Results for Development is supporting countries to build and sustain strong national immunization programs. We bring change agents, donors and global immunization experts together to co-create and implement transformative strategies that lead to greater resilience, equity and sustainability.

The Challenge

Immunization remains one of the most cost-effective and impactful public health interventions available. However, maintaining high immunization coverage requires sufficient and sustained investment and strong and equitable health systems. Low- and middle-income countries also face challenges scaling up the use of new vaccines and increasing domestic financing as donor funding declines.

For countries to sustainably finance and implement immunization programs, country strategies and global policies on funding eligibility, co-financing and transition need to be well defined, comprehensive and up to date. Change agents need access to the latest information on the full array of policy options, and strategies for overcoming challenges related to immunization financing and programming. And immunization practitioners, policymakers and partners need support from peers in other countries facing similar challenges to learn about what works, generate new evidence and co-create solutions to address immunization program challenges.

Our Approach

R4D is enhancing vaccine equity by supporting countries to build strong, resilient and self-sustaining national immunization programs that are informed by global evidence. We are supporting countries and development partners to:

  • Work with local change agents to generate evidence, identify innovations and co-create solutions to immunization challenges.
  • Implement local solutions to chronic health system barriers to achieve and sustain high and equitable routine immunization coverage.
  • Facilitate peer learning that enables country practitioners to discuss critical immunization challenges and effective strategies, approaches and good practices to address these challenges.
  • Leverage practical guidance for program managers, advocates and policymakers to mobilize resources and use them efficiently for immunization programs.
  • Analyze policies on eligibility for donor assistance, transition, co-financing and sustainable immunization financing for middle-income countries.

Our Results

R4D is supporting countries to achieve their immunization goals through locally led solutions including:

  • In 2017, R4D launched the Learning Network for Countries in Transition (LNCT), a global peer-to-peer collaborative learning network. Through LNCT, R4D supported 20 member countries across Europe, Africa and the Asia-Pacific region transitioning from financial assistance from Gavi, The Vaccine Alliance. We implemented a country-driven learning agenda and produced 50 global public goods focused on improving the sustainability of immunization programs. These resources were accessed by more than 20,000 users in more than 120 countries.
  • Building on the success of LNCT, Gavi re-engaged R4D in 2021 to implement the Linked Immunisation Action Network (Linked) to support 46 middle-income countries (MICs) that have transitioned from Gavi support or never received Gavi support. Linked supports immunization practitioners, policymakers and partners for a facilitated process of sharing experiences and identifying common immunization program challenges and the transformative practices that will lead to greater resilience, equity, and sustainability. The network also supports countries as they translate those learnings into locally driven change. Linked is a relatively low-cost approach that enables Gavi to engage immunization program leaders across many middle-income countries and support them to drive their own progress. In 2023, Linked embarked on a systematic measurement of whether and how the network’s collaborative learning approach is contributing to impact. The findings demonstrate that Linked is an enabler, a catalyst, and an accelerator for countries’ progress towards the MICs outcomes and objectives.
  • Through the USAID-funded Health Systems Strengthening Accelerator, R4D supported country governments and stakeholders to co-created and implement local solutions to address systemic barriers to high and equitable immunization coverage. This work included supporting Guinea to increase community health worker and community relay engagement in routine immunization, involvement of civil society and local elected officials in supporting routine immunization in Guinea, supporting Togo to identify and address systemic and financial barriers to life course vaccination, facilitating cross-country learning opportunities to sustainably implement COVID-19 vaccination for priority populations in the long-term, supporting Ministry of Health and civil society in Mauritania to address vaccine hesitancy at the community level for both routine immunization of children under five and COVID-19 vaccination, and conducting a systemic literature review of the evidence around leveraging immunization campaigns to strengthen routine immunization.
  • In Jigawa state, Nigeria, R4D co-created an approach with key health and other government stakeholders to mobilize domestic resources for routine immunization at the Local Government Area and increase domestic financial ownership. R4D — through the USAID-funded MOMENTUM Routine Immunization Transformation and Equity Project (M-RITE) — is strengthening the capacity of local health managers through technical assistance, training, mentorship, and coaching synchronized with the state budget cycle, so they can prepare and negotiate budgets and advocate for routine immunization prioritization in Local Government Area and state budgets.

Photo: Women civil society leaders in Mauritania setting out for their communities to carry out social mobilization, awareness raising and household visits to address vaccine hesitancy and boost coverage for COVID-19 and other vaccine preventable diseases. © R4D/Health Systems Strengthening Accelerator


Global & Regional Initiatives

R4D is a globally recognized leader for designing initiatives that connect implementers, experts and funders across countries to build knowledge and get that knowledge into practice.