1. Multi-Year Plans Strengthening immunization systems and introduction of hepatitis B vaccine in Central Europe and the Newly Independent States St. Petersburg, Russian Federation, June 24-27 2001

2. Multi-year plans (MYP) A good immunization MYP outlines the strategies, actions and resources needed to reach all target groups with quality immunization services and achieve national targets for reduction of VPD The planning period is usually 3-5 years - so that medium-term strategic priorities and resource needs are clearly defined The exact format of a MYP can differ from country to country - according to health system structure, local needs and tradition

3. Planning cycle Program assessment & evaluation Analysis Development / revision of MYP Implementation Monitoring

4. National health plan MYP for immunization Annual immunization plan Sub-national microplans 3 – 5 years - 1 year Regions Districts. Operational components Relation between immunization plans at national and sub-national levels

5. The five operational components of immunization systems Service delivery Vaccine Supply & Quality Logistics Advocacy & Communication Surveillance

6. Three broader health systems functions provide the foundation for immunization operations

7. Components of a MYP Programme objectives Activities including responsibilities for implementation and costs –training –introduction of new vaccines –Accelerated disease control activities –social mobilization Indicators (related to priority areas and targets) Budget and financing Time-line

8. Monitoring of MYP This is based on collection and analysis of a set of indicators selected by the national immunization program and included in its annual report In countries receiving donor support, progress should be monitored by the inter-agency coordination committee (ICC) National data are reported to WHO and UNICEF on an annual basis (April) and used in international reports and database

9. Main reasons for limited implementation of MYP Disconnect between assessment and plan –The plan does not address main problems Unrealistic planning –Inadequate funding –Limited human resources –Weak time management and priority-setting Responsibilities for implementation of activities not well defined

10. In conclusion: A MYP is an important document because it outlines national strategic priorities and resource needs for the medium-term It provides a framework for coordination of donors Health planners can use it for estimating and allocating national budgets and resources It is complemented by annual national and sub- national plans Finally, monitoring of implementation of the MYP is essential for fine-tuning or revision of strategies and activities

11. Multi-Year Plans Strengthening immunization systems and introduction of hepatitis B vaccine in Central Europe and the Newly Independent States St. Petersburg, Russian Federation, June 24-27 2001