1. 2018 Immunization Coverage Data at Subnational Level
A descriptive analysis
31 July 2018
WHO IVB/EPI

2. 2018 data collection of immunization subnational administrative data
Data requested:
Denominator (number of children targeted), numerator (number of children vaccinated) and coverage
For the 1st and 3rd dose of DTP- containing vaccines (DTP1, DTP3) and 1st dose of measles containing vaccine (MCV1)
For the 2nd subnational administrative level (referred as Admin2, often known as district)
Aggregated for the whole calendar year (from 1 January through 31st December )
From 194 WHO Member States
Data received:
Data for additional antigens, doses and vaccines: BCG, DTP2, DTP4, HepB birth dose, HepB1, HepB2, HepB3, Hib1, Hib2, Hib3, IPV1, MCV2, OPV0, PAB, PCV1, PCV2, PCV3, Pol1, Pol2, Pol3, RCV1, RCV2, Rota1, RotaC, TT2+, VAD1, Varicella and YFV
Reported to be Admin1 and/or Admin2
From 141 WHO Member States
Data received as of 15 July 2018
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3. 141 member states from all WHO regions shared 2017 subnational data
These are all the countries for which data was received: 144 countries.
A lot of countries shared data given that it is the first year subnational is collected through the JRF. Thanks to many regions already collecting in the past.
We still see disparities between regions, with WPRO and EMRO lagging behind.
AFR: Nigeria data shared but withdrew after they had the results from their coverage survey and realised that they have some strong quality issues with their administrative system.
Data received cover many Gavi eligible countries: 65 (out of 73) shared their subnational data.
8 Gavi eligible countries that did not report their 2016 subnational data are: Djibouti, Cambodia, Kiribati, Mongolia, Nigeria, Papua New Guinea, Solomon Islands, Viet Nam.
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4. Subnational administrative data available from 141 WHO Member States
Data received from nearly 24,000 Admin2, in which live 70% of the global surviving infants
Data completeness:
54 countries reported on admin1 level only, 7 on admin2 level only, and 80 on both admin1 and admin2 levels
Data is reported from about 2,300 admin1 and nearly 23,000 admin2
Subnational administrative data available from 141 WHO Member States
(53 countries with no subnational administrative data available – this includes 8 small countries with no subnational geographical divisions)
Population size:
From the reported data, the smallest admin2 has only 1 targeted child for immunization, and the largest admin2 is Bangalore Urban in India with a target population over 180,000 children
Over 70% of the world's surviving infants live in countries reporting subnational administrative data
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5. Data completeness: illustration
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6. Population size & coverage: illustration
Find more country visuals on: a/view.other.immu-admin2- dtp3?lang=en.
2017 DTP3 Coverage
Each bubble correspond to an admin2 of the country.
Bubble size is proportionnal to the number of children in the target group.
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7. DTP3 Admin2 coverage data
Target population (rounded average and median) per admin 2
Distribution of reported Admin2 DTP3 coverage by coverage range
Average
Median
African Region
7,287
5,492
Region of the Americas
718
197
Eastern Mediterranean Region
3,493
2,484
European Region
701
339
South-East Asia Region
18,862
6,068
Western Pacific Region
6,962
3,013
Global
4,050
563
DTP3 data reported from about 22,000 admin2
Total Number of children vaccinated with 3 doses of DTPcv in all admin2: over 83,000,000
Reaching GVAP goal:
countries report 70% of their admin2 have more than 80% DTP3 coverage
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GVAP

8. DTP1 Admin2 coverage data
Target population (rounded average and median) per admin 2
Distribution of reported Admin2 DTP1 coverage by coverage range
Average
Median
African Region
7,287
5,492
Region of the Americas
718
197
Eastern Mediterranean Region
3,493
2,484
European Region
701
339
South-East Asia Region
18,862
6,068
Western Pacific Region
6,962
3,013
Global
4,050
563
DTP1 data reported from about 22,000 admin2
Total Number of children vaccinated with 1 dose of DTPcv in all admin2: over 79,000,000
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9. MCV1 Admin2 coverage data
Target population (rounded average and median) per admin 2
Distribution of reported Admin2 MCV1 coverage by coverage range
Average
Median
African Region
7,287
5,492
Region of the Americas
707
196
Eastern Mediterranean Region
3,493
2,484
European Region
701
339
South-East Asia Region
18,862
6,068
Western Pacific Region
6,962
3,013
Global
3,989
545
MCV1 data reported from over 22,000 admin2
Total Number of children vaccinated with 1 dose of MCV in all admin2: over 78,000,000
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10. Dropout at Admin1 level Global
World Subnational Dropout by Administrative Level for 2017
Colored by percentage of (DTP1-DTP3) / (DTP1) vaccinations.
