Gavi policy/ Strategy

updates
Regional Working Group
SEARO/WPRO

24 January 2017

www.gavi.org
Agenda

 Key elements related to Gavi support in 2017

 Vaccine and cold chain support

 HSS applications: the new Country Engagement Framework

 Leadership Management and Coordination

 Partner Engagement Framework

1
Focus on coverage, equity & sustainability
Countries are encouraged to place a strong emphasis on
coverage and equity in terms of:
• reaching the unreached “fifth child”
• “leaving no child behind”
• clearly articulating coverage and equity agenda and priorities

Sustainability should be integrated in the design and

implementation of all types of Gavi support, including:
• Consideration of longer term co-financing obligations
• Earlier stage transition countries to prioritise long-term change
• Later stage transition countries to focus on short term impact

2
Alignment with country plans
Gavi requirements for NVS applications:
• Vaccine introductions/ campaigns to be reflected in cMYP
• cMYP to be valid for at least one year from date of introduction
• Coordination Forum and NITAG to endorse proposal

When applying to Gavi support:

• Demonstrate how support addresses gaps identified in cMYP
• Demonstrate how government/ partner support contributes to
immunisation
• Demonstrate how Coordination Forum has been involved in the
application process

3
Basic functionality of Coordination Forum
The main objectives of the Coordination Forum (ICC or
equivalent) are to:
• Provide strategic direction, oversight and transparency

• Ensure a coherent view on strategy, planning, funding and

performance

• Promote complementarity and harmonisation of activities and

investments among stakeholders

To be eligible for support NVS and CCE Optimisation

Platform support, Gavi requires countries to ensure a basic
functionality of their Coordination Forum.

4
Grant performance framework
Grant performance framework is a central element of Gavi
support

Contains inputs, activities / processes, outputs and

outcomes based on two types of indicators:
• Core indicators – mandatory, based on standard definitions
• Tailored indicators – additional, to enable monitoring of the
complete results chain for each specific grant

Additional tailored indicators should be included at the time

of each application.

5
 Progress of indicators against targets in 2015

India 29 3 2 6
Indonesia 7 2 1
SEARO

Bangladesh 10 3 3 2
DPRK 11 4 2 5
Nepal 4 3 2 2 1
Timor-Leste 4 5 3 2
Myanmar 4 2 2 6
Bhutan 2 4 1
Sri Lanka 2 2 3 1 1

Viet Nam 14
Cambodia 9 4 2 2
Papua New Guinea 6 1 3 2
WPRO

4
Lao PDR 4 6 2 2 1
Solomon Islands 4 7 10 2
Kiribati 2 6 1 2 2
Mongolia 5 1
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Met Target 90-99 70-89 BELOW 70 NO PROGRESS

6
Agenda

 Key elements related to Gavi support in 2017

 Vaccine and cold chain support

– HPV support

– Measles support

– Cold Chain Equipment Optimisation Platform (CCEOP)

 HSS applications: the new Country Engagement Framework

 Leadership Management and Coordination

 Partner Engagement Framework

8
The New Gavi HPV Programme: HPV 2.0

Countries can apply:

• Directly for national introduction or implementing a phased national

introduction;

• For support for multi-age cohort HPV vaccinations (9-14 years of

age) in year one of introduction

9
HPV introduction- Gavi support

10
PROPOSED FINANCIAL AND VACCINE SUPPORT FOR
MULTI-AGE COHORT VACCINATION

Routine Cohort (e.g. 9 yrs)

Vaccines Support Co-financing

Vaccine
$2.40 / targeted girl
Introduction Grant
(VIG)

Additional Cohorts (e.g. 10-14 yrs)

Vaccines Support No Co-financing (Gavi supported)

0.65$/ 0.55$/0.45$ / targeted girl

Operational Cost (aligned to new HSIS policy per the
transitioning stage)

11
Agenda

 Key elements related to Gavi support in 2017

 Vaccine and cold chain support

– HPV support

– Measles support

– Cold Chain Equipment Optimisation Platform (CCEOP)

 HSS applications: the new Country Engagement Framework

 Leadership Management and Coordination

 Partner Engagement Framework

12
Objective of the new measles support

Main objective of the new approach for Gavi measles

support:

 Implementation of a comprehensive strategy for

measles-rubella control

 Increasing routine immunisation coverage and

decrease over-reliance on campaigns

 Improving the quality of campaigns

 Improving sustainability of MCV support

13
New Measles and Rubella strategy

The new Measles and Rubella Strategy provides comprehensive support for
the following:

 MR Catch-up campaigns, when followed by or coincident with MR introduction

 MCV2 and MR vaccine introduction into routine immunisation through co-

financing

 Measles and MR follow-up campaigns

 Outbreak response fund (managed by the Measles and Rubella Initiative

(M&RI)

To be eligible:
 Countries must be fully financing MCV1 with domestic resources

 For MR support, the country must have a DTP3 coverage ≥70% and either
– Routine MCV1 coverage ≥ 80%
– Most recent measles campaign coverage ≥ 80%

