National Immunization Program

Chapter 8: Monitoring, Supportive Supervision and Evaluation

Monitoring, supervision and evaluation are the key components of the National Immunization Program because it
emphasizes that all target population are immunized, vaccines are available, health workers are competent, the
service delivery network are functioning and the community is satisfied with the immunization program available
to them. In line with this, the DOH crafted a set of indicators to assess the different components of NIP such as
service delivery, governance financing and regulation.

The sources of data for the indicators will be coming from routine reports, surveillance data, administrative
reports, and special/research reports at each level of operation from the local to the national level. Active and
passive data collection will be utilized but the frequency of data collection and who will collect the data were not
mentioned in the manual of operations.

The collected data will be reviewed, consolidated and analyzed. Data interpretation and correlation were not
mentioned. The consolidated data will be stored in a computerized database for easy reference and retrieval. A
system will be also utilized to determine the completeness and timeliness of the report.

The Form 1, Sample for recording timeliness and completeness of monthly reporting from health facility to
municipal/city stated that if the surveillance system is good the percentage score should approach to 100%. The
only problem with that is the absence of a more objective scale to determine what score constitute excellent, very
good, good, fair, pass, or fail.

At the service delivery level, the following tools will be utilized for routine recording of immunization related
activities: immunization register, immunization card, defaulter register, stock record and refrigerator chart. On
page 182 section F, the refrigerator temperature char should be changed to refrigerator temperature chart.

The infant immunization card serves as a reminder for the parents and health care workers for the vaccination
schedule and immunization status of the infant. The immunization card would be better if it included Rota and PCV
vaccines to cover the entire vaccination program of the government.

The data collected should be synthesized into a summary form either manually or electronically for transmission to
the next higher administrative level. The manual emphasized that at the Barangay level the barangay midwife is
expected to accomplish this task, can other healthcare workers like nurses do this task?

On Page 189 Form 2. FHSIS Barangay Summary Table on Vaccine Preventable Diseases by Age Group and Sex
Section on Morbidity Disease report for the Month, the heading states vaccine preventable diseases but it seems
that other vaccine non preventable diseases like Genital ulcer, Gonorrhea, Syphilis etc are also enumerated.

The manual emphasized the use of immunization chart in displaying immunization coverage and other information
pertinent to the vaccinee. It also enumerated steps in preparing the chart in order to tract progress of the
immunization schedule.

The manual emphasized the importance of constantly monitoring performance throughout the implementation
period in order to assess its performance and implement corrective actions if problems arise along the way. Some
of the most common problems encountered are: poor access to service, poor utilization of services and its
corresponding corrective actions. Minor correction on Page 194 section H2 under number 1 it should be problems
are usually rather than problems can are usually.
Chapter 9: Health Promotion

There are numerous barriers inherent to the patient for the complete access to immunization services. Some of
the reasons were: lack of information, wrong information, and other sociocultural-political factors. Knowing these
barriers, the DOH came up with tools and strategies to foster behavior change in order to improve the health
seeking behaviors of the community. The module enumerated the most common barriers present in the
community that prevents them to access to NIP and remedies to overcome it. Minor corrections on the first
paragraph, please change behaviorbehavior to behavior and please omit the second. on section B number 2.

The module highlighted the desired behaviors among politicians, community leaders, health providers, managers
and the community that must be attained. The desired immunization related behaviors among mothers should not
only bring the eligible children during immunization campaigns but also during immunization days.

On page 207 section D3 desired behaviors, it emphasizes additional information gathering to understand the gaps
between desired and actual behavior and action. Two methods were used namely focused group discussion and in-
depth interview. The only critique for this part is the failure of the module to concretely identify what are the
desired/undesired behaviors to look or watch out for during the discussion.

Based on the identified weaknesses and barriers, appropriate behavior change strategies will be implemented to
promote positive change. These includes: communication, training, service improvement, enactment of policy and
other related activities.

Chapter 10: Mobilizing Community Support

The success of the immunization program doesn’t only depend on the community alone. The vaccine supply and
logistics play an essential role in sustaining adequate supply of vaccine among health centers. This module
emphasizes the need to identify the key stakeholders and potential partners to encourage them to participate in
mobilization of resources for immunization in the community.

The author highlighted that the ultimate success of the immunization program depends on the community
awareness of the situation and their support/participation. A more informed community will likely avail the
services yielding higher coverage.

The module enumerated the steps in successful integration and participation of the program. The first step would
be knowing the community then identify program aspects for community development and establish a link with
them. On page 219 section D.3 the spelling should be changed to community from communit.

The planning for the implementation of the program should be done with the stakeholders. The steps would be
first analyze the situation, identify measures to improve immunization coverage in the community and hold a
community planning meeting. Section E.3 it should be hold a community planning meeting only. Monitoring the
immunization services with the community should be done to assess the effectivity of the program.