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A Comprehensive Policy framework for the National Immunization Programme

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Title: A Comprehensive Policy framework for the National Immunization Programme


1
A Comprehensive Policy framework for the National
Immunization Programme
  • Dr Nihal Abeysinghe,
  • M.B.,B.S., MSc, M.D.
  • Chief Epidemiologist,
  • Ministry of Health

2
Immunization Programme Sri Lanka Vaccines used
at present
  • BCG for Tuberculosis
  • Oral polio for Poliomyelitis
  • DPT / DT for Diphtheria, Pertusis Whooping
    Cough Tetanus
  • Measles
  • Rubella
  • Tetanus
  • Hepatitis B
  • Japanese Encephalitis

3
Present status of the Immunization Programme, Sri
Lanka
  • Dramatic reduction in illness, disability death
    from
  • Poliomyelitis (0) since 1994
  • Diptheria (0) in 2005
  • Tetanus (25) / Neonatal Tetanus (0)
  • Whooping Cough (32)
  • Measles (24)
  • Childhood tuberculosis
  • Japanese Encephalitis
  • Rubella
  • Very high vaccine coverage gt 95

4
Decision Making Process
  • Evidence based decision making
  • Epidemiology Unit recognizes the needs
  • Makes addition to the surveillance system
  • Carries out burden cost studies
  • Proposes to the Advisory Committee on
    Communicable Diseases
  • Reviewed approved by the Advisory Committee on
    Communicable Diseases ACCD
  • Discussion with a wider group of stakeholders
    Immunization Summit-held on 5th January 2007
  • Negotiate for funding convince the Finance
    Ministry
  • Acquire logistics, other facilities prepare the
    field staff
  • Develop a communication strategy
  • Develop plans for Continuous follow up,
    Monitoring Evaluation

5
Strength of the Sri Lankan EPI Number of Years
Taken to Reach Over 90 Coverage Following
Introduction of a New Vaccine
6
Present Challenges
  • Sustaining high coverage
  • Achieving eradication elimination targets
  • Ensuring vaccines of assured quality
  • Introducing new vaccines
  • Strengthening the capacity for surveillance of
    Vaccine-preventable diseases Adverse Events
    following immunizations
  • Ensuring financial sustainability for the
    immunization programme
  • Strengthening Primary Health care system

7
Cost Considerations in the National EPI
  • Introduction of a new vaccine is always
    considered within the framework of the National
    EPI, not separately
  • Total cost
  • Vaccine
  • Injection supplies
  • Other routine recurrent cost
  • Cold chain equipment
  • Transportation

8
Policies that would help us to achieve the
desired status
  • Equity and equality
  • Ownership, partnership and responsibility
  • Government
  • Other stakeholders
  • International organizations
  • Accountability
  • publicly accountable for the policies, goals,
    strategies and actions
  • Assured quality, safe products and services
  • Internationally recognized standards of quality,
    safety, and services are delivered according to
    best practices.

9
Policies that would help us to achieve the
desired status
  • Adaptability to local needs and circumstances
  • commitment of all responsible stakeholders to
    appropriately adapt to the local needs and
    circumstances.
  • Sustainability through technical and financial
    capacity building
  • All stakeholders including the government should
    work collectively, to ensure financial and
    technical self reliance with continuing,
    incremental infrastructure building.
  • Policies and strategies based on evidence and
    best practices
  • The choice of policies, strategies and practices
    should be based on evidence from surveillance,
    monitoring and evaluation, operational research,
    diseases burden and impact assessments, and
    economic analyses

10
Key Strategies
  • Implementing the comprehensive Multi Year Plan
    annual plans
  • Reaching children in difficult to reach areas
  • Ensuring quality vaccine supply accessories
  • Improving quality services by enhancing the
    service facilities, vaccine storage capacity
    surveillance of Adverse Events Following
    Immunization
  • Creating a Community demand
  • Introducing new vaccines to combat emerging new
    VPD with financial sustainability plans
  • Regular reviewing of the programme
  • What works What not

11
Key Strategies
  • Ensuring financial sustainability
  • Improving National regulatory authority
    activities by regular discussions
  • Promoting operational research Disease Burden
    studies
  • Improving management of human resources
  • Strengthening laboratory capacity
  • Strengthening capacity for data management
  • Planning for immunization in complex emergencies
  • Develop implement a comprehensive communication
    strategy
  • Include immunization in epidemic preparedness
    plans
  • Define delegate responsibilities to
    stakeholders

12
Thank you
  • Epidemiology Unit
  • Ministry of Health
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