14
New measles support

15
Agenda

 Key elements related to Gavi support in 2017

 Vaccine and cold chain support

– HPV support

– Measles support

– Cold Chain Equipment Optimisation Platform (CCEOP)

 HSS applications: the new Country Engagement Framework

 Leadership Management and Coordination

 Partner Engagement Framework

16
Gavi support for CCE Optimisation Platform

• Provides support to improve cold chain systems, complements efforts to

Nature of strengthen other supply chain strategy “fundamentals”
support
• Platform provides support for purchase of eligible device and service

• Average GNI pc for the past three years ≤ US$1,580 (Gavi standard eligibility)
Eligibility • Accelerated transition countries with at least two full years from the date of review
by the IRC

• Country joint investment will be funded by national budget, bilateral funds, or

Gavi financial support (e.g. HSS grant)
Funding &
• Payment from Gavi & country is required before release of purchase order
duration
• Support will be phased for a maximum duration of 5 years

• Accelerated transition countries (with less than two full years from date of
review) and fully self-financing countries are not eligible for joint
Other investment, but have access to procurement services supporting the
platform by contacting UNICEF Supply Division directly.

17
17
Application process

Countries to submit NVS applications (w/o HSIS) through Gavi’s online

country portal accessed via: https://portal.gavi.org

Countries to submit CCE Optimisation Platform support (w/o HSIS)

applications via email to: proposals@gavi.org

18
18
Application timelines in 2017

Round 1 Round 2 Round 3

Cut-off for 18 January 3 May 2017 8 September
submission of 2017 2017
applications

IRC application 8-17 March 14-23 June 3-17 November

review dates 2017 2017 2017

Gavi decision by June 2017 by November by March 2018

2017

Country applications will be accepted on a rolling basis. If a country

misses a deadline for cut-off date for submission, the application will be
reviewed at the subsequent IRC meeting.

19
19
Agenda

 Key elements related to Gavi support in 2017

 Vaccine and cold chain support

 HSS applications: the new Country Engagement Framework

 Leadership Management and Coordination

 Partner Engagement Framework

20
Country Engagement Framework (CEF) – New design principles

Key building
From To – “Our new vision”
blocks

• Paper-based application • Increased dialogue at the priority setting

Application development process phase aligned to national process and
process leveraging existing information
• Focus on implementation

• Separate proposals, distinct • One request for new support spanning the
budgets & work plans for duration of the country’s upcoming strategic
Proposal each type of support period
integration • One integrated operational budget and
workplan for all Gavi support, updated
annually aligned to national processes
• Separate reviews for each • Holistic review of portfolio of support, with
Review
type of support by IRC, based differentiated mechanisms for review
mechanism
in Geneva

Process • Complex processes and • More efficient processes (better use of

efficiency guidelines information, simplified guidelines)

Strengthened Secretariat and partner engagement throughout

21
21
 Initial phasing-in of the new
approach in 5 countries - 2016
Implementation timeline of the new approach Continued learning and
phasing-in across other
countries - 2017

• Chad
• Guinea Bissau
• Niger • Bangladesh
• Haiti • Nigeria

• Papua New Guinea

• Guinea • Comoros
• Liberia
• Sierra Leone
• Togo • Malawi

Gavi will work with all countries being phased-in to the new approach on a
country-by-country basis

22
22
 Preliminary 2017 CEF timelines for Bangladesh & Papua New
Guinea Key milestones

2017

Countries Activities J F M A M J J A S O N D

I. Upfront engagement
Programme capacity assessment
World Bank appraisal mission
Bangladesh
II. Review

III. Finalization of documents & budget

IV. Approval & disbursement of funds

I. Upfront engagement Elections

Discussions with Global Fund
Country dialogue workshop
Papua New PSR development
Guinea
II. Review
III. Finalization of documents & budget
IV. Approval & disbursement of funds

23
23
Role of Alliance partners
Country and regional

• Desk review of background documents: review existing documents and

prioritisation of issues to be discussed during the dialogue workshop
• In-country workshop: Participate in the workshop, and provide support
throughout the dialogue process to ensure robust process
Upfront PSR
stage • Support to countries in developing key documents;
• Programme Support Rationale
• Budget and workplan (aligned with the objectives and activities in the PSR)
• Grant Performance Framwork

• Regular reporting: support regular reporting on the portal and offline (including
Regular updating the GPF)
monitoring, • Joint appraisal: participate in joint appraisal
reporting,
• Budget and workplan: support updates to the budget and workplan
renewal

24
24
Agenda

 Key elements related to Gavi support in 2017

 Vaccine and cold chain support

 HSS applications: the new Country Engagement Framework

 Leadership Management and Coordination

 Partner Engagement Framework

25
Objective, scope and principles of the LMC approach

Scope

Two main areas of focus

1 Government EPI teams or departments (national, and
subnational where devolved)

2 National coordination forums (e.g. ICCs/HSCCs)

Guiding principles
 Interventions based on country specifics, needs and demand
 Support new, impactful approaches, complementing existing interventions
 Implemented mostly through (expanded) partners

