Strengthening routine EPI through PEI network
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Strengthening routine EPI through PEI network






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  • 2009=471602010=8340
  • Aybak: there are inaccessible clusters, in the hospital reform system they are not accepting out reach or mobile activity.

Strengthening routine EPI through PEI network Strengthening routine EPI through PEI network Presentation Transcript

  • Strengthening Routine EPI through PEI Network
    TAG Meeting, 24-25, March,2011 Islamabad
  • Overview of National Routine EPI ProgramDr Zahra MohammedDr Rohullah
  • EPI Service Delivery Modality
    Routine EPI Vaccination through
    Fixed EPI clinics- 1210
    PIRI (Periodic Intensification of Routine Immunization)- Child Health Weeks
    SIAs for Polio, measles, and TT
  • Coverage of various EPI Antigen (National)2008-10
  • % Districts with >80% Coverage of DPT-3& OPV-3 - 2008-10
  • Access Vs Utilization Nationally: Proportion Categories –2008-10
    Cat1: >80% Coverage, <10% DOR;
    Cat2 : >80% Coverage , >10% DOR
    Cat3: <80% Coverage, <10% DOR;
    Cat4 : <80% Coverage , >10% DOR
  • Districts in various categories: Access Vs utilization for 2010
    • More number of measles Outbreak
    • More number of NNT cases
    • Most of the polio cases
    • More non-reporting districts
    Category 1
    Category 2
    Category 3
    Category 4
  • Child Health Weeks- Accelerated RI
    Total 32 districts with DPT-HepB-Hib-3 coverage included
    Three rounds in each district done
  • Issues and Challenges
    Discrepancy between different sources of population data for planning purpose
    15%-30% of populations have no access to HS/living in hard-to-reach areas/nomads/new illegal settlements/IDPs
    Poor monitoring of stakeholders (NGOs)
    Insecurity : a key problem for both access and utilization
    Poor outreach and mobile services
  • Way Forward
    Updating and strengthening of micro-plans in phase-wise manner ensuring its appropriate implementation
    Refresher training of vaccinators
    Strengthening of Cold Chain capacity following recommendation of EVM
    Ensuring that Polio Program structure devotes some percentage of the time and resources in strengthening routine immunization
  • PEI North
  • Strengthening Routine EPI is important strategy for PEI
    With decreasing number of SIAs, Increasing immunity gap among population particularly in most parts of the country without poliovirus circulation.
    Transmission and high risk zones :
    2009 =9
    2010 =8
    2011 =8
    Areas with no circulation:
    2009 =6
    2010 =4
    2011 =2( first 6 months)
    Strengthening Routine immunization is the most effective way to maintain population immunity
  • Supporting routine EPI through PEI network
    Using AFP surveillance data to improve routine EPI services.
    Regular supervision of EPI fixed centers by PPO
    Supporting District EPI team in routine EPI district micro planning
    Including routine EPI activities during internal AFP surveillance review.
  • Median of routine EPI coverage in the vicinity of AFP cases
  • Area coverage survey from detailed AFP case review
  • Using AFP surveillance data to improve routine EPI services
  • Activity to improve routine EPI-2009,2010
  • PPO Observations in Fix centers
    No OPV in Fix Center
    No OPV for one month
    BCG no diluent
    NO gas for fridge
    180 Vials expired
  • Including Routine EPI During AFP Surveillance review central region
    Out of 8 vaccination centers visited, vaccinator was found absent in 3 of the centers at the time of review.
    Knowledge of vaccinators in general was not adequate and the micro plan was not complete. Penta3 coverage (<60%) according to register
    Vaccine supply was more than the requirement (> 3 months supply)
    Drop out rate >10%
    On Job training was provided and feedback to PEMT and NGO
  • Conclusion
    With decreasing number of SIAs in non transmission zone, routine EPI is the only way to maintain population immunity.
    AFP surveillance was effectively used to improve routine EPI coverage in Northern region.
    Northern region experience is to be shared with other regions
    Strong coordination is required among partners to identify low routine EPI Pockets and plan to cover them accordingly.
  • Thank You