Increasing subnational commitment for measles and rubella elimination: the role of regional reports

Issue/problem To assess the progress towards measles and rubella elimination in the WHO European Region, the National Verification Committee of each Member State is requested to submit an annual status report (ASR) to the WHO Verification Commission for review and evaluation. Documentation required for Italian ASR are provided by the Ministry of Health, the National Institute of Health, and the 21 Regions. However, these ASR do not allow Regions to understand deeply their situation in the elimination process. Description of the problem The aim of this project is to produce regional synthetic annual reports, using the same data sources of the national ASR, that are sent to Regions to give them feedback about their progress towards elimination. A set of indicators has been identified within the framework of the national ASR. A green or red flag has been assigned to each indicator when regional data are better or worse than the national average, respectively. Where available, international targets were provided. Results In 2014 the incidence of measles and rubella in Italy was respectively 27 and 0.4 per million population. For all Regions coverage for both 1st and 2nd doses of routine measles and rubella vaccines was below the target of 95%. Analyzing those Regions with a percentage of red flags higher than the average percentage of red flags of the country, it emerged that 6/8 Regions were in the South of Italy (75%), 4/9 in the North (44.4%) and 1/4 in the Centre (25%). Lessons Regional reports are a valid tool to enhance the verification process at the sub-national level and may encourage regional and local authorities to implement appropriate strategies to remove barriers to the elimination goals. Southern Regions of Italy need to increase their efforts compared to other Regions. Key messages: In line with WHO recommendations to reinforce the commitment of the 21 Italian Regions, regional reports are able to provide Regions with detailed information about their progress and critical issues Regions of South Italy should mobilize better their financial, technical and human resources to achieve the elimination goals.