26
 EPI TEAM

1 ‘Menu’ of EPI team interventions

‘Menu’ of interventions
(depending on country context and need)

New guidelines to support adequate EPI team capacity

through HSIS support Support for PNG
under discussion
EPI management partners – a long-term embedded peer-coach Sequential roll-out
to the EPI team with strong managerial/ health experience planned in key
countries in 2017

Enhance EPI performance management practices through

data-driven tools, performance dialogues and follow-up action

Interactive EPI management training programme based on

EPI managers’ daily realities and with links to technical areas

To be developed from
Exchange visits between EPI teams to observe best-practices 2017 onwards
in the management of high-performing programmes

vJan 2017 27
 COORDINATION FORUMS

2 ‘Support package’ for Coordination Forums (ICCs/HSCCs)

▪ Guidance document with requirements and recommendations

New developed and part of new NVS/CCEOP application guidelines
guidance

▪ To address gaps in functionality of Coordination Forums (CF)

Training/TA
▪ Technical support to Coordination Forums provided by partners (~15
countries mainly from AFRO/EURO/EMRO in first wave)
▪ Toolkit on www.gavi.org/support/coordination/
▪ Templates (TOR, agenda, minutes) ▪ Self-assessment ▪ Dashboard
Toolkit on
Gavi
website

vJan 2017 28
 COORDINATION FORUMS

2 Requirements for Coordination Forums (ICCs/HSCCs)

▪ Members: Full range of voices in EPI with decision-making authority

• Chaired by senior MoH decision maker (e.g. Minister or PS)
• EPI manager and relevant MoH departments (e.g. planning/HSS)
• Relevant ministries (e.g. MoF)
• Key donors, (implementing) partners and CSOs most active in immunisation

▪ Mandates:
• Review and approve applications for Gavi support, grant renewals and PEF
submissions; ensure their alignment with strategic and operational plans
• Ensure broad and participatory process in application development
• Oversee progress of Gavi investments based on discussion and approval of Joint
Appraisal

▪ Governance best practices:

• TOR containing key dimensions of how Coordination Forum should function (e.g.
mandate, meeting frequency, membership selection, decision making procedures,
role of a CF Secretariat)

vJan 2017 29
Agenda

 Key elements related to Gavi support in 2017

 Vaccine and cold chain support

 HSS applications: the new Country Engagement Framework

 Leadership Management and Coordination

 Partner Engagement Framework

30
Objective of the session

 Remind the main objective of the PEF

 Discuss implementation progress in 2016

 Review request for 2017

 Discuss role of regional working groups on PEF

31
PEF is a new paradigm

• PEF is a new model to fund

Technical Assistance to
countries
• Replaces the Business Plan
model applied in 2011-2015

• Focuses on country level

capacity and transfer of skills
• Seeks to leverage the
comparative advantage of
partners to boost Partners providing TA
immunisation outcomes in
countries

32
32
 Introduction

Reminder of the key principles of the PEF

 Country focus:
 Building TA plan on the basis of country needs/ request
 Focus on hands-on support and capacity building
 Clear activities and milestones in each country
 Country-focused reviews going up to global level

 Clarified accountability :
 New accountability framework
 Measurement of outcomes at country level

 Differentiated approach:
 Prioritisation of 20 focus countries
 Moving away from “one-size-fits-all”, moving towards tailoring TA to target
high-impact interventions

 Stronger engagement of Alliance partners at country and regional levels

33
 PEF Functions

A number of ‘PEF Functions’ to implement in all countries

ATT Area PEF Function
1) Comprehensive immunization plans
2) Holistic plan to improve equity of immunisation with the following specific action:
i) Equity assessments undertaken […]
Country
ii) Countries have updated their cMYP, […]
Planning,
Management, 3) Every country acts on the annual plans to address low coverage, inequity […]
Immunisation Systems Delivery

and Monitoring
4) Countries develop feasible, sustainable and quality HSS proposals […]
5) For each country identified as not having timely implementation of grants, rapid […]
6) Countries achieve more than 80% of indicators in Performance Framework […]

Can you please include in there who is

1) The WUENIC methodology is updated, estimates are available annually […]*
2) Countries meet data quality and survey requirements […]
Data accountable for each PEF function
3) Partners ensure the quality and relevance of sentinel surveillance activities, […]*
(WHO/ UNICEF)?
4) 30 countries […] meet minimum standards for vaccine safety surveillance […]
1) Countries ensure functioning of their supply chain […]
2) Countries receive timely support from partners to address problems in stock management
Supply Chain
3) Countries submit timely reporting of in-country stocks of Gavi-supported vaccines […]
and Vaccine
Wastage 4) Countries reduce vaccine wastage rate including
i) Reduction of wastage through adoption and implementation of adequate policies […]
ii) Closed vial wastage at each level of the supply chain below or equal to 1%
a. Countries ensure that all measles SIAs are undertaken […]
Vaccine Uptake b. Countries introduce vaccine within 3 months of the agreed date […]
c. Countries have achieved 90% of reference coverage 2 years after intro […]
a. Countries fulfil their co-financing commitments (within a year of being due)

