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E.P.I

E.P.I. History. May 1974 EPI-Pak, 1976 Establishment of vaccination schedule -1984

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E.P.I

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  1. E.P.I

  2. History • May 1974 • EPI-Pak, 1976 • Establishment of vaccination schedule -1984 • GAVI-Global Alliance for Vaccine & Immunization is a public-private global health partnership committed to saving children’s lives and protecting people’s health by increasing access to immunization in poor countries. launched in 2000

  3. Programme responsibilities at provincial level Since health is a provincial subject, the DG, Health Services and EDOs Health are ultimately responsible for programme implementation and administration. The main provincial responsibilities are: • Planning, finance, implementation and administration at provincial level • Collection of vaccines/syringes/needles from the Federal EPI Cell for further distribution to the districts • Repair and maintenance of cold chain equipment • Monitoring, evaluation and reporting • Supervision at all EPI service delivery level • Training of all EPI workers except Mid-level Managers • Repair and maintenance of vehicles

  4. Supervisory Management • The Programme is being supervised by the National, Provincial and district staff at every level in the country. • The focal point for the EPI is the District Officer Health Preventative (DOH) or district EPI Coordinator (DEC).

  5. EPI Goals • Full immunization of children under one year of age in every district • Global eradication of poliomyelitis • Reduction in maternal and neonatal tetanus • Cut half number of measles-related deaths

  6. Objective • 80% coverage in every district by 2012. • Interruption of polio virus transmission by 2010. • Elimination of Neo-natal tetanus by 2015. • Reduction of measles mortality by 90% by 2010 as compared to 2000 level. • Reduction of diphtheria, pertussis and childhood tuberculosis to a minimum level. • Control of other diseases by introducing new vaccines in EPI

  7. EPI Programme • Exclusive Immunization provider • Private sector- 3% • 6000 fixed centres • > million outreach and mobile vaccination sessions/year • > 10 000 vaccinators • 6000 LHV’s • 100,000 LHWs

  8. EPI-Pak targets • 5.8 Million children • 5.9 Million pregnant women

  9. EPI Schedule Source: WHO

  10. Number of reported cases Diphtheria 34 Measles 863 Pertussis 164Polio   89 Tetanus (neonatal) 781 Tetanus (total) 816 Source: WHO 2009

  11. Population data (in thousands)Total population 180'808 Live births 5'403 Pop. < 5 years 24'121 Pop. < 15 years 66'781 Female 15-49 years 44'582Source: WHO 2009

  12. Fully immunized children coverage

  13. Problems in achieving EPI targets in Pakistan

  14. Problems in achieving EPI targets • Inadequate service delivery • long distance to EPI centres • Lack of awareness of immunization benefits • unaffordable cost to reach the centres • unavailability of vaccinators • EPI centre- 1 in 10 UC in Punjab and 2 vaccinator in, in each UC • Political commitment

  15. International Collaboration • Canadian International development Agency (CIDA) • Department for International Development [DFID] • GAVI • Japan International Cooperation Agency (JICA) • Rotary International • UNICEF • United States Agency for International Development (USAID) • WHO • World Bank

  16. Cold chain

  17. What is cold chain? • The term cold chain is the name given to the system of transporting and storing vaccines within the safe temperature range of 2ºC - 8ºC. • The cold chain involves all the people, equipment and procedures which ensure that an effective vaccine reaches the people who need it - usually children.

  18. Cold Chain

  19. Cold chain system • The cold chain system comprises three major elements: • · Personnel, who use and maintain the equipment and provide the health service; • · Equipment for safe storage and transportation of vaccines; and • · Procedures to manage the Programme and control distribution and use of the vaccines. • Competent personnel and efficient procedures are a vitally important part of the cold chain system:

  20. Technical features that impact on vaccine storage and temperature monitoring

  21. Vaccine carriers

  22. REMEMBER - All vaccines can be safely kept in the temperature range 2ºC - 8ºC. • Vaccines can become less effective or even lose their effectiveness altogether if they: • Get too hot • Freeze • exposed to light

  23. DO NOT FREEZE THESE VACCINES DTP (Diphtheria-tetanus- pertussis vaccine "Triple antigen") CDT (Combined diphtheria-tetanus vaccine) ADT (Adult diphtheria-tetanus vaccine) TT (Tetanus toxoid) · Hib vaccines Hepatitis B Vaccine · Hepatitis A Vaccine Monovalent pertussis vaccine Influenza vaccine DO NOT EXPOSE THESE VACCINES TO LIGHT: BCG Vaccine MMR (measles/mumps/rubella) vaccine Oral poliomyelitis vaccine (OPV)

  24. Dosage

  25. Quiz: Immunization

  26. 1.  A child's temperature should be checked routinely before vaccinations are administered?

  27. 2. What if the patient comes late for measles vaccine?

  28. 3. Can BCG vaccine be given any time during infancy if missed at birth?

  29. 4. How many doses of OPV are recommended for children <5years of age?

  30. What about if a 3 year old child came with no vaccination at all?

  31. Thank You

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