Approximately sizeed by sum of surviving infants for Admin1 regions.
Countries without subnational data colored light grey.
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11. Dropout at Admin1 level African region
AFR Subnational Dropout by Administrative Level for 2017
Colored by percentage of (DTP1-DTP3) / (DTP1) vaccinations.
Approximately sizeed by sum of surviving infants for Admin1 regions.
Countries without subnational data colored light grey.
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12. Dropout at Admin1 level Region of the Americas
AMR Subnational Dropout by Administrative Level for 2017
Colored by percentage of (DTP1-DTP3) / (DTP1) vaccinations.
Approximately sizeed by sum of surviving infants for Admin1 regions.
Countries without subnational data colored light grey.
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13. Dropout at Admin1 level Eastern Mediterranean region
EMR Subnational Dropout by Administrative Level for 2017
Colored by percentage of (DTP1-DTP3) / (DTP1) vaccinations.
Approximately sizeed by sum of surviving infants for Admin1 regions.
Countries without subnational data colored light grey.
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14. Dropout at Admin1 level European region
EUR Subnational Dropout by Administrative Level for 2017
Colored by percentage of (DTP1-DTP3) / (DTP1) vaccinations.
Approximately sizeed by sum of surviving infants for Admin1 regions.
Countries without subnational data colored light grey.
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15. Dropout at Admin1 level South-East Asian region
SEAR Subnational Dropout by Administrative Level for 2017
Colored by percentage of (DTP1-DTP3) / (DTP1) vaccinations.
Approximately sizeed by sum of surviving infants for Admin1 regions.
Countries without subnational data colored light grey.
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16. Dropout at Admin1 level West Pacific region
WPR Subnational Dropout by Administrative Level for 2017
Colored by percentage of (DTP1-DTP3) / (DTP1) vaccinations.
Approximately sizeed by sum of surviving infants for Admin1 regions.
Countries without subnational data colored light grey.
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17. Limitations in the sub-national administrative data reported
Data completeness
Interpretation bias
Data quality
Not all member states included: 27% not included
22,000+ reported Admin2 represent about two third of all Admin2 worldwide
Admin2 coverage data mainly originates from 3 regions: Africa, the Americas and South-East Asia
Some of the data received as Admin2 is actually for the 1st, 3rd or even lower level
Also, some Admin1 may refer to 2nd subnational administrative level. This may explain some of the disparities in terms of district sizes.
Some reported districts not linked to a specific geographical place (eg. migrant population, army camps, etc). These non- geographically based population often don’t have a denominator
The diversity in reporting limits comparability across countries.
Numerator errors: introduced when tallying, summarizing, and reporting the administered doses by health facilities and district administrations
Inaccurate denominators: population estimates often based on census data and derived estimates, leading to distortions over time as certain districts may grow faster than others
Numerator / denominator mismatches: population mobility creates mismatches between numerator and denominator, aggravated in countries with important migratory movements
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18. Notes
Please share your comments, questions and analysis to WHO through (subject line: Subnational data);
When using them, always source WHO products, data and information related to the immunization subnational administrative data: "Subnationally reported immunization system performance data for calendar year 2017 submitted on the joint annual data collection process.";
The slides, materials and visuals will be updated periodically.
Last update: 31 July 2018.
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