A Qualitative Study of the Development and Utilization of Health Facility-based Immunization Microplans in Uganda

In 2006, Uganda adopted the Reaching Every District strategy with the goal of attaining at least 80% coverage for routine immunizations in every district. Despite having adopted the RED strategy in 2006, by 2015, only 40 of the 112 districts had updated microplans. The development and utilization of health facility/district immunization microplans is the key to the strategy. A number of reports have shown suboptimal development and use of microplans in Uganda. This study explores factors associated with suboptimal development and use of microplans in two districts in Uganda to pinpoint challenges encountered during the microplanning process.

Results: Three key findings emerged from this study. First, there are significant knowledge gaps about the microplanning process among health workers at all levels (community and district health facility and nationally). Limited knowledge about communities and program catchment areas greatly hinders the planning process by limiting the ability to identify hard-to-reach areas as well as prioritize areas according to need. Secondly, the microplanning tool is bulky and complex. Finally, microplanning is being implemented in the context of already over-tasked health personnel who have to conduct several other activities as part of their daily routines.

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