A comprehensive international evaluation of Colombia’s Expanded Programme on Immunization (EPI) took place from 27 August-7 September 2012. The evaluation of the data quality component of the EPI evaluation started earlier, on 23 August 2012, as it was a full data quality self-assessment (DQS) including a review of the national immunization registry being rolled-out in the country. The primary objective of the international evaluation was to: assess the organization, structure, and operation of the national EPI to maintain achievements in the elimination of some vaccine-preventable diseases (VPDs); address the unfinished immunization agenda by making the benefits of vaccination available to all; and, address new challenges such as the introduction of new vaccines. Evaluators visited six departments and the capital district of Bogotá, 24 municipalities, and 53 health care centres (public and private), and performed 686 interviews. Of those interviewed, 85 were from the political spheres, 65 EPI managers, over 100 managers from other programmes or representatives of cooperation agencies or institutions, and 383 users.
Compared to the previous international EPI evaluation in 2001, Colombia’s EPI has been strengthened and has a high technical quality team. Likewise, a national immunization technical advisory group (TAG), with prestigious professionals, has been constituted and works closely with the EPI providing timely recommendations. Campaigns to eliminate rubella and follow-up measles-rubella campaigns, as well as a national plan to control yellow fever have been implemented. Surveillance indicators for VPDs under elimination/eradication have improved. Finally, new vaccines such as rotavirus, seasonal influenza, pneumococcal conjugate vaccine, and HPV have been introduced, the latter in August 2012. The evaluation also highlighted a decreasing trend in coverage rates and several challenges, many related to the country’s health system, that do not promote job stability for health care personnel working in immunization. Data quality was variable between the departments evaluated, with problems in numerator and denominator data being highlighted. However, the implementation of a national immunization registry, positively viewed by the users interviewed, is well underway. Data quality and registry implementation experiences from Bogotá were suggested as useful to move the national immunization registry implementation process forward.
A number of other recommendations were proposed and the activities that need to take place in order to meet those recommendations have been included in a five-year comprehensive action plan for 2013-2017.