Sustainability and b. Countries increase domestic budget allocated to immunisation […]

Transition c. Countries are on track for successful transition […]
d. Countries have a transition plan endorsed before entering accelerated phase […]

34
 Final 2016 PEF budget allocation for TCA in
SEARO/WPRO countries – breakdown

WHO CDC
Avg. $1.20 Mio Avg. $1.09 Mio Avg. $0.36 Mio UNICEF World Bank
2
$Mio

1.57

1.11
0.95 1.06
0.20 1
0.83 0.09 0.45 0.78 0.76
0.22
0.20 0.20
0.39 0.34
0.40 0.28
0.27 0.27 0.06 0.32 0.30 0.30
0.62 0.61 0.61 0.20
0.13
0.3
0.43 0.23 0.16
0.31 0.29
0.20 0.14 0.17 0.00 0.00 0.00 0.00
0.09
Timor Leste

Nepal

Kiribati
India

DPRK
Solomon Islands

Cambodia

Bhutan
Indonesia

Myanmar

Lao PDR

Mongolia
Bangladesh
PNG

Vietnam

Self-financing
Tier 1 & 2 countries Tier 3 countries
countries 35
 2016 TCA

Milestone reporting for 20 PEF priority countries to track TCA progress

Example: Madagascar
TCA Milestones November 2016

• Development of a cold chain platform proposal,

proposal made available

• Performance Surveillance PFA indicator improved

• Report: Strengthen coordination and performance

between MoH, ICC and Partners; Capacity build to
improve HSS planning, management Improve
vaccine C&E; Engage CSOs to strengthen
community linkages with immunization services
Strengthen M&E

The Partner Portal:

Centralized space for
all partners to report
on activity progress
transparently

36
2016 PEF TCA overview, Tier 1 & Tier 2

Funding Staffing Milestones

2016 TCA 2016 TCA 2016 TCA

funds 2016 TCA staff staff Milestones
disbursed funds budgeted recruited Milestones on track
Country Partner (k$) utilised (%) (#) (%) (#) (%)

UNICEF 877 42% 11 100.00% 3 100.00%

India
WHO 433 22% -- -- 4 50.00%

UNICEF 70 0% -- -- 1 0.00%
Indonesia
WHO 427 74% -- -- 3 33.33%

UNICEF 360 93% 2 100.00% 5 80.00%

WHO 302 100% 3 100.00% 3 100.00%

Myanmar
World Bank 200 100% -- -- 1 100.00%

CDC 87 100% 1 100.00% 5 100.00%

UNICEF 394 40% -- -- 1 0.00%

PNG
WHO 430 62% 1 0.00% 3 0.00%

Total $3,380,111 52% 18 95% 29 62%

37
 2016 TCA

Performance of partners in country (PEF Tier 1) [as of Nov 2016]

Milestones
completed
(%)
Progress of partners in country, by milestones completed and cash utilization
125 Unclear how milestones on High cash usage; strong
track given cash usage self-reported progress UNICEF
India-UNICEF Chad-UNICEF WHO

100 DR Congo-UNICEF

Afghanistan-WHO Ethiopia-WHO

Indonesia-WHO
75 Uganda-UNICEF Uganda-WHO
Can you pleaseDROnly keep Nigeria-UNICEF
Congo-WHO
SEARO/
Ethiopia-UNICEF
WPRO countries and put all tier 1 and
Pakistan-WHO

50 2 on one page?
India-WHO Kenya-WHO

Indonesia-UNICEF Pakistan-UNICEF

25 Kenya-UNICEF
Nigeria-WHO
Afghanistan-UNICEF

0 Chad-WHO

Poor performance Milestones not on track,

despite high fund utilization
-25
0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95 100 105 110 115 120

Cash utilization (%)

Legend

= $500,000 in funds budgeted

38
Source: Those with 0% milestones completed may not have reported on those milestones
 2016 TCA

Performance of partners in country (PEF Tier 2) [as of Nov 2016]

Milestones
completed
(%)
Progress of partners in country, by milestones completed and cash utilization
125
UNICEF
Unclear how milestones on High cash usage; strong WHO
track given cash usage self-reported progress
100 South Sudan-UNICEF Myanmar-WHO Myanmar-UNICEF

