Improved immunization access through health systems strengthening project for townships in myanmar: A mixed method study

Many areas of Myanmar have limited access to immunization due to a range of management, logistics and security barriers. The objectives of this study were to describe the situation of immunization services and the health systems strengthening (HSS) project, and to analyze the effect of the health systems strengthening project on access to immunization services. Mixed-method study design was used. Secondary data for all health systems strengthening and immunization services from 2011 to 2015 were collected. The qualitative data were collected by key informant interviews with 28 key stakeholders from the HSS project and the expanded program on immunization (EPI) project, and six study townships and twelve Rural Health Centers, along with twelve focus group discussions with 121 mothers of children under two years of age. The results showed that DPT3/Pentavalent 3 immunization coverage increased from 79.4 in 2011 to 87.8 in 2015. The integrated service packages were conducted in remote areas. The appointed midwife to PHS 2 ratio went from 6.57 in 2011 to 2.06 in 2015. The government budget mainly supported salaries, and the HSS project supported integrated immunization service packages and supervision. In addition, the basic health staff (BHS) received leadership and management training. In conclusion, the findings of this study provided substantial insight into health systems strengthening factors such as service delivery, healthcare workforce, information, medical products and technology, financing and leadership, improving access to immunization services which have an effect on the national intervention programs and policies, and implementation of interventions.