within the sub-district, to review all settlements within the sub-district and annotate boundary issues where necessary. The tool utilizes satellite derived settlement data and high-resolution GIS-based modelled population estimates to automatically calculate the catchment of each service delivery point. The output of this tool is two-fold: first, once the microplanning exercise has been completed, it outputs a geospatial microplan. Second, it feeds all that information back into a central geodatabase which can be utilized for any and all other potential geospatial activities, for instance planning of house-to-house vaccination campaigns.

In addition to monitoring of the microplanning activity, the output of this application can be used to monitor the implementation of the routine immunization service delivery, though outside of the GMT. The microplan generated in the GMT contains information about the frequency and days of the fixed post and outreach sites sessions, as well as the settlements due for mobile health services.