Yemen-UNICEF

CAR-UNICEF
75 Madagascar-WHO

Niger-WHO Haiti-WHO Mozambique-WHO

Madagascar-UNICEF
PNG-WHO
50 Somalia-UNICEF Haiti-UNICEF

Niger-UNICEF Somalia-WHO
Mozambique-UNICEF

25
CAR-WHO

0 South Sudan-WHO PNG-UNICEF

Yemen-WHO
Cash utilization (%)
Milestones not on track,
Poor performance
despite high fund utilization
-25
0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90

Legend

= $500,000 in funds budgeted

39
Source: Those with 0% milestones completed may not have reported on those milestones
2016 PEF TCA overview, Tier 3

Funding Staffing
2016 TCA
2016 TCA funds funds utilised 2016 TCA staff 2016 TCA staff
Country Partner disbursed (k$) (%) budgeted (#) recruited (%)

UNICEF 152 75% 1 100.00%

Bangladesh
WHO 95 90% 0.8 100.00%
UNICEF 90 52% 0.5 100.00%
Cambodia
WHO 122 95% 0.5 100.00%
UNICEF 250 68% 1.5 100.00%
Lao PDR
WHO 206 91% 1.5 100.00%
UNICEF 158 87% 3 66.67%
Nepal
WHO 64 77% -- --
UNICEF 257 74% 1 100.00%
Somolon Islands
WHO 41 77% -- --
UNICEF 189 26% 1 100.00%
Timor-Leste
WHO 216 89% 0.9 100.00%
UNICEF 185 63% 0.5 100.00%
Vietnam
WHO 143 92% 0.5 100.00%

Total $2,167,620 75% 13 92%

40
 2017 TCA
Each 2017 TCA proposal was compiled through a single transparent
document across partners, for each country

Partners had visibility on the activities

and budgets proposed by one another to
promote transparency and collaboration

To submit the proposals, representatives

from each partner were asked to sign-off
as confirmation that the activities were
final. This final validation locked the
spreadsheet for further editing by that
partner and sent a notification e-mail to
the PEF team.

The final validation step also encouraged

coordination between our partners and
country EPI teams by leaving a space for
MoH representatives to sign-off after
viewing the TCA proposal. 41
 2017 TCA

Overview of submission process (Tier 1/2)

Proposal MOH
Tier Country submitted approved

Afghanistan  
India  
Can you please update this table with
• Submissions camejust the SEARO/
relatively late WPRO
Pakistan  2 and3) (close to the deadline) which was
Indonesia  
detrimental to exchanges between
Ethiopia  
Tier 1 partners and MoH
Kenya  
Uganda  
Nigeria   • Most countries submitted proposals in
Congo, DR   line with the guidelines and quality
Chad   milestones
Myanmar  
PNG   • An additional iteration was required
Somalia   with countries which did not abide by
South Sudan  
the budget guidelines and had poor
Mozambique  
Tier 2 quality milestones
Madagascar  
Haiti  
Yemen   • Variable level of involvement of the
Niger   MoH in the whole process
CAR  

42
 2017 TCA

Total requested 2017 TCA support, totaling ~$62M of total support

$M 2017 PEF TCA, by country for all partners ($M)

3.5
3.3
Can you please update this
Expanded Partners graph
World Bank and
CDCjust UNICEF
include the
WHOSEARO/
3.0
2.7
countries
2.6

2.5
2.5 2.4
2.3 2.3 2.3
2.2

2.0
2.0
2.0 1.9

1.7

1.5 1.4
1.3 1.3 1.4 1.3
1.3
1.1
1.0
1.0 0.9 0.9
0.9 0.9 0.9
0.7 0.8 0.7 0.7
0.7 0.7
0.6 0.6 0.6 0.6
0.6 0.6 0.6 0.6 0.6
0.5 0.5
0.5 0.5
0.5 0.4 0.4
0.3 0.3
0.4
0.4 0.3
0.3 0.3 0.3 0.3 0.3
0.2 0.2 0.2 0.2
0.2 0.1
0.1 0.1 0.1 0.1
0.0
0.0
Papua New Guinea

Sierra Leone
Uganda

Georgia
Yemen

Haiti

Sudan

Nepal
Cameroon

Mauritania

Togo

Moldova
Pakistan

Chad
Nigeria

Djibouti

Burkina Faso
Senegal

Azerbaijan

Guyana
Timor-Leste

Eritrea

Mali

Guinea-Bissau

Bolivia
Cuba
Ethiopia

Tanzania

Lesotho
Rwanda

Cote d’Ivoire

Nicaragua

Guinea

Ghana
Gambia
India

South Sudan
Somalia

Liberia

Malawi

Burundi
Kenya

Mozambique
CAR

Solomon Islands

Cambodia

Tajikistan
Comoros

Honduras
Angola

Zambia
Afghanistan

Indonesia

Niger
Myanmar

Uzbekistan

Kyrgyzstan

Sao Tome
Congo Republic

Sri Lanka
Zimbabwe

Armenia
Benin
Bangladesh
Congo, DR

Madagascar

Lao PDR

Vietnam
Note: full details on 2017 TCA proposals available in separate excel document

For Core Partners, includes requests from partners (WHO / UNICEF), which may be over budget; excludes requests for additional TA from Gavi Senior Country Managers,
Gavi functional teams (e.g. Vaccine Implementation, Data).

