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Extended Program on Immunization (EPI)

Overview

The Expanded Programme on Immunization (EPI) is a disease prevention activity aiming at reducing illness, disability and mortality from childhood diseases preventable by immunization.
These diseases are referred as 8 EPI target diseases and cause millions of ailments, disabilities & deaths each year.

  • Poliomyelitis
  • Neonatal Tetanus
  • Measles
  • Diphtheria
  • Pertussis (Whooping Cough)
  • Hepatitis-B
  • Hib Pneumonia & Meningitis
  • Childhood Tuberculosis

The diseases are preventable and can be eradicated like Smallpox, as very safe & effective vaccines are available.

27 % of deaths in < 5 years age group are due to vaccine Preventable Diseases.

80% children of world are being protected against childhood TB.

3 million children & 19.5 million CBAs are being protected against eight vaccine preventable diseases and tetanus respectively.

1000 deaths in less than 5 year children will daily occur in Pakistan, if EPI is discontinued. Immunization is one of the most successful and cost effective health interventions. It has eradicated small pox, lowered the global incidence of polio so far by 99% and achieved dramatic reductions in illness, disability and death from diphtheria, tetanus, whooping cough and measles. It is a world-wide Programme being carried out in all countries assisted by WHO, UNICEF and other donor agencies.

The global target of the Programme is to immunize over 95% of infants and child-bearing-age females.
Historical Development

  • Pilot Project
1978
  • Integrated into regular Health Services
1983
  • Accelerated Health Programme (AHP)
1985
  • Addition of  Vaccine for HepB
2002
  • Addition of Vaccine for Hib Meningitis & Pneumonia
2008

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Objectives

The overall objective of the EPI is reduction of mortality and morbidity from the eight EPI diseases by offering immunization services.

Following are the EPI diseases

  • Poliomyelitis
  • Diphtheria
  • Pertussis (Whooping cough)
  • Tuberculosis
  • Tetanus
  • Measles
  • Hepatitis-B
  • Hib Meningitis & Pneumonia

With this objective, the Programme started in Pakistan in 1978 and is still continuing. The programme is evaluated at intervals of 2-3 years.

Specific objectives of the Programme are as follows:

  • Achievement of 90/80 % immunization coverage by 2010
  • Elimination of Neonatal Tetanus
  • Elimination of Measles by 2010.
  • Reduction of VPDs morbidity & mortality by 2/3rd by year 2015 as compared to 2000 as per MDG-4.
  • Certification of Eradication of Poliomyelitis after being free for 3 years from polio
  • Introduction of new vaccines in the EPI immunization Schedule i.e. Pneumococcal Vaccine in 2011 and Rota-virus Vaccine in 2013.
     

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Components of EPI

  • Routine Immunization
    • Children 0-23 months – immunization with 8 EPI antigens
    • Pregnant ladies by TT.
  • Supplemental Immunization Activities
    • Routine immunization does not ensure 100% coverage of the mobile population i.e. nomads, NAs, hard to reach areas / missed areas. So SIAs are scheduled to ensure coverage of this population / areas.
    • NIDs / SNIDs: children < 5 years receive polio drops (3-days campaign)
  • Disease Surveillance
    • To detect every case of target diseases, the suspected cases of seven VPDs are reported by health facilities to the district health authorities for immediate launching of the control measures.
  • Mopping up
    • Special campaigns 5-8 km around the infected locality to localize the disease and stop its transmission.
       

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Achievements

  • 80.2 %( 0-11 months) children fully immunized (CES-2006).
  • 35.8 Million Children immunized against measles through special campaign in 2008.
  • TT Immunization to target women (15-49 yrs.) in 6 high risk Districts in Punjab.
  • Vitamin-A supplementation –twice a year with coverage >95%.
  • Storage capacity enhanced for the buffer stocks of all vaccines for the period of 3 months.  
  • Improved monitoring & supervision through
  • Provision of 59 single cabin vehicles for DO(H) under GAVI.
  • 104 Suzuki Potohar jeeps for DDO (H) under GAVI.
  • Provision of 3652 motorcycles to EPI staff under GAVI.
  • Provision of cold chain equipment to 8 flood hit districts.
  • Capacity building of health managers and EPI staff, (17,804).
  • Orientation training workshops for medical officers LHVs, LHWs, etc.
  • Training of health personnel for cold chain repair and maintenance.
  • Training workshops for vaccine stock management carried out in all districts during 2010 & 2011.

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Future Plans

  • Draft PC-I for the period 2012-16 developed in context of devolution under 18th amendment.
  • Procurement of EPI vaccines, syringes and cold chain equipment worth Rs. 77.1 million for the year 2010-11 (under process)
  • Funds of Rs. 669 million demanded for procurements of EPI vaccines and syringes during the year 2010-11
  • Establishment of 138 new EPI centers during 2011(under process)
  • To stop all wild polio virus transmission by Dec 2011
  • Develop ownership of  National/Provincial Emergency Action Plans to UC level
  • Enhance Inter Sectorial collaboration
  • Improve and sustain routine EPI coverage
  • Improve  and sustain high quality polio campaigns
  • Strengthen disease surveillance for vaccine preventable diseases
  • Increased collaboration with CSOs & opinion makers.

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Contacts
Program Manager
Director Health Services (EPI), Punjab
24-Cooper Road, Lahore
Ph#: 042-99201143-99204397
Fax: 042-99200405
Email: epipunjab@yahoo.com

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Organogram (Click here)

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Site Last Updated: 26th November 2014