Immunization and surveillance

1. Category 1
High coverage (>=80%),
Low drop-out (<10%)
Category 2
High coverage (>=80%),
high drop-out (>=10%)
Category 3
Low coverage (<80%),
Low drop-out (<10%)
Category 4
Low coverage (<80%),
high drop-out (>=10%)
Target Population of Children <1 Year of Age
Availability of EPI and VPD Reporting and Recording Tools
Timeliness and Completeness
EPI and VPD Surveillance Data Agreement
Gap identified Recommendation for Improvement
Disagreement
between target
population figure
at the district and
HF level
□ Compare population data from various sources including
data from National Immunisation Days
□ Communicate/discuss with the district DPHN and
HRIO/EPI Coordinator and harmonize
Gap identified Recommendation for Improvement
Lack of standard
data collection
forms
□ In-charge to obtain copies of standard missing tools from
the district (district should ensure they have these for
distribution)
□ In-charge should make photocopies, in absence of
standard tally sheets, Monthly report and IBS weekly
reports
Poor data
archiving (hard-
copy tools)
□ Ensure separate filing for tally sheet(s), Monthly Report,
immunisation register and IBS weekly reports
□ Arrange all archived tools by month and year, and label
files and reports with the facility name and MM/YYYY
□ Ensure that all archived tools are adequately stored in a
safe place such as shelves or cabinets
Gap identified Recommendation for Improvement
Poor access
(<80%
coverage)
□ Map catchment area to include all populations
□ Meet with the community to discuss possible reasons for low attendance and suggested solutions
□ Screen all infants for immunisation during each visit and give all of the vaccines they are eligible to receive
□ Inform parents about benefits of immunization and reassure about side-effects
Poor utilization
(High drop-out
>=10%)
□ Consult the community and change work plan to make sessions more convenient for the community
□ Check whether all planned sessions have been held, aim to improve reliability by holding all planned sessions
□ Review stock recording system, vaccine usage and wastage rates and take action
□ Ensure that health workers clearly explain to parents/caregiver when each vaccines are due and why they are needed
Gap identified Recommendation for Improvement
Poor timeliness or
completeness of
reporting Monthly
from HF to the district
□ Ensure health workers understand the importance of timely and
complete reporting of the Monthly Report to the district (by the 5th of
the following month)
□ Discuss the causes of late reporting with health facility staff and
develop SMART recommendations to improve timeliness and
completeness of reporting
Gap identified Recommendation for Improvement
Disagreement in the number
of vaccinations between
immunisation register, tally
sheet and Monthly Report
report
□ Ensure that health workers review the tally sheet(s) and
immunisation register when recording immunisation data on
the Monthly Report monthly report
□ Request HF In-charge and EPI staff to review tally sheet totals
for each month and ensure they are in agreement with Monthly
Report before reporting to the district
Disagreement in the number
of vaccinations between
Monthly Report report and
DHIS2
□ district HRIO/EPI Coordinator should review Monthly Report
forms for completeness and accuracy, and provide regular
feedback to health facility staff
Disagreement in the number
of VPD cases recorded
between clinical registers and
IBS weekly reports, or
between district weekly IBS
reports and DHIS2 records
□ Review standard case definitions with the facility staff to ensure
proper disease classification
□ Request HF In-charge to review weekly reports to ensure
accuracy and completeness of records
□ district HRIO/EPI Coordinator should review weekly IBS reports
for completeness and accuracy, and provide regular feedback to
health facility staff
Poor data recording (Immunisation register and tally sheets):
□ A new entry in the child register should be created for every new infant or child
(including transit) that presents at the health facility (as well as those children
from outside the health facility catchment area)
□ All immunisations administered at static, mobile and outreach session should be
recorded in the child register
□ A separate tally sheet is used for each static and outreach immunisation session
□ Tally each immunisation immediately after vaccination is administered and
transfer to Monthly Report immediately after the session by age group
EPI Monitoring Charts (RED Categorisation)