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Topic of presentation:
“EPI IN PAKISTAN; A SUCCESS
OR A FAILURE ?”
PRESENTERS:

FARHEEN ZAFAR BUTT


SABA AHMED

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PROGRAMME OVERVIEW
EPI was launched in 1987.
AIM:
It aims at protecting children by immunizing
them against
Child hood tuberculosis
Poliomyelitis
Diphtheria
Pertussis
Measles
&
Tetanus

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Aim continues….
AND also protecting their mothers
against tetanus.

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PROGRAMME OBJECTIVES
Reduction of mortality and morbidity
resulting from 7 EPI target diseases
by immunizing children of age 0-11
months and women of child bearing
age.
90% routine immunization coverage
of all EPI antigens by 2012.
Interruption of polio virus transmission
by 2010.
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“Program objectives “continues….

Elimination of neonatal tetanus by 2015


Reduction of measles mortality by 90% by
2010.
Reduction of diphtheria ,pertussis and
childhood T.B. to a maximum level.
Control of other diseases by introducing new
vaccines in EPI as and when they are
available using EPI as a spearhead for
promoting other PHC activities and finally
integrating EPI into primary health care

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EPI SCHEDULE:
ROUTINE IMMUNIZATION SCHEDULE:
BCG & OVP 0 dose are given at birth,
DPT, HBV & OVP at 6, 10 and 14 weeks
Measles vaccine at the age of 9 months.
The pregnant ladies and child bearing age
ladies are provided immunization against
TT.

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EPI schedule continues…

THE SCHEDULE OF VACCINATION OF


PREGNANT WOMEN AND LADIES OF
CHILD BEARING AGE IS:
TT 1 at first contact,
TT 2 at least 4 weeks after 1st dose,
TT 3 at least 6 months after 2nd dose,
TT 4 at least 1 year after 3rd dose and
TT 5 at least one year after 4th dose)

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Program Responsibilities at
Federal level
Overall planning
guidance, support , monitoring and
evaluation
Coordination with International
Agencies
Purchase of vaccines/syringes and
supply to provinces
Mid-level Managers Training

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Program Responsibilities at
Provincial level
Implementation
Collection of vaccines/syringes/needles from
the Federal EPI Cell for further distribution to
the districts
Repair and maintenance of equipment
Monitoring, evaluation and reporting
Supervision at all EPI service delivery level
Training of all EPI workers except Mid-level
Managers

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Evaluation of EPI success:
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%age of children immunized in
each province (up to 2006)
ANTIGEN PUNJAB SINDH NWFP BALOCHISTAN

BCG 89.9 84.2 74.3 59.0

DPT3 82.6 66.5 61.3 40.2

MEASLES 80.2 63.6 57.6 40.9

FULLY
IMMUNIZED
76.2 59.8 52.0 32.0

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ANTIGEN AJK FATA FANA

BCG 95.5 53.4 86.9

DPT3 91.1 37.4 66.5

MEASLES 88.70 32.0 70.60

FUULY 84.0 25.6 59.6


IMMUNIZED

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EVALUATION RESULTS:
The trend of graphs shown in previous slides;
indicates that EPI in Pakistan has been quite
successful. Where as there is a room for
improvement.

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Recent additions in EPI
targets:
meningitis Surveillance
The Federal EPI has established Sentinel sites at
several tertiary care hospitals in the country to see
the disease burden of Bacterial Meningitis in the
country which will facilitate the EPI Program for the
introduction of Hib vaccine in the country.

High levels of advocacy achieved through


involvements of politicians, religious leaders and
community elders using Inter Personal
Communication (IPC), Print and Electronic media
tools.
The federal Government ensured required funding
for the routine programme.
EPI Diseases Surveillance system established

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Combination tetravalent
vaccine
Introduction of Combination tetravalent
vaccine (DPT + HepB) from 2008. This
will eliminate the coverage difference
between DPT3 and Hep B 3.

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HURDLES IN ATTAING 100%
RESULTS:
The course of vaccine is not
completed.

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In complete or last minute planning at federal and
provincial level.

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IDEAS FOR
IMPROVEMENT:
How to improve?
BY:
• Developing integrated social mobilization
/communication plans for EPI at all levels.
• Developing more responsibility and resources for
social mobilization to provinces and districts for
Facilitating local strategies.
• Holding more frequent meetings among
partners.

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How to improve the
communication strategy
General
• Focus messages on reaching every
child every round, e.g. search for the
missed children beginning
• Strengthen EPI communication,
especially between PEI rounds.

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Mass media
• Extend mass media broadcasting
before and after rounds.
• Work more creatively with PTV and
build their capacity to plan and produce
effective spots.
• Improve the use of BBC, VOA and
other international networks.
• Place spots on cable TV channels.
• Explore synergies with neighboring
country mass media channels.

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Other channels
• Place the ‘every child, every time message’ on such
as balloons, matchboxes, poster, stickers on
vehicles, product labels focusing on the “every child,
every time” message.
• Distribute calling card to closed homes.
• Employ special communication strategy for reaching
hard-to-reach groups e.g. elites: glossy and
special interest magazines, airlines, supermarkets,
paediatricians, Rotary and Lions Clubs,
hairdressers, housing co-operatives, GSM networks,
ISPs, internet cafes, taxi drivers, colleges, etc.
• Involve pre-schools (securing prior permission from
parents).

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Using electronic media can be a good source of
generating awareness about EPI among lay men.

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REFRENCES:
WHO/UNICEF
Review of National
Immunization
Coverage1980-
2003
Pakistan PEI/EPI
Communication
Review Report By
Mike Favin, Robert
Tyabji and Susan
Mackay Islamabad,
22 July 2001

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