This document summarizes the leadership, management, and coordination (LMC) of immunization programs in Ethiopia. It describes the organizational structure for immunization coordination including the Ministry of Health, regional health bureaus, the Interagency Coordinating Committee, technical working groups, and the National Immunization Technical Advisory Group. It highlights progresses made in planning, monitoring, advocacy, and human resources. It also outlines successes in coverage gains, challenges with turnover and data quality, and prospects for continued capacity building, research, and addressing equity issues.

1. Title: EPI Leadership, Management &
Coordination
By Yohannes Lakew (BSc. MPH)
November, 2019
Addis Ababa, Ethiopia.

2. Introduction to Immunization LMC in Ethiopia1
Progresses of LMC2
Successes of LMC3
Challenges of LMC4
Prospects of LMC5
Presentation Outline

3. Leadership, Management and Coordination (LMC)
LMC Programmatic Area:
• Capacity building or activities in support of the structures,
• Capabilities and processes to oversee, manage and
• coordinate immunization efficiently and effectively at the national
and sub national levels
• Focusing on areas with coverage and equity challenges –
• strategic and operational planning,
• monitoring of implementation and follow-up of those plans;
• and enhancement of performance management practices of the EPI

4. LMC
Immunization System
Health Service
System
External
Environment
The
Immunization
System
Environment
Immunization
Service Delivery
Vaccine Supply,
Quality &
Logistics
Surveillance
Management & Planning
Communications
Monitoring & Evaluation/Data
Capacity
Building
Life course
&
Integration
The
Immunization
System
Leadership
Monitoring
Coordination

5. INTRODUCTION
COORDINATIONS

6. MoH-MCHD
RHB’s
National
Team
The MCHD is the overall coordinating body of all EPI activities at the
national level; on policy formulation, Technical and financial support,
Standardization of materials, and updating strategies….
Regional Health Bureau’s also provide similar support to the lower
administration levels and health facilities.
Provides technical and financial support to the regions. Ensures updating
EPI implementation guidelines, strategies, standardization of training
manuals, job aids and any related supplies
Introduction of Immunization LMC

7. Organ gram of EPI Coordination

9.  Highest coordination platform: to assist, advise and support
to the Ministry;
Technical issues
Resource mobilization
Monitoring and Evaluation
 Chaired by the State Minister.
 Members are;
Heads of UN agencies,
 Directors NGOs,
 Directorates of MOH and
Civil Society organizations
ICC
Immunization coordination's forum

10. • Immunization Taskforce (TF),
the Technical arm and meets
regularly
• Three TWG under the TF, each
of which also meets every two
weeks.
• The Technical working groups
are;
Monitoring and
evaluation,
Logistics and
 Communication
technical working.
• Regional TFs: Provide technical
support on immunization
activities in the regions
ICC
TF
Cont …ICC Functional Structure

11. • FMOH-RHB Joint Steering Committee
• It is a platform that deals with key agendas of the nation in the
health sector.
• JSC is chaired by ministers of health,
• Members of JSC
Heads of RHBs and Core or relevant process owners
 relevant Directors
• Meetings which are held every two months.
• MCHD Director presents immunization updates in every
meeting
JSC
Cont …

12. • Scientific & technical advisory group on immunization
Policy, Strategy and Technical matters
• Independent and composed of high skilled
independent experts
• MoH will prioritize, and make final decisions on advices
provided by the NITAG.
NITAG
Cont …

13. PROGRESS
Planning
Monitoring
Advocacy and programme communication
Special strategy HR people (improve CE)

14. Planning is major tasks LMC as progresses,
• Comprehensive HSTP (Health Sector Transformation Plan) is a five years
core plan developed by FMOH in collaboration with RHBs and
developmental partners
• Currently, developing the second HSTP (2021-2025) is ongoing
• EPI cMYP (2016-2020): only a year remains and 2021-2025 will be
developed this year after end-year evaluation
• Annual Work EPI plan has been developed and derivate from cMYP
• Integrated Woreda based plan: annual plan developed at Woreda level
done
• EPI specific operational MP: developed at health facility catchment areas
focusing on mainly on session plans and vaccine requirements
2. Progresses of LMC

15. Monitoring a progress
• Continues Supportive supervision to strengthen immunization
ISS,
 RMNCHA,
EPI Program specific,
Partner on EPI
• Continues immunization program reviewing of indifferent settings
ARM,
RMNCHA,
 EPI,
Partner EPI review
Cont …

16. Advocacy and Programme Communications
• High level regional Advocacy has been done to strengthen regional
LMC,
• Immunization is key component of Woreda Transformation
Special support to the high risk groups
• Special support has been to pastoral regions to strengthen LMC
(HSSPD)
• Technical and financial support for low performing districts (PIRI)
Cont …

17. • Strong ICC and NITAG for advisory and technical decision making.
• Basic health service package is developed and immunization is
included.
• Positive trends in immunization coverage through the years
• Narrowing equity gaps by geography (Urban/Rural) and educations
through making the service to all
• Eradicating WPV2 and WPV3
• MNT elimination
• New vaccine introduction (HPV, MCV2…)
3. Successes of LMC

18. • High leadership turn over (At all levels)
• Limited quality data for decision making for leadership
• Suboptimal Planning and monitoring (lower level and others)
• Inadequate Immunization technical and finance support
• LMC performance Gaps among regions (agrarian, urban and
pastoral)
• Insecurity and presence of IDPs
4. Challenges of LMC

19. • Competing priorities due to the ongoing Humanitarian and nutrition
emergencies
• Inadequate horizontal and vertical effective communication
• Inadequate ownership and political commitment
• Difficulties in pulling together all recommendations from the
conducted review meetings and supportive supervisory reports
Cont …

20. • Developing Immunization policy and implementation Technical
guidelines
• Continues capacity building for EPI experts and managers on LMC,
Vacciniology, MLM,
• Evidence generation for decision making (research and innovations)
• Continues support to address Equity and Quality
• Improve communication, (advocacy, program communication,..)
• Design special strategies such as “ One health approach” for pastoral
Regions
• Immunization legislation for school register
5. Prospects of LMC

21. • Incorporating immunization updates in the basic/pre service training
• Reviewing immunization structures
• Strengthen regional ownership and political commitment
• Urban immunization strategy in the context of Universal Health
Coverage
• Strengthen Public private partnership
• Strengthening multi sectorial/ Stakeholders, partners and donors
coordination and integration
Cont …

22. Thank you