Routine immunisation in the big four countries

1
Routine immunisation in the big four countries

• Vaccine Preventable Diseases Unit, WHO/DDC/AFRO
• 11th TFI 10th AIRCC Meeting, Luanda, Angola,
  2-5 December 2003

2
Below 50 during whole decade Fluctuations partly
due to data quality problem
Nigeria routine 2003 data not available
3
Reported DPT3 vaccination coverage by health
zone, DRCJan- June 2003
Almost 80 problem of access
lt50
50-79
gt80
No data
4
DPT3 Vaccination Coverage by State, Nigeria Valid
doses by 23 months, 2003 Survey results
(unofficial, preliminary)
JRF 2002 data DPT3 ca 10
lt50
50-79
gt80
No data
5
Estimated infants un-vaccinated, 2003
10 increase in coverage in each of the 4
countries, will - reduce number of un-vaccinated
children in the Region by ca. 1,041,000 - protect
884,000 more infants against measles
2002 JRF and survey 2003
6
Some country specifics
7
Some country specifics
8
Major WHO support - routine immunisation, 2003

• Support acceleration activities for routine
  immunisation
• Polio eradication and measles control initiatives
  
• Technical assistance
• Cold chain management (inventory, purchases and
  training of logisticians)
• Transport management system
• Training needs assessments

9
Challenges

• Almost 3/4 of AFR un-vaccinated children in Big 4
  
• Angola
• Problems of infra-structure and human resource,
  especially in newly accessible districts
• Ethiopia
• Most key staff at EPI Central management team
  supported by partners
• Negotiations and reaching consensus takes long,
  especially at Regional level
• Decentralisation still on going and is a major
  cause of high staff turn-over

10
Challenges (2)

• DRC
• Very difficult terrain, in-security, migrating
  population
• Nigeria
• Very low routine coverage and circulating WPV
• Weak monitoring system for routine data is
  incomplete and late
• Investing in system strengthening, national
  commitment and sustainability

11
Issues to be considered by TFI

• Supporting the country initiatives for Reaching
  Every District (RED)
• Coordinated, synergistically, long-term
  commitment
• Strengthen system, expand
• Decentralising ICCs
• How to improve monitoring for routine in Nigeria
• Supporting human resource development and
  capacity building, especially in Angola and
  Ethiopia

12
Issues to be considered by TFI (2)

• Further advocacy for MOH-Ethiopia to recruit more
  staff to strengthen central level management team
  for increased efficient support to the Regions
• Recruitment of 2 internationals to support
  routine immunisation activities in Nigeria
• Coordinating use of available resources (ADC) to
  strengthen routine