For Expanded Partners, only includes currently contracted amounts (i.e. does not assume full utilization of funds currently enveloped for: Financial Management ($4.5M 43
budget), Coverage and Equity ($3.0M budget), Country Support ($1.0M budget), and Leadership, Management, and Coordination ($4.5M budget)).
 $M

1.0
1.5
2.0
2.5
3.0
3.5

0.0
0.5
Pakistan

2.0
1.9
Congo, DR

1.8
Ethiopia
Kenya
Afghanistan
Chad

1.8 1.8 1.7

1.6
Nigeria
India

1.6 1.5
Uganda

0.8
Indonesia
Yemen
CAR
South Sudan

1.2 1.1 1.1

Papua New Guinea
Somalia
Haiti
Madagascar

1.1 1.0 1.0 1.0

Niger

1.0 1.0
Mozambique

0.8
Myanmar
Timor-Leste
Lao PDR
Angola
Cameroon

0.6 0.6 0.5 0.5

Sudan
0.5 0.5
Djibouti
Rwanda
Zambia
e this graph and just include the SEARO/ WPRO

Mauritania
0.3
0.4 0.4 0.3

Solomon Islands
Comoros
Cote d’Ivoire
Senegal
0.3

Nepal
Zimbabwe
0.3

Liberia
0.3 0.3 0.3 0.3 0.3

Burkina Faso
Togo
0.3

Sierra Leone
Cambodia
Bangladesh
0.3 0.3 0.3

Malawi
Eritrea
0.3 0.3

Uzbekistan
Tajikistan
Burundi
0.3 0.3 0.3

Georgia
Armenia
0.3 0.3

Kyrgyzstan
Benin
0.3

Mali
Tanzania
0.3 0.3 0.3 0.2

Nicaragua
2016 PEF TCA budget, by country for WHO / UNICEF ($M)

Azerbaijan
0.2
0.2

Guinea-Bissau
Lesotho
0.2
Reminder: overview of 2016 PEF TCA budget for WHO/UNICEF

0.2

Guinea
Bolivia
0.2

Cuba
Ghana
Guyana
0.2 0.2 0.1

Gambia
Sao Tome
0.1 0.1 0.0

Congo Republic
0.4

Vietnam
Honduras
Moldova
Sri Lanka
0.0 0.0 0.0

44
2017 TCA
 $M

1.0
1.5
2.0
2.5
3.0
3.5

0.0
0.5
Pakistan

2.0
1.9
Congo, DR
Ethiopia

1.8 1.8
Kenya

2.0
Afghanistan

1.7
Chad

1.6
Nigeria
India

1.6 1.5
Uganda

0.8
Indonesia

2.0
Yemen

1.8
CAR

1.1
South Sudan
Papua New Guinea

1.1
1.0
Somalia
Haiti
Madagascar

1.1 1.0
1.0
Niger

1.0
Mozambique

1.1
Myanmar

0.7
Timor-Leste
Lao PDR
1.3

Angola

0.6 0.5
Cameroon
Sudan
0.5 0.5
Djibouti
0.7

Rwanda
Zambia 0.4 0.3
Mauritania
countries

Solomon Islands
0.4

Comoros
Cote d’Ivoire
Senegal
0.3
0.3 0.3 0.3

Nepal
0.9

Zimbabwe
Liberia
Burkina Faso
Togo
0.3

Sierra Leone
Cambodia
0.3 0.3 0.3 0.3

Bangladesh
Malawi
0.3 0.4

Eritrea
Uzbekistan
Tajikistan
0.3 0.3 0.3

Burundi
0.5 0.4

Georgia
0.3

Armenia
Kyrgyzstan
Benin
Mali
2016
0.4

Tanzania
0.3 0.3 0.3 0.2

Nicaragua
Azerbaijan
0.3

Guinea-Bissau
Lesotho
0.2 0.2
0.7

Guinea
Bolivia
Cuba
0.2 0.2
0.2

Ghana
0.1

Guyana
0.2

Gambia
2016 PEF TCA budget plus 2017 additional requests, by country for WHO / UNICEF

0.1

Sao Tome
Summary of WHO/UNICEF increase in budget request, relative to 2016

0.3

Congo Republic
Vietnam
0.4

Honduras
Moldova
Addt’l spend requested above budget

Sri Lanka
0.0 0.0 0.0

45
2017 TCA

Can you please update this graph and just include the SEARO/
Question for discussion at Regional Working Group

 What are the best practices/ lessons learnt in providing TA to

countries in the region?

 What are the countries that are facing challenges in

implementing TA? What are the major bottlenecks and what
way forward

 What are the countries that require dedicated attention from the
regional level in 2017?

