Health system strengthening tracking study

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The 2008 HSS tracking study is complementary to the HSS evaluation, providing a more in depth country perspective that helped highlight implementation issues in 6 countries

The GAVI health system strengthening (HSS) tracking Study is designed to provide real‐time evidence regarding the technical, managerial, and policy processes for the successful implementation of GAVI HSS grants in a set of six countries: Ethiopia, the Democratic Republic of the Congo (DR Congo), Kyrgyz Republic, Nepal, Vietnam and Zambia.  These countries were selected to reflect a broad range of country settings and experiences.

The study was carried out in August 2008 by JSI Research & Training Institute, Inc. (JSI) and its partner organisation in Sweden, InDevelop‐Institute of Public Management (InDevelop‐IPM).


Recognising that achieving immunisation coverage is dependent upon strong service systems, the GAVI Alliance Board took the first steps to widen GAVI support to health system strengthening (HSS) in early 2005.

Countries are encouraged to use GAVI HSS funding to target the "bottlenecks" or barriers in the health system that impede progress in improving the provision of and demand for immunisation and other child and maternal health services.

Objectives of tracking study

The study's three objectives were:

  1. improving the quality of project design/applications and strengthening implementation;
  2. developing responsibility and ownership over the monitoring of GAVI HSS and promoting its integration into ongoing processes at the country level;
  3. establishing a network of countries implementing GAVI HSS beginning with the countries in the case studies-and facilitating cross‐country learning and capacity building among them.


The Tracking Study sought to strengthen in‐country capacity to monitor GAVI HSS through the active engagement of local research organisations with the Ministry of Health (MoH) and partners responsible for HSS management, oversight and coordination.

Country workshops were an important element in that implementers and stakeholders across both national and sub‐national levels were brought together to dialogue on the status of implementation and bottlenecks encountered.


Visit the Country Hub section to find in depth country reports for the six countries selected for the Tracking Study: Ethiopia, DR Congo, Kyrgyzstan, Nepal, Vietnam and Zambia.

More on this topic

168 million

GAVI-supported vaccine campaigns have resulted in 100 million individuals being immunised against meningitis A and 68 million against yellow fever since 2000.

Meningitis A Conjugate Vaccine Immunizaton Campaign. Joint WHO/UNICEF 2011 Progress Report: January to December 2012. March 2013, p.3 | 2011 data. Yellow Fever Initiative. Joint WHO and UNICEF 2011 Progress Report Nov 2012, p.13, 15. 2012 data: Based on data from Epidemiology of Yellow Fever in the African Region: 2012 report. WHO Regional Office for Africa. April 2013, p.6.

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