2HistoryMay 1974EPI-Pak, 1976Establishment of vaccination schedule -1984GAVI-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
3Programme 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 levelCollection of vaccines/syringes/needles from the Federal EPI Cell for further distribution to the districtsRepair and maintenance of cold chain equipmentMonitoring, evaluation and reportingSupervision at all EPI service delivery levelTraining of all EPI workers except Mid-level ManagersRepair and maintenance of vehicles
4Supervisory Management The Programme is being supervised bythe National, Provincial and district staffat every level in the country.The focal point for the EPI is the DistrictOfficer Health Preventative (DOH) ordistrict EPI Coordinator (DEC).
5EPI GoalsFull immunization of children under one year of age in every districtGlobal eradication of poliomyelitisReduction in maternal and neonatal tetanusCut half number of measles-related deaths
6Objective 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
7EPI Programme Exclusive Immunization provider Private sector- 3% 6000 fixed centres> million outreach and mobile vaccination sessions/year> 10 000 vaccinators6000 LHV’s100,000 LHWs
8EPI-Pak targets5.8 Million children5.9 Million pregnant women
13Number of reported cases Diphtheria. 34 Measles. 863 Pertussis Number of reported cases Diphtheria Measles Pertussis Polio Tetanus (neonatal) Tetanus (total) Source: WHO 2009
14Population data (in thousands) Total population. 180'808 Live births Population data (in thousands) Total population 180'808 Live births '403 Pop. < 5 years '121 Pop. < 15 years 66'781 Female years 44' Source: WHO 2009
17Problems in achieving EPI targets Inadequate service deliverylong distance to EPI centresLack of awareness of immunization benefitsunaffordable cost to reach the centresunavailability of vaccinatorsEPI centre- 1 in 10 UC in Punjab and 2 vaccinator in, in each UCPolitical commitment
18International Collaboration Canadian International development Agency (CIDA)Department for International Development [DFID]GAVIJapan International Cooperation Agency (JICA)Rotary InternationalUNICEFUnited States Agency for International Development (USAID)WHOWorld Bank
20What 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.
22Cold chain systemThe 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:
23Technical features that impact on vaccine storage and temperature monitoring
26REMEMBER - 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 hotFreezeexposed to light
27DO 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 vaccinesHepatitis B Vaccine ·Hepatitis A VaccineMonovalent pertussis vaccineInfluenza vaccineDO NOT EXPOSE THESE VACCINES TO LIGHT:BCG VaccineMMR (measles/mumps/rubella) vaccineOral poliomyelitis vaccine (OPV)