EXPANDED IM.ppt immunization program 12333

EXPANDED IM.ppt immunization program 12333

1. Expanded Program
of
Immunization

2. Objectives of the lecture
1 -Scope of the program
2 -Objectives of the EPI
3 -Strategies of the program
4-The target population
5 -Schedule of immunization in KSA
6 -Dose, route of administration and type of
each vaccine.
7 -Contraindications of vaccination
8 -Estimation of the eligibles
9 -Records and reports
10 -Defaulter tracing
11 -Cold chain

3. Scope of the EPI
Experience with smallpox eradication program
showed the world that immunization was the
most powerful and cost-effective weapon
against vaccine preventable diseases.
In 1974, the WHO launched its “ Expanded
program of immunization ” (EPI) against six
most common preventable diseases
(diphtheria, pertussis, tetanus, polio,
tuberculosis and measles.

4. “Expanded” means:
•Expanding the number of diseases to be
covered
•Expanding the number of children and
target population to be covered
•Expanding coverage to all corners of the
country and spreading services to reach
the less privileged sectors of the society

5. Objectives of the EPI
•To reduce the morbidity and mortality of the
major six childhood diseases.
•To achieve 100% coverage for eligible children
by an ongoing integrated program
•To deliver an integrated immunization services
through health centers, as primary health care
service package
•To develop a surveillance system which
collect adequate information on the diseases
preventable by immunization
•To minimize the efforts and cost of treatment
•To promote a new healthy generation

6. Strategies of the EPI
•Integrate vaccination sessions with PHC
services
•Appropriate measures to expand the
vaccination coverage of the eligible
population
•Ensuring regular supply of potent vaccine
•Strengthening the cold chain
•Training of health personnel
•Promotion of community participation
•Incorporating health education activities
related to EPI

7. •Ensuring logistic support ( supplies and
equipments)
•Introducing a system for continuous
monitoring and periodic evaluation
•Undertaking operational research to
find out deficiencies and difficulties in
the program and suggest methods of
improvement

8. Targets
•Under 5-years children.
•Women in the child
bearing age (15-45 years).

9. •Schedule of immunization
•Type of the vaccine
•Dose of each vaccine
•Route of administration
•Precautions of vaccination

10. Contraindications of
vaccination
•There are only 3 contraindications:
•Immune compromised child ( mainly
AIDS) → no BCG
•Child who develops convulsions after
the first dose of DPT → DT
•Severely ill child to the extent that he
urgently referred to the hospital

11. Estimation of eligibles
•The target population is estimated on the
basis of total population as registered
during survey and the increase in the
population on the basis of birth rate and
growth rate.
•Example:
•Annual growth rate ………………… ...4%
•Total registered population………...1000
•Birth rate……………………………… ..50l1000
•No. of expected births = 0-1
year…………… .50

12. •No. in child bearing age…………………… .20%
•No. of pregnant women expected =
•no. of 0-1 year infant =…………..50
•No. of children under 2 years = double the no. of
infants…….= 100
•Estimated requirements of vaccine per episode
of supply (for each vaccine calculated
separately):
•Total number of children to be vaccinated in one
year x Number of doses to be given + 10%
wastage

13. Periodicity of the supply
Example:
•No. of children below 2 years of age:…..6126
•No. of children below 2 years already
immunized ……1126
•No. of eligible = 6126-1126 ……….=5000
•Proposed coverage……………… ...=85% = 4250
•No. of doses of given to each……….3
•Annual requirement …………… .. …= 4250 x 3 +
10%= 12750 +1275 = 14025 doses
•Monthly doses……..= 14025 ÷ 12 = 1169 doses
•Convert doses into vials i.e if the vial contains
10 doses………………………… 116 vial

14. Records and reports
•Records are required for:
1.Monitoring of program progress.
2.Identification of defaulters.
3.Comparing with EPI-related
disease situation.

15. Types of records:
1.Yearly vaccination register- by age, sex,
nationality and dosage numbers.
2.Daily vaccination register- with
identifying family register number.
3.Follow up register.
4.Stock indent register.
5.Immunization card ( details of
immunization and the date of next visit).

16. Reports
•Monthly immunization report
showing total number of doses, age,
sex, nationality are sent in the first
week of each month.
•This information would form a strong
base for the development of a
surveillance system for EPI and EPI
related diseases.

17. Cold chain
•Cold chain is a system of storing,
transporting and distributing of
vaccines in the correct temperature
and way from the factory to the
vaccinated child.
•Cold chain is a corner stone of the
EPI, because the vaccine loses the
efficacy if incorrectly kept.

18. Cold chain levels
•The central level.
•Regional level.
•Primary health care
center level.