|Timing||The case studies were developed in 2017, and examined epidemiological, demographic and social trends over the last 15 years.|
|Data sources||The main sources of information for the case studies included published literature about health and immunisation in urban settings, relevant national health policy and planning documents, and data bases of the World Health Organisation, Demographic and Health surveys, Multi Indicator cluster surveys and UN-HABITAT population data.|
|Summary of main findings|| ○ There is rapid urban growth in all reviewed countries, not only in major cities, but also in provincial and district capitals, with significant numbers residing in urban slums.|
○ In five out of the six countries, coverage gaps between the highest and lowest wealth quintiles for urban populations are quite significant.
○ All six countries are reporting vaccine preventable disease outbreaks in urban areas in recent years.
○ Social conditions expose the urban poor to higher risk of vaccine preventable disease outbreak.
○ There have been some innovations in operational responses to lower coverage amongst the urban poor, but implementation sustainability is constrained by externally financed projects operating in highly complex local governance contexts.