Introduction to Key Issues and Learning to Inform the Future: A MOMENTUM Resource on Key Issues for Private Sector Engagement in Immunization

This post is authored by Susan Rae Ross, Sr. Private Sector Engagement Advisor, Office of Maternal and Child Health and Nutrition, USAID Global Health Bureau; Dr. Folake Olayinka, Immunization Team Leader, Office of Maternal and Child Health and Nutrition, USAID Global Health Bureau; Dr. Gaurav Sharma, Sr. Maternal, Newborn, Child Health Technical Advisor; and Dr. Christopher Morgan, Sr. Immunization Technical Advisor for the MOMENTUM Private Healthcare Delivery Project.

Historically, the private sector — both nonprofit and for-profit — has played an extremely varied role in immunization service delivery in low- and middle-income settings. The current COVID-19 pandemic calls for innovative solutions and increased collaboration with new partners, including the private sector, to expand reach and access to all vaccines.

MOMENTUM Private Healthcare Delivery, part of a suite of innovative awards funded by USAID, harnesses the potential of the private sector to deliver quality maternal, newborn, and child health services; voluntary family planning; and reproductive health care. The project strengthens private health system functions and works with local organizations and partners to expand affordable health coverage that serve women, children, and communities for the long term. MOMENTUM Private Healthcare Delivery has developed a brief for immunization program managers and key country stakeholders on “Private Sector Engagement to Boost Reach of Immunization Programs: An Introduction to Key Issues," which reviews the private sector’s role in expanding immunization service provision. In this brief, MOMENTUM Private Healthcare Delivery provides a high-level summary of evidence published prior to the pandemic, comprising four global or regional reviews and a 2017 WHO Guidance document, and derives main considerations for pandemic response and beyond.

The introduction brief shows that immunization services differ greatly from one country to the next. From places where the government prohibits private sector involvement, mixed settings where private providers may offer up to 20 percent of immunizations, or settings where private/ non-governmental providers are the major immunization providers. These are settings affected by conflict or natural disasters that make their public health systems especially fragile. Some promising practices have also emerged around various types of private sector engagement, including targeted payment schemes and franchise arrangements and optimization of private providers in the planning, training, and logistics of country immunization programs and supporting procurement subsidies.

The introduction brief identifies some key factors to promote equitable access to high-quality services — including some challenges and risks to manage while engaging with the private sector in immunization. This list provides additional guidance to immunization program managers seeking to involve non-government providers to support COVID-19 vaccine roll out.

Of greatest importance is the need to document and learn from the many adaptations currently underway in the COVID-19 vaccine roll out to build on best practice and prepare for future pandemics. MOMENTUM Private Healthcare Delivery, along with other USAID and MOMENTUM projects, as well as other multilateral initiatives, such as WHO’s recently launched PSE Country Connector, aim to help understand where new partnerships have enabled expansion in vaccination structures and systems, and how these lessons may build stronger, more resilient immunization programs in the future. This Key Issues Brief, and additional work to be shared later this month, start to map out the details of this learning agenda and call for other interested stakeholders to join.