 What should be the formal role of the RWG in the PEF

process?

46
2017 PEF TCA overview, Tier 1 & Tier 2

Funding Milestones

2017 TCA funds

Country Partner proposed ($) Milestones (#)

UNICEF $947,494 5
India WHO $618,001 2

CDC $147,586 3

UNICEF $216,000 6
Indonesia
WHO $635,152 12

UNICEF $388,800 13
Myanmar WHO $430,836 8

World Bank $150,000 2

UNICEF $416,713 2
PNG WHO $659,120 7

CDC $204,702 1

Total $4,814,404 61

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2017 PEF TCA overview, Tier 3

Funding Milestones

2017 TCA funds

Country Partner proposed ($) Milestones (#)

UNICEF $164,656 8
Bangladesh WHO $137,329 6

World Bank $200,000 2

UNICEF $107,395 4
Cambodia
WHO $196,580 12

UNICEF $270,000 4
Lao PDR
WHO $293,180 8

UNICEF $266,800 10
Nepal
WHO $90,950 6

UNICEF $277,564 10
Somolon Islands
WHO $144,450 12

UNICEF $299,826 8
Timor-Leste
WHO $267,440 8

UNICEF -- --
Vietnam
WHO -- --

Total $2,716,170 98

48
2017 TCA overview PEF Priority Countries, India

Activities Programmatic area Partner

Support the implementation and national monitoring of Mission Indradhanush HSS UNICEF
Support planning, preparedness assessment, and roll out of Pneumococcal and Vaccine
UNICEF
Rotavirus vaccine in identified states Implementation
Vaccine
Support the implementation of a high quality MR SIA UNICEF
Implementation
Supply chain and
Support national EVM assessments UNICEF
vaccine wastage
Address immunization equity in states with low immunization coverage HSS WHO
Provide technical assistance to understand the disease and economic burden of
Data CDC
cholera in the State of West Bengal
Vaccine
STOP MR consultant CDC
Implementation

49
2017 TCA overview PEF Priority Countries, Indonesia
Activities Programmatic area Partner
Analyze caregiver KAPB regarding measles, rubella, and JE Demand Generation UNICEF
Develop communication strategies for the MR campaign, JE campaign, HPV
Demand Generation UNICEF
demonstration project and IPV introduction
Early identification of rumours during MR campaign, JE campaign, HPV
Demand Generation UNICEF
demonstration project and IPV introduction
Country Planning,
Support MoH in monitoring the first phase of the MR campaign UNICEF
Management, and Monitoring
Supply chain and vaccine
Strengthen technical capacity of health workers UNICEF
wastage
Supply chain and vaccine
Temperature monitoring of selected cold stores UNICEF
wastage
Supply chain and vaccine
Develop cold chain equipment rehabilitation and expansion plan UNICEF
wastage
Timely and efficient implementation of GAVI Transition plan 2017-2018
Accelerated Transition WHO
activities under CESAP
Technical assistance towards a successful roll out of MR, HPV, JE
Vaccine Implementation WHO
introduction and continue support for IPV implementations
Identify un-/under-vaccinated children using MR campaign during MR SIA in Country Planning,
WHO
pockets of low coverage Management, and Monitoring
Conduct PIE for IPV on possible new vaccine introductions such as Rota, Country Planning,
WHO
PCV Management, and Monitoring
Leadership, Management, and
Capacity-building of provincial EPI managers focused on micro-planning WHO
Coordination
Measles Rubella laboratory capacity strengthened Data WHO

50
2017 TCA overview PEF Priority Countries, Myanmar
Activities Programmatic area Partner
Support communication interventions in the following areas: a) C4D; b) demand
Demand Generation UNICEF
generation; c) communication plan of action
Country Planning,
Implement recommendations from desk review on coverage and equity Management, and UNICEF
Monitoring
Roll-out immunization supply chain data use manual and capacity-building on Supply chain and
UNICEF
generation and use of immunization supply chain data vaccine wastage
Assessment of progress, update, and facilitate the implementation of 2015 EVM Supply chain and
UNICEF
improvement Plan vaccine wastage
a) Strengthen cold chain equipment inventory management; b) Strengthen
Cold chain equipment UNICEF
mechanisms for repair and disposal of old equipment
Follow up on implementation of 2016 PEF TCA Supply Financing activities,
Financial Management UNICEF
including establishment of Vaccine Independence Initiative (VII)
Country Planning,
Plan, implement, and monitor strategy targeted for hard to reach area with focus on
Management, and WHO
migratory and peri-urban
Monitoring
Technical support for improvement of data quality Data WHO
Technical support for new vaccine introductions, JE catch-up campaign and Vaccine
WHO
Preparation for HPV application to GAVI Implementation
Technical support for planning, implementation, M&E and reporting of HSS
HSS WHO
interventions supported by GAVI HSS 2 proposal
Develop a plan for improving birth registration, train health personnel involved with
Data World Bank
immunization and birth registration, sensitize women on birth registration

