Recent improvements in immunisation coverage and the provision of primary healthcare services have stalled. The coverage gaps that still exist reflect a variety of underlying issues that could be resolved by a better health system design. For better service delivery and a stronger Universal Health Coverage, vaccination programmes and other primary healthcare services can complement one another. Addressing dynamic and multifaceted risks and impediments is necessary for improvements. They include the availability of a skilled labour force, the deployment of high-quality data systems, as well as innovative, adaptable, data-driven leadership and management that is sensitive to regional demands. In order to support community engagement and vaccination, it will also be necessary to make improvements to the procurement, supply chain, logistics, and delivery systems, as well as to the integrated monitoring of vaccination coverage and epidemiological disease surveillance with laboratory systems. Last but not least, it takes political will, on-going resource commitment, and opens accountability systems.
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