Table 3. Service Delivery Strategies for Conflict-Affected Populations Described in APRs (2014), HSS Proposals or the Most Recent Multi-Year Immunisation Plan .

Country	Service Delivery Strategy Identified in National Policy and Planning Documentation
Afghanistan	Increase immunisation delivery points, aggressive mobile outreach to isolated communities, and provision of services through private providers in insecure areas. This includes contracting out of health service delivery to NGOs in 31 out of 34 provinces. Locally tailored solutions through provincial management structures in insecure areas are considered important.
Chad	Implementation of SIAs are conducted to address gaps in routine services. There is a high reliance on NGOs and international support to provide services for refugees in the east and south of the country.
CAR	Advocacy measures are conducted with multinational forces for improved security to support vaccine introductions. There are activities to support intensification of routine immunisation, and there are increased roles for NGOs in zones of insecurity.
Cote D'Ivoire	Despite reports of over 700 000 stateless persons, as well as instability in the north and east of the country, no specific strategies are described for conflict-affected populations.
DRC	A plan for refugees is described, including an emergency stock of vaccines and development of guidelines for immunisation for displaced populations. Elsewhere it states that specific strategies to reach the children in health zones with armed conflicts are not yet developed.
Ethiopia	Fixed immunisation posts have been established at cross border sites where there are large population movements.
Kenya	No specific strategy is described for displaced populations, despite this country having the largest displaced population camp in the world. The comprehensive multiyear plan identifies a high reliance on NGOs, which operate 54% of health facilities in the country.
Myanmar	Special outreach programs are implemented in remote areas and those affected by armed conflict. Planning documents identify increased roles for NGOs in border areas or areas under non-government control.
Nigeria	No specific strategies are described in 3 documents (APR, HSS, or cMYP).
Pakistan	The country uses existing services to reach displaced populations. Vaccinators utilise 60-80 days per year for national Immunisation Days strategy.
Somalia	Child Health Days are implemented in all urban, rural, and hard to reach areas, although security was viewed as a barrier to implementation. The multi-year plan for immunisation also mentions expanding routine immunisation outlets for IDPs.
The Sudan	Plans are described to (a) implement integrated service delivery strategy in emergency settings, elsewhere described as "accelerated routine activities." (b) Expand immunisation coverage in security compromised areas largely through limited "hit- and- run or acceleration campaign approach" facilitated by CSOs and NGOs. (c) open a channel of communication with armed groups through local leaders and UN agencies along with involvement of NGOs.
South Sudan	No specific strategies are described in 2 available national documents (GAVI, APR, and HSS). However, the HSS strategy does outline contractual/MOU mechanisms with civil society organisations. Elsewhere UNICEF and the World Food program have initiated a RRM using food distribution and support registration and health services for conflict affected populations.75
Uganda	No specific strategies are described, despite barriers to immunisation being noted in the conflict-affected north.
Ukraine	No data available.
Yemen	Enhancement of routine immunisation in conflict-affected areas is identified, including more frequent outreach and mobile strategies. Increased roles for CSOs in conflict areas that lack public services are also described.

Abbreviations: NGOs, non-governmental organisations; SIAs, supplementary immunisation activities; APR, annual progress report; HSS, health system strengthening; cMYP, comprehensive multi-year plans for immunisation; IDPs, internally displaced people; CSOs, civil society organizations; DRC, the Democratic Republic of Congo; UNICEF, United Nations Children’s Fund; RRM, rapid response mechanism; MOU, memoranda of understanding; UN, United Nations; CAR, Central African Republic.