Reported National Level Stock-Outs of Home-Based Records—A Quiet Problem for Immunization Programmes That Needs Attention

Abstract

Home-based records (HBRs) are an important tool for recording and communicating within primary healthcare service delivery. Unfortunately, HBRs are currently unable to fulfil their intended purpose in many communities either because the HBR is not functionally well-designed to serve its objectives, not made available, not fully adopted and/or not appropriately utilized by caregivers and/or health workers. This brief report describes the occurrence of nationally reported HBR stock-outs and HBR financing patterns during 2014 and 2015 across 195 countries reporting immunization system performance data to the World Health Organization and United Nations Children’s Fund. National level HBR stock-outs were reported by 19 and 22 countries during 2014 and 2015, respectively, with eleven countries reporting stock-outs during both 2014 and 2015. During 2015, 12 of the 22 countries reporting HBR stock-outs were from the African Region and two-thirds of the countries were Gavi-eligible. Information on HBR stock-outs was either not available or not reported by 66 countries (19 were Gavi-eligible) for 2014 and 53 (11 were Gavi-eligible) countries for 2015. Among the 22 countries reporting HBR stock-outs in 2015, 12 (54%) countries reported a single HBR financing source, and nine (41%) countries reported more than one source for HBR financing. The occurrence of HBR stock-outs remains a concern, particularly in Gavi-eligible countries introducing new vaccines where dedicated funding is received for revising and printing new recording tools, including HBRs. Additional attention is needed to understand the root causes for stock-outs and identify solutions to ensure a well-designed, durable HBR is readily available in the right quantity, in the right place at the right time in all countries.