Strengthening Routine EPI through PEI Network<br />TAG Meeting, 24-25, March,2011 Islamabad<br />
Overview of National  Routine EPI  ProgramDr Zahra MohammedDr Rohullah<br />
EPI Service Delivery Modality<br />Routine EPI Vaccination through<br />Fixed EPI clinics- 1210<br />Outreach<br />Mobile<...
Coverage of various EPI Antigen (National)2008-10<br />
% Districts with >80% Coverage of DPT-3& OPV-3 - 2008-10<br />
Access Vs Utilization Nationally: Proportion  Categories –2008-10<br />Cat1: >80% Coverage, <10% DOR; <br />Cat2 : >80% Co...
Districts in various categories: Access Vs utilization for 2010<br /><ul><li>More number of measles Outbreak
More number of NNT cases
Most of the polio cases
More non-reporting districts</li></ul>Category 1<br />Category 2<br />Category 3<br />Category 4 <br />
Child Health Weeks- Accelerated RI<br />Total 32 districts with DPT-HepB-Hib-3 coverage included<br />Three rounds in each...
Issues and Challenges<br />Discrepancy between different sources of population data for planning purpose<br />15%-30% of p...
Way Forward<br />Updating and strengthening of micro-plans in phase-wise manner  ensuring its appropriate implementation<b...
PEI North <br />
Strengthening Routine EPI is important strategy for PEI<br />With decreasing number of SIAs, Increasing immunity gap among...
Supporting routine EPI through PEI network<br />Using AFP surveillance data to improve routine EPI services. <br />Regular...
Median of  routine EPI coverage in the vicinity of AFP cases<br />
Area coverage survey from detailed AFP case review <br />
Using AFP surveillance data to improve routine EPI services <br />
Activity to improve routine EPI-2009,2010<br />
PPO Observations in Fix centers<br />No OPV in Fix Center<br />No OPV for one month<br />BCG no diluent<br />NO gas for fr...
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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

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

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