Country | Challenge | Solution |
---|---|---|
All three countries | Delayed transmission of AE reports from all levels of healthcare system to national PV center | • PV coordinator and focal points to be pro-active in ensuring reports are collected and reach national PV center • PV coordinator to update focal points regularly on reports received by national PV center • Partner with established organizations to assist with transmission from remote HCFs • Continuous mentoring to maintain motivation • Recognize achievements e.g. certificates to focal points with > 5 AEs reported from district • Enable electronic reporting of AEs via mobile phone messenger applications |
ADR reporting form not standard among countries and not as user-friendly as 1-page WHO AEFI reporting form | • Following consultation with national experts, 1-page ADR form introduced in Malawi, in line with 1-page and 1.5-page forms in Côte d’Ivoire and DRC | |
Perceptions among HCPs toward AE reporting | • Emphasize importance of reporting procedure • Reassure HCPs that AEs can occur even when medicine has been used correctly • Engage hospital management and involve senior staff in PV training | |
Delayed data entry into VigiBase | • Engage data manager within national PV center with clear roles and responsibilities | |
PV-related activities ongoing within public health programs without knowledge of key PV stakeholders and PV coordinator; full collaboration with EPI not established | • Present PV enhancement plan to program directors • Gain participation of PV coordinator in PV trainings organized by health programs | |
ERC not sufficiently trained (Malawi) and no regular causality assessment meetings following signal detection (all three countries) | • Allocate funding to ensure routine functioning of ERC on causality assessment • PV coordinator to ensure safety concerns are submitted to ERC and that meetings are organized promptly | |
Malawi | No official PV coordinator until six months into implementation; replaced after one year | • Plan for and engage PV coordinator ahead of implementation to allow for continuity • Train the national PV center personnel in AE data entry into VigiFlow for sharing into VigiBase |
EPI coordinators engaged as focal points: tended to become less concerned with PV during vaccination campaigns or epidemics; regularly transferred to other functions | • Engage clinicians and pharmacists as focal points • Engage back-ups to PV coordinator and focal points | |
Initial training focused on HSAs who had limited medical knowledge to complete AE reports | • Train wide range of HCPs: HSAs, clinicians, nurses, pharmacists, etc. | |
Côte d’Ivoire and DRC | Delayed project implementation because of administrative complexities | • Anticipate delays in project timelines • Examine all possible constraints with approving legal agreement • Address issues that may delay implementation • Re-present project to newly appointed PV stakeholders in country |