A delphi study on the impact of the interventions proposed to the GAVI alliance health system strengthening program

Delivering effective and sustainable interventions to the greatest number of children is crucial for the reduction of child mortality and the attainment of the Millennium Development Goal. Between 2006 and 2010, a significant share of the Global Alliance for Vaccination and the Immunization funds will be invested in the strengthening of health systems (GAVI HSS), to achieve and sustain increased immunization coverage and other health services (with focus on child and maternal health).
The study was conducted using a random sample of the proposed interventions by 35 countries to strengthen health systems and services for the approved Fund "GAVI HSS." The Delphi technique used to gather the data in three rounds between April and August 2008, using a structured questionnaire and a semi-structured. The panel of experts was composed of 21 professionals from WHO, UNICEF and UNFPA, selected on the basis of their expertise in Public Health, Maternal and Child Health.
Consensus was reached on 57 interventions (70%) deemed likely to have a positive impact on at least one of the Care-Related Activities (CRA) analyzed in this study (Integrated Management of Childhood Illnesses; Intrapartum Care; Prevention and Treatment of Chronic Diseases; Health Services Delivery; and Health Service Planning and Management). The majority of these interventions that were deemed more likely to have an impact were related to “Health Services Delivery” and “Health Service Planning and Management”. The highest number of interventions identified as unlikely to have positive impact were related to “Prevention and Treatment of Chronic Diseases”.
According to experts consulted, the interventions on which there was consensus, will have a positive impact on other areas beyond vaccination. The scope of this impact will vary between the care related activities, the interventions are more likely to have a greater impact in the areas of healthcare management than in the areas of general health care.