51
2017 TCA overview PEF Priority Countries, Papua New Guinea

Activities Programmatic area Partner

a) Update the cold chain facilities and equipment inventory;
Supply chain and
b) Develop a nation-wide Cold Chain Rehabilitation and Expansion Plan UNICEF
vaccine wastage
c) Facilitate and monitor installation, repair and maintenance of vaccine fridges
Develop a proposal for combined HSS2 /Transitional grant to be submitted to Gavi
HSS WHO
for approval
Leadership,
Improve capacity of the National and Sub National EPI Team in all aspects of EPI
Management, and WHO
planning, implementation, and monitoring
Coordination
Country Planning,
Implementation of the Special Integrated Routine EPI Strengthening Programme
Management, and WHO
(SIREP) in low performing provinces and districts
Monitoring
Support the EPI program at the national and sub national level to ensure data quality
Data WHO
analysis and management
a) Strengthening VPDs’ surveillance, b) Sentinel surveillance for Japanese
Vaccine
Encephalitis, Congenital Rubella Syndrome (CRS), Rota Virus diarrhea, Invasive WHO
Implementation
Bacterial Meningitis and Typhoid Fever
Vaccine
Strengthen AFP surveillance WHO
Implementation
Vaccine
Strengthen immunization safety surveillance at national & sub-national levels WHO
Implementation
STOP MR consultant Data CDC

52
Evaluation of Technical
Assistance (TA) provided
through the Partners’
Engagement Framework
(PEF)
Status update for RWG

www.gavi.org
53
Why is this evaluation being conducted?

Gavi Board requested evaluation of the effectiveness and efficiency of

TA provided to countries by Gavi partners

Examine TA provided under the Targeted Country Assistance (TCA) of

the PEF to promote learning and provide insights to help Gavi improve
the TCA model and prepare for future strategies

▪ Independent, prospective (2016-2020) evaluation

– Assess the relevance, effectiveness and efficiency of TA provided to the 20 priority
countries by core and expanded partners as part of Gavi’s 2016-2020 strategy
▪ Deloitte was selected by an adjudication committee to conduct this evaluation

54
54
Objectives and main evaluation questions

The evaluation aims to examine the TA provided under Targeted

Country Assistance (TCA) component of PEF (2016-20)

Evaluation Question 1: How

Domain 1: effective and efficient is the TCA
TCA Planning planning process?
Assessment
Evaluation of the
TCA component of Domain 2: Evaluation Question 2: Which TA
PEF in Tier 1 & Tier TCA Delivery models are most effective and
2 countries Assessment efficient, and why?

Domain 3:
Evaluation Question 3: To what
Outcome
extent does TA contribute to
Objectives: Assessment
improvements in the national
1. Understand the extent to which the new TCA model has immunization programme?
incorporated the principles of country ownership, transparency,
and accountability

2. Assess in what ways the new model has shaped the delivery of
TA and improved its effectiveness

3. Examine the contributions of the TCA to the larger national

immunisation programme

4. Identify the internal and external factors that affect TA delivery

and outcomes
55
55
Snapshot of TA evaluation approach

In-depth Interviews. Tier 1

Semi-structured countries
360 Online Survey: interviews to gather
Ongoing assessment insights on TA planning,
of the scope and delivery and outcomes
quality of TA delivery

All Tier 1 &

Tier 2 Mixed methods
countries approach will be
employed across all
3 evaluation Observations of
JA and other TA
Desk Reviews/ domains planning
Document processes in
4 case study
Reviews country Tier 1
Systematic countries
review of key
documents (DRC, Nigeria,
Afghanistan,
Ethiopia)
After Action Reviews:
Facilitated group discussions
following key TA planning
sessions

56
56
Status and focal points

▪ November 2016: Gavi DCEO sent a letter to the MoH and country Alliance partners of
Tier 1 and Tier 2 countries informing about the evaluation
▪ Data collection ongoing:
– desk review
– interviews (SCMs, EPI and HQ and country partners (core and expanded) in Tier 1 countries
– Direct observations in 4 case-study Tier 1 countries (Ethiopia, Nigeria, DRC, Afghanistan)
▪ 360° online survey launched as a pilot in 4 case-study countries (Ethiopia, Nigeria,
DRC, Afghanistan)
▪ February 2017: Presentation of preliminary results to PEF management team​
▪ End February 2017: Delivery of the DRAFT baseline report
▪ Q2 2017: Dissemination of findings of baseline report

Gavi focal points

▪ Abdallah Bchir, Head, Evaluation abchir@gavi.org
▪ Alba Vilajeliu, Senior Programme Officer, Evaluation avilajeliu@gavi.org
Deloitte Evaluation Team focal points
▪ Sally Stanfield, Evaluation Director sstansfield@deloitte.com
▪ Meklit Hailemeskal, Evaluation Lead mhailemeskal@deloitte.com

TA Evaluation FAQs document

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