STRENGHTENING EPI IN BALOCHISTAN

A Presentation for
World bank Mission
6th April.2015

Comparison of Countrywide EPI Coverage

PDHS 2012-13
BCG

Penta I

Penta III

Measles 1

Fully Immunized
Children

Balochistan

48.9%

37.7%

27.1%

37.3%

16.4%

Punjab

85.5%

87.2%

64.5%

70.0%

65.6%

Sindh

76.7%

65.1%

38.6%

44.6%

29.1%

KPK

71.1%

77.1%

69.6%

57.8%

52.7%

Pakistan

85.2%

78.8%

65.25%

61.4%

53.8%

Province

Confirmed Polio Cases By Poliovirus Type, 2010-15*

Quetta Block
No WP3 58 Mos
19 WP1 After 24 Mos
SIADs in Low Season
Cases (n)

No cVDPV2 25 Mos
Outbreak
response

2010

2011

2012

2013

2014

Total Cases 07

Total Cases 53

Total Cases 18

Total Cases 00

Total Cases 19

* Afp.rec Data as of 09-02-14

Virus Type

WPV3

WPV1

cVDPV2

STRATEGIES AND MAIN ACTIVITIES

Human Resource Management

Costing and Financing

Vaccine, Cold Chain and Logistics

Immunization Services Delivery

Monitoring, Reporting and Supervision

Demand Creation , Communication & Advocacy

A NEW MODEL OF
PEI/PEI

Permanent Vaccination Teams Pilot Project

Permanent Vaccination teams project
was piloted in HRUC Kotwal A of
Quetta, in which 32 LWHs were
allotted on average 240 houses
Total of 11763 children were
vaccinated in 7617 houses with
detailed micro census of the UC
(names and ages of children, parents
names, RI status of children etc)

UC MAP

40 houses survey report

Main Findings
Positive community support and acceptance
Collected the base line data of the UC with registration of all under 5 years of
children for all EPI/RI vaccinations.
The resources utilization was 100%,
Without security achieved the target.
81 % RI achived

DGHS
Partners
Organization
(WHO,
UNICEF,CDC,
PPHI
DC LHW
Program

Secretary
Health
PC EPI
DHO
DC
EPI/DDHO
DSV
UCSO
Vaccinators

CHVs

Community

IPH
Quetta
Reporting &
Feedback

Monitoring and
Supervision

New Organogram for

EPI

LHWs

ADC

5 Years Costing for Routine Immunization in

Balochistan
(2015 to 2020)
S. No

Routine Immunization
Components

1 Vaccines and Syringes

Cost for 5 Year in PKR

Cost for one year in Miilion PKR

5 Years Cost (Million US $)

3,155,880,044

631.18

30.94

2 Vehicle & Motor Cycles

54,000,000

10.80

0.53

3 Cold Chain Equipment

1,341,300,000

268.26

13.15

2,028,200,460

405.64

19.88

245,140,000

49.03

2.40

91,644,000

18.33

0.90

26,568,000

26.57

1.30

96,660,000

19.33

0.95

10 Trainings (District and UC Levels)

Overhead (Training manuals,
11 ACSM, Research)

44,040,000

8.81

0.43

30,000,000

6.00

0.29

12 Establishment Cost
Repair & Maintenance Cost (Cold
13 Chain & Vehicles)

132,840,000

26.57

1.30

4,497,180,000

899.44

44.09

2348.69

115.13

2348.69

115.13

Service Delivery (CHVs, LHWs,

4 Vaccinators, Mobile POL,)
Monitoring and Reporting
7 (District Level)
Monitoring and Reporting
8 (Provincial Level)
Monthaly Review Cost
9 Operational Cost

Total Routine Immunization

Grand Total (in Milion)

Total Cost without Vaccines

and Cold Chain

11,743,452,504
11743.4525

1449.25

Service Delivery
Component

Requirem
Unit Cost
ent

CHVs

2000

7000

LHWs
Incharge Vaccinators
(Present)
Incharge Vaccinators
(New)

4000

2600

900

3600

400

15000

Motorcycles for ORT

Vehicles for Mobile
Activity
POL for Mobile
Teams
Vaccine and
Logistics
Transportation

1200

70000

34

3500000

30

Total for
One Year
(PKR)
1680000
00
1248000
00
3888000
0
7200000
0
8400000
0
1190000
00

Total for 5
Years (PKR)

Total for Total for

One Year 5 Years
(Millions (Millions
US $)
US $)

840000000

1.65

8.24

624000000

1.22

6.12

194400000

0.38

1.91

360000000

0.71

3.53

84000000

0.82

0.82

119000000

1.17

1.17

20000 7200000

36000000

0.07

0.35

1960000

9800000

0.02

0.10

Monitoring & Reporting

Monitoring & Reporting (District Level)
Component

Unit Cost or
Requireme
Total for
Stipend/Mont
nt
One Year
h

UCSO
580
ADC
30
DC EPI/DDHO
30
DSV
30
Surveillance and Out Breaks

UCSO Laptop (1 Time)

