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IMMUNIZATION IN UGANDA Dan Wamanya USAID/Uganda. PROBLEMS WITH IMMUNIZATION. Low immunization coverage rate over the past 12 years Decline in immunization coverage in all the districts of the country over the last 5 years High immunization drop out rate. PERCENT OF CHILDREN FULLY IMMUNIZED.
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PROBLEMS WITH IMMUNIZATION • Low immunization coverage rate over the past 12 years • Decline in immunization coverage in all the districts of the country over the last 5 years • High immunization drop out rate
PERCENT OF CHILDREN FULLY IMMUNIZED Source: DHS 1989/95/2000
PERCENT OF CHILDREN AGED 12-23 MONTHS RECEIVING IMMUNIZATIONS
CAUSES OF LOW COVERAGE • Poor communication strategies resulting in low demand for immunization services • Inadequate management of challenges related to health sector reform • Disruptions of routine immunization resulting from eradication campaigns
CAUSES OF LOW COVERAGE Con’t • Inadequate involvement of the private sector in the delivery of immunization • Vocal opposition to immunization by some opinion leaders and FM radio stations
UGANDA IMMUNIZATION PARTNERS • USAID/AFR funds WHO & UNICEF SOS Disease Surveillence Routine Immunizations Supplemental Immunization Activities • BASICS II Advisor with UNEPI Models for Routine Immunization Links to IMCI
UGANDA IMMUNIZATION PARTNERS Con’t • DELIVER Logistics • DISH II IEC/BCC IMCI • GAVI
PARTNER COORDINATION • ICC was formed in 2000 • Provides policy and oversight of resource need and implementation • Meets every three months, is chaired by MOH, and all donors attend • Gives high level attention to immunization
MOH & USAID/UGANDAFOCUS AREAS • New Integrated Strategic Plan – Use of Universal Primary Education to implement health interventions • Making decentralization work for health, especially the delivery of immunizations.
MOH & USAID/UGANDAFOCUS AREAS Con’t • Improve access to EPI services through opening of new outreaches • Use IMCI, SOS and child health days to reduce missed opportunities • A strong advocacy and social mobilization strategy for EPI
MOH & USAID/UGANDAFOCUS AREAS Con’t • Investing in functional and sustainable disease surveillance systems • Conducting Supplemental Immunization Activities (SIAs) - Polio eradication - Measles control - MNT elimination
CHALLENGES AND LIMITATIONS • Scaling up at the national level to cover all 56 districts • Engaging the private sector in immunization • Limited communication with USAID/Uganda about USAID/W funded activities
CHALLENGES AND LIMITATIONS Con’t • Introduction and the cost of new vaccines • Continued supplemental immunization campaigns • Increasing urban and peri-urban populations
POSITIVE DEVELOPMENTS & OPPORTUNITIES • Good EPI infrastructure exists • Regular supply of adequate potent vaccines • Experience gained through successful NIDs • Improvement in funding levels