Immunization Services - PowerPoint PPT Presentation

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Immunization Services

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Means different things to different people. Regional and agency differences ... Complements weak routine for key diseases. Early warning for outbreaks. Special Surveys ... – PowerPoint PPT presentation

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Title: Immunization Services


1
Immunization Services
  • DR. KANUPRIYA CHATURVEDI
  • DR .S.K. CHATURVEDI

2
Objectives
  • Describe what comprises routine immunization
    services
  • Components
  • Activities within components
  • Role of a Plan of Action

3
What is routine immunization
  • No standard definition
  • Hard to define
  • Means different things to different people
  • Regional and agency differences
  • The sum of human and logistical activities/events
    to ensure the regular delivery uptake of
    vaccines the monitoring of their positive
    adverse impact

4
What is routine immunization
  • Implies the regular delivery, i.e., known
    schedule, of EPI vaccines
  • Fixed posts /or outreach
  • Part of a larger plan
  • Not time limited
  • Goal to provide needed vaccines to all eligible
    persons and to successive birth cohorts

5
Routine services Ensuring that all children
receive the WHO recommended vaccination schedule
Age EPI visit Vaccine Hepatitis B - options Hepatitis B - options Hepatitis B - options
Age EPI visit Vaccine Option1 Option2 Option3
Birth 0 BCG (OPV) Hep B Hep B
6 weeks 1 OPV1, DTP1, Hib1 Hep B1 monovalent or in combo DTP-Hep B1
10 weeks 2 OPV2, DTP2, Hib2 Hep B2 monovalent or in combo Hep B2 (monovalent) DTP-Hep B2
14 weeks 3 OPV3, DTP3, Hib3 Hep B3 monovalent or in combo Hep B3 (monovalent) DTP-Hep B3
9-12 months 4 Measles (Rubella)
6
WHOs Approach Components of routine
immunization systems
Vaccine Supply Quality
Logistics
Service delivery
Advocacy Communication
Surveillance
7
Components glued together by
  • Planning
  • Management
  • Coordination
  • Supervision
  • Training
  • Financing

Components glue exist at national,
provincial, district local level. Cascading
effect
8
Activities..
Vaccine Supply Quality
  • National level
  • ..Policy on
  • Procurement
  • Quality
  • Local production
  • National Regulatory Authority
  • Strategies for international procurement
  • Timely vaccine ordering
  • Financial security for purchase
  • Supply planning (VVMs, vaccines, syringes)
  • Lower Levels
  • ..Ordering supply planning
  • ..Getting vaccine supplies to the lower
  • levels for administration

9
Activities
  • National Level
  • .Policy statement implementation
  • Injection safety
  • Health care waste disposal
  • Cold chain
  • National central cold store
  • Vaccine/supply management
  • Transport management
  • Supplies, supervision
  • Lower levels
  • Vaccine/supply management
  • Cold chain
  • Transport
  • Getting the vaccine to the people

Logistics
10
Activities.
  • National level
  • Policy
  • Standards guidelines
  • Case definitions
  • Disease, coverage, adverse
  • events monitoring for nation
  • Data management systems
  • Improving data quality
  • Laboratory Services
  • Local level
  • Disease, adverse
  • events monitoring
  • Vaccine supply
  • Vaccination info management
  • Register
  • Tally sheets

Surveillance
11
Activities.
  • Types of surveillance in EPI
  • Routine
  • Generally passive, provides idea on trends,
    impact of program
  • Special routine AFP, fever/rash
  • Sentinel
  • Complements weak routine for key diseases
  • Early warning for outbreaks
  • Special Surveys
  • Set baseline disease burden

Surveillance
12
Activities
  • National Level
  • Technical documents guidelines
  • Capacity building
  • Partnerships with media
  • Social Mobilization
  • Local Level
  • Partnerships with the community
  • Social Mobilization

Advocacy Communication
13
Activities
  • National Level
  • Supporting local level
  • Local level
  • Vaccination activities

Service delivery
14
Activities
Delivery modes - Fixed sites - Outreach -
Mobile services - Pulse campaigns - Campaigns
Service delivery
Each mode has its own advantages disadvantages,
its own indications for use,
considerations No single mode is appropriate for
all circumstances/diseases
15
The glue
5 key components of EPI
1. Planning 2. Management 3. Coordination 4.
Supervision 5. Training 6. Financing
Activities to get the job done National
provincial district health
facility
16
Monitoring Program Performance
  • Key indicators (an example)
  • Coverage levels
  • Fully vaccinated child, individual antigens
  • Access to services
  • BCG and/or DTP1 coverage
  • Tracking follow up activities
  • Dropout - DTP1 to Measles
  • Median age of receipt of vaccines
  • Missed opportunities
  • Cold chain quality
  • Vaccines at correct temperature
  • Provider knowledge/practices

17
Plans of Action (POA)
5 key components of EPI
1. Planning 2. Management 3. Coordination 4.
Supervision 5. Training
POAs.. ..Detailed costed activities to ensure
adequate implementation of key components and the
glue 5 year 1 year plan National,
provincial, district level plans Must be a
living document used to monitor routine
immunization services
18
Plans of Action
  • Different formats in different countries, regions
  • Should contain
  • For each component
  • Goals/objectives
  • Key activities
  • Timeline
  • Cost
  • Responsibility
  • For each type of glue
  • Key activities
  • Timeline
  • Cost

19
District Plans of Action
  • Important for efficient service delivery
  • Similar to national, but with emphasis on
  • High risk areas
  • High risk populations
  • Special activities, e.g., outreach, mobile
    services
  • Social promotion
  • Supervision
  • Local funding sources and channels

20
Inter-agency Coordinating Committee (ICC)
  • Composition
  • Example MOH, WHO, UNICEF, USAID, Rotary, NGOs,
    etc
  • Varies by country
  • Promotes collaboration cooperation
  • Prevents
  • Duplication of activities
  • Ensures that all activities/components/glue are
    covered and will be addressed in the POA
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