Despite widespread conflict and insecurity, South Sudan has witnessed a remarkable improvement in routine vaccination coverage in 2017. Since the introduction of the pentavalent – or five-in-one vaccine for infants that combines five antigens, namely: Diphtheria; Pertussis; Tetanus; Hepatitis B (HB) and Haemophilus influenza type b, the country raised pentavalent vaccine coverage from 45% in 2016 to 57% in 2017.

To strengthen routine immunization in the country, a Joint Appraisal meeting was held from 5 to 9 February 2018 in Juba. Top health experts from Ministry of Health, Gavi Alliance, WHO, UNICEF, John Snow, Inc. (JSI), Centre for Communicable Disease Control (CDC) among others reviewed the implementation, progress, challenges, opportunities and resource needs for improving the immunization system in the country and identified key barriers to coverage improvement including inadequate human resources, hyperinflation affecting effectiveness of operational plans, looted cold chain and disrupted banking infrastructure that affects timely disbursements of operational funds.

The Joint Appraisal process is an annual activity for reviewing progress, challenges, opportunities and resource needs for improving the immunization system in the country.

Honorable Dr Riek Gai Kok, Minister of Health, expressed gratitude to Gavi Alliance, WHO and partners for the immense contribution in the face of daunting economic and social challenges. He also acknowledged the continued support to rapidly interrupt the cholera outbreak with 1.4 million doses utilized to complement the traditional response strategies as well as the increasing trend of routine immunization as remarkable in the current context.

A successful routine immunization system requires the synchronization of multiple programme components to provide a child the opportunity to be successfully vaccinated, says Mr Kofi Boateng, the WHO Immunization Focal Point. The development of the new comprehensive Multi Year Plan for 2018 – 2022 provides strategic focus for: improving coverage, introduction of new vaccines, and enhancing effectiveness of vaccine management as well as ensuring the timely use of immunization data, Mr Boateng added. He further highlighted the joint appraisal has endorsed interventions to improve on staff motivation at the lowest level, recruit new staff for the 22 new states and support the roll out of the Boma Health Initiative (BHI), the Ministry of Health  flagship programme for strengthening health systems.

Vaccines must be procured, and successfully delivered to the service delivery level, while constantly maintained through a functioning cold chain. Health workers must be trained in vaccine management, handling and administration; data recording and reporting, and appropriate interaction with caregivers of young children.

“We appreciate the support from Gavi and Alliance partners”, said Mr Evans Liyosi, WHO Representative a.i. to South Sudan.  With the over 30 million USD invested in the past two years, we are able to reach more than 5 million children with multiple vaccines through campaigns and routine immunization. He also called upon all stakeholders to strengthen the health system at the lower levels to ensure the gains made are maintained.

The country faced some measles outbreaks with cases reported from 14 counties. Measles vaccine follow-up campaigns were implemented in 2017, vaccinating 1.8 million children 6 – 59 months of age.  In addition, over 4.6 million people 1 – 29 years were vaccinated with Meningitis type A vaccine.

The Joint Appraisal Report and work plan has been approved by the Inter-agency Coordinating Committee paving way for implementation of activities for 2018.