From foundations to forward momentum: Improving immunisation efforts in CAR
In late 2024, we began working with the Central African Republic (CAR)’s national Expanded Programme on Immunisation (EPI). While our partnership is still in the early stages, the EPI team has already moved from grappling with foundational capacity gaps to delivering more coordinated, data-informed, and efficient immunisation services – even in one of the world’s most challenging contexts.
As with all our partnerships, this journey began with a candid baseline assessment. In the EPI team, this assessment revealed that team members had low confidence in key areas such as data use, problem-solving, and team coordination, while facing structural challenges such as unclear roles, limited access to resources, and a poor feedback and collaboration.
Amp Health’s EPI Management Partner (MP), Daniel Mugunga Matabaro, worked closely with the team, providing targeted coaching and mentoring to address these gaps. Leadership development was embedded in the team’s day-to-day work, with a focus on using existing programme challenges as opportunities to build skills and strengthen systems.
“After the first monthly briefing, it felt as though my eyes had been opened, and I gained a new level of confidence in my work. Inspired by this motivation, I took the initiative to meet with the Director of the EPI Directorate to express concerns about issues within my department. My concerns were well received by the leadership. As a result, I feel much happier and more empowered in my role.””
This investment has paid off. A follow-up survey in March 2025 showed marked improvement across core competencies, with team members reporting stronger capabilities in planning, communication, decision-making, and collaboration. Meanwhile, improved use of data is leading to better service delivery, as is seen in the increase in vaccine coverage.
At baseline, only two out of ten team members felt confident using data for decision-making. Now, with clearer accountability mechanisms, regular data review meetings, and improved communication between central and district levels, the team is identifying coverage gaps earlier and responding faster. For example, follow-ups with district teams via WhatsApp and phone calls have helped clarify data discrepancies and guide more targeted outreach efforts
Better coordination is driving more inclusive and effective planning. With new systems in place, like regular structured meetings and joint planning sessions, the EPI team is now engaging stakeholders more proactively and working more collaboratively. The development of the 2025 Annual Operating Plan is one example: partners were not just consulted but co-created the plan alongside the EPI team, resulting in shared ownership and more coherent implementation.
Leadership growth is building momentum for change and team members are stepping into their roles with more confidence and initiative. The Data Manager, for instance, has taken on a more strategic leadership role – liaising with district focal points, advocating for resources, and helping drive the team’s data agenda. Meanwhile, Heads of Service are mentoring their colleagues, cascading skills and fostering a culture of continuous improvement.
More recently, a system of weekly structured meetings bringing together central managers and regional focal points was established, focused on the analysis of coverage data and the planning of corrective actions.
This system made it possible to detect a 15% drop in coverage of the third dose of the pentavalent vaccine in the Carnot district in June 2025. Within six weeks, the rapid mobilisation of mobile teams and community leaders resulted in coverage increasing from 68% to 89%. At the same time, vaccine stockouts decreased by 40% thanks to a more reliable forecasting system.
These improvements were supported by targeted coaching efforts from Daniel, Amp Health’s EPI MP, and Brice Makon, MP for the Country Leadership Program (CLP) – another Amp Health partnership in CAR. The Chief Doctor of the Carnot district, who is a CLP member, received guidance from Brice on coordinating with multisectoral stakeholders and using data effectively. Simultaneously, the EPI team benefited from coaching by Daniel, who also collaborated with the data management team at the central level to strengthen data systems. This led to more frequent and structured interactions between the central and district levels, enhancing collaboration and the use of data for decision-making.
In the words of an EPI team member: "This partnership has taught me how to transform data into strategic intelligence. Today, we no longer suffer problems; we anticipate and prevent them. This approach has revolutionised the way we work, and our results speak for themselves.” The progress so far is a powerful indicator of what’s possible when frontline teams are supported to lead. With continued support from Amp Health, the CAR EPI team is becoming a stronger, more agile force for public health delivery.