580
Laptop District
30
Total Cost of Monitoring & Reporting

25000 174000000
10000
3600000
15000
5400000
7000
2520000
38067522
40000
23200000
50000
1500000
248287522

Component

Requirement

Unit Cost or
Stipened per
Month

DA/TA/Lodging

Laptops
5
70000
HR Support (IT)
3
100000
Quarterly Reviews
4
1000000
Total Cost of Monitoring & Reporting

Total for
One Year

Total for Total for 5

One Year
Years
(Millions
(Millions
US $)
US $)

Total for 5 Years

870000000
18000000
27000000
12600000
190337610
23200000
1500000
1142637610

Monitoring & Reporting (Provincial Level)

Total for 5 Years

1.71
0.04
0.05
0.02
0.37
0.23
0.01
2.43

8.53
0.18
0.26
0.12
1.87
0.23
0.01
11.20

Total for Total for 5

One Year
Years
(Millions
(Millions
US $)
US $)

13058800
350000
1200000
4000000

65294000
350000
6000000
20000000

0.13
0.0034
0.01
0.04

0.64
0.0034
0.06
0.20

18608800

91644000

0.18

0.90

Operational & Establishment

Cost
Operational Cost
Component

Requirem
ent

UC Level
District Level

Unit Cost

Total for
One Year

Total for 5
Years

Total for Total for 5

One Year
Years
(Millions (Millions
US $)
US $)

580

2000 13920000

69600000

0.14

0.68

30

7000 2520000

12600000

0.02

0.12

300000

1500000

0.003

0.015

16740000

83700000

0.16

0.82

Provincial Level

25000

Operational Cost

Establishment Cost
Component

UC Level

Requireme
nt

Unit Cost

580

District Level

30

Total Cost of Establishment

Total for
One Year

20000 11600000
20000

Total for Total for 5

One Year
Years
Total for 5 Years
(Millions (Millions
US $)
US $)
58000000

0.114

0.569

600000

3000000

0.006

0.029

12200000

61000000

0.12

0.60

Capacity Building & Overhead

Cost
Capacity Building
Component

Requireme
Unit Cost
nt

District
30
UCSO
580
Vacinators (2 months)
400
CHVs/LHWs
6000
Cost of Capacity Building

20000
2000
2080000
1000

Total for
One Year
600000
1160000
4160000
6000000
11920000

Total for 5 Years

3000000
5800000
4160000
30000000
42960000

Total for Total for 5

One Year
Years
(Millions
(Millions
US $)
US $)
0.006
0.011
0.041
0.059
0.12

0.029
0.057
0.041
0.294
0.42

Overhead Cost
Component

Requireme
nt

Training Manuals
MIS
Communications/Adverti
sement
Reporting Tools
Research (IPH)
Overhead Cost

Unit Cost

12000000
1
1000000
1
1
1

Total for
One Year

Total for Total for 5

One Year
Years
Total for 5 Years
(Millions
(Millions
US $)
US $)

2000000
1000000

10000000
5000000

0.020
0.010

0.098
0.049

10000000 10000000
1000000 1000000
200000
800000
13000000

50000000
5000000
4000000
74000000

0.098
0.010
0.008
0.15

0.490
0.049
0.039
0.73

Repair & Maintenance

Repair & Maintenance Cost

Component

Cold Chain

Requirem
ent

Unit Cost

Total for
One Year

Total for 5
Years

Total for Total for

One Year 5 Years
(Millions (Millions
US $)
US $)

4000000

20000000

0.039

0.196

Vehicle and Motorcycles

2000000

10000000

0.020

0.098

6000000

30000000

0.06

0.29

Repair and Maintenance Cost

NISP DLIs
DLIs

Yr1

Yr2

1. Percent of children aged between 12-23 months

in the province or territory who are fully
immunized

2. Percent of Union Councils (UCs) for which

revised computerized UC level micro plans are in
functional use at district and provincial levels

3. Percent of UCs reporting at least 80% coverage

of full immunization in children between 12-23
months, which have these reports validated by
independent TPV
4. Percentage of districts with at least 80%
timeliness & completeness reporting on vLMIS
5. Percent of districts with their recognized
surveillance sites having functional online
surveillance for Vaccine Preventable Diseases
(VPD) & Adverse Events Following Immunization
(AEFI)

Yr3 Yr4 Yr5 Total

2

NISP DLIs
Indicator

6. At least 80% score will be achieved in all

components in the effective vaccine management
(EVM) assessment at provincial level
7. Percent of detailed UC supervisory plans available
for all district supervisors to all provincial supervisor
officers
8. Level of expenditures incurred by the respective
DoHs and MONHSRC spent on public awareness
campaigns for immunization through print and
electronic media
9. Percent of children under two years of age with
vaccination card available
10. Budget allocations for immunization are
continuous, adequate and can be easily tracked
within the government financial management
information system

Yr1

Yr2

Yr3

Yr4

Yr5

Total

2
X

Thanks