Equity indicators for immunisation in Gavi 4.0 (2013-2017)

Gavi, the Vaccine Alliance is a public-private partnership that helps vaccinate more than half the world’s children against deadly and debilitating infectious diseases. Gavi's 2016-20 strategy had four goals, each supporting the overall mission: “to save children’s lives and protect people’s health by increasing equitable use of vaccines in lower-income countries”. Goal 1, known as the vaccine goal, was to "accelerate equitable uptake and coverage of vaccines". We provided early research to help operationalise this goal.

© UNICEF/UN0827358/Ayene

Project

A project conducted with colleagues from McGill and Gavi, the Vaccine Alliance, to design equity indicators to track global immunisation progress relevant to Gavi’s 4.0 (2016-2020) Sustainable Development Goals strategy.

Findings

Using up-to-date approaches to measure inequalities in vaccination coverage and quantify their determinants, we found that, within countries, inequalities in vaccine coverage were influenced by factors such as geographic location, socioeconomic status and maternal education levels.(1, 2)

Across countries, a range of factors including political stability, out-of-pocket spending, gender equality, government health spending, and national immunisation system performance shaped vaccine coverage and equity.(3)

Impact

Based partly on early results from our analysis, in its strategy for 2016-2020, which included a central focus on immunisation coverage and equity, Gavi lowered the wealth quintile benchmark (from 20 to 10 percentage points), and added indicators related to geographic equity and gender (maternal education). 

Research

1. Catherine Arsenault*, Sam Harper, Arijit Nandi, José Mendoza Rodriguez, Peter Hansen, Mira Johri. Monitoring equity in vaccination coverage: A systematic analysis of Demographic and Health Surveys from 45 Gavi-supported countries: Vaccine. 2017 Feb 7;35(6):951-959. https://doi.org/10.1016/j.vaccine.2016.12.041.

2. Catherine Arsenault*, Sam Harper, Arijit Nandi, José Mendoza Rodriguez, Peter Hansen, Mira Johri. An equity dashboard to monitor vaccination coverage for the Sustainable Development Goals, Policy and Practice : Bull World Health Organ 2017;95:128–134 http://dx.doi.org/10.2471/BLT.16.178079

3. Catherine Arsenault*, Mira Johri, Arijit Nandi, José M Mendoza Rodríguez, Peter M Hansen, Sam Harper. Country-level predictors of vaccination coverage and inequalities in Gavi-supported countries, Vaccine 35 (18), 2479-2488. 2017 Mar 29 https://doi.org/10.1016/j.vaccine.2017.03.029