About the Evaluation

Initiated in 2013, the Gavi Full Country Evaluations (FCE) are three-year prospective studies that aim to understand and quantify the barriers to and drivers of immunization program performance, with emphasis on the contribution of Gavi, the Vaccine Alliance in four countries: Bangladesh, Mozambique, Uganda, and Zambia. PATH is determining how Gavi’s process, products, and resources work at the country level to influence immunization-related outcomes. The overall goal of the Gavi FCE is to understand and quantify the barriers to and drivers of immunization program improvement, including the contribution of the Vaccine Alliance. The scope of the Gavi FCE includes Gavi’s support for new and underused vaccines, as well as Gavi’s cash-based support to countries.

The evaluations are carried out by a consortium of research partners led by PATH and financed through Gavi, the Vaccine Alliance, a public-private partnership that funds and improves access to vaccination in the world’s poorest countries. With the help of universities and health institutes in each country, PATH is gathering real-time data in order to provide feedback to Gavi and country stakeholders. The project also estimates trends at the national and sub-national levels to assess the alignment of program activities with a given country’s needs and priorities.

In addition to improving future immunization activities, the prospective nature of the evaluation provides real-time feedback on vaccine program implementation to Gavi and country stakeholders, which allows for timely action by country leaders and implementers, Gavi, and Vaccine Alliance partners.  Last, the methods developed and utilized by the FCE are designed to be exportable and adaptable to future contexts and countries.

The evaluations are split up into two phases: Phase 1 (2013-2016) and Phase 2 (2017-2020). The Phase 1 evaluations were undertaken in Bangladesh, Mozambique, Uganda, and Zambia from 2013 to 2016. During Phase 1, IHME led the consortium, focusing on four countries: Bangladesh, Mozambique, Uganda, and Zambia. The Phase 2 evaluations will be conducted from 2017 to 2020 in Mozambique, Uganda, and Zambia. During Phase 2, PATH will lead the consortium, focusing on three countries: Mozambique, Uganda, and Zambia. For both Phase 1 and Phase 2, there is a cross-country component that synthesizes findings across the target countries. For more information on the findings, and to access the annual reports and briefs, please visit our findings page

Value of the Full Country Evaluations

It is critical to show that past and continuing investments in health are making an impact and that resources devoted to health programs are effective. Past evaluation studies of support from Gavi are primarily retrospective, focused on specific streams of funding, and have limited country ownership of evaluation results. This evaluation effort represents an important shift toward focused, forward-looking, and in-depth monitoring and evaluation activities that take into account the evaluation needs of country-level immunization programs. This will better inform policy implementation and strengthen local capacity to conduct monitoring and evaluation activities.

Three important principles underlie the Gavi Full Country Evaluations (FCE):

  1. Harmonize monitoring and evaluation activities in each country by leveraging all available data and work collaboratively with country partners to conduct primary data collection.
  2. Strengthen country ownership and capacity by partnering with in-country institutes and undertaking shared dissemination.
  3. Provide timely, regular, and systematic feedback to country institutes and Gavi.