IMMUNIZATION PROGRAMME IN TANZANIA

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IMMUNIZATION PROGRAMME IN TANZANIA

• Dr Aza

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Introduction

• The Expanded Programme on Immunization (EPI) in
  the country started in 1975 with the aim of
  reducing morbidity and mortality caused by
  measles, poliomyelitis, whooping cough, tetanus
  and tuberculosis in children under 5 years of
  age.
• The programme is currently involved in delivering
  safe vaccines for vaccine preventable diseases to
  under one and women of child bearing age and/or
  populations at risk.

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• The programme also involves procurement of
  vaccines, supplies and equipment from the
  manufacturer/suppliers to the point of vaccine
  administration in a recommended condition.
• In the process of delivering vaccines,
  appropriate storage and transport facilities are
  important issues of the programme.

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Vaccine-preventable diseases

• Vaccine preventable diseases in Tanzania that are
  currently addressed by immunization programme
  include
• ?? Polio,
• ?? Measles,
• ?? Neonatal Tetanus,
• ?? Diphtheria,
• ?? Pertusis,
• ?? Tuberculosis
• ?? Hepatitis B.

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• The current available vaccines in the programme
  are
• Bacille Calmette-Guerin(BCG)
• Oral Polio Vaccine(OPV)
• Diptheria-Pertusis- Tetanus-Hepatitis B(DPT-HB)
• Measles vaccines and
• Antitetanus toxoid for pregnant women

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Programme financing

• Programme receives funds from GAVI(Global
  Alliance for Vaccines and Immunization), Central
  government and other partners such as UNICEF,
  WHO, JICA, DANIDA, Ireland Aid, USAID, Rotary
  international and the Basket Fund.

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Programme organization and management.

• The Expanded Programme on Immunization is under
  the Reproductive and Child Health Section, which
  belongs to the Directorate of Preventive Services
  of the MOH(Ministry of Healthy).
• At the national level there is a Programme
  Manager who is the overall in-charge of the
  programme.
• The programme comprises of four sections, which
  are Monitoring, Training, Administration and Cold
  Chain/Logistics.

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At National(central)level

• The role of the Programme at Central level is to
  formulate policy guidelines and standard and
  guidelines on immunization strategies for
  immunization, planning and budgeting, training,
  procurement and storage of vaccines, supplies and
  equipment, distribution, monitoring and
  evaluation.
• The Central level is also vested with the role of
  managing the resources i.e. storage, distribution
  facilities, and equipment.

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At regional level

• At this level, the programme is under the
  Regional Medical Officer (RMO) who is being
  assisted by Regional Cold Chain Officer (RCCO)
  and Regional MCH(Mother and Child
  Health)Coordinator.
• Their functions include planning and budgeting,
  storage, distribution, monitoring and
  supervision, training, technical support and
  management of resources of immunization
  activities at regional level.

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At district level

• At the district, the District Medical Officer
  (DMO) is the in-charge of the programme and is
  being assisted by the District Cold Chain Officer
  (DCCO) and the District MCH Coordinators.
• Their roles include planning and budgeting for
  immunization activities, storage and
  distribution, monitoring and supervision,
  facilitating the implementation, training and
  providing technical support to the facilities.

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Program performance

• Immunization Schedules
• There are two immunization schedules currently in
  use. The first schedule is targeting to children
  under one year of age and the second is for women
  of childbearing age, that is, 15-49 years.

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Under one year
ANTIGEN SCHEDULE
BCG At birth
OPV0 At birth
DPT-HB1,OPV1 Four weeks
DPT-HB2,OPV2 Eight weeks
DPT-HB3,OPV3 Twelve weeks
Measles Nine month
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Child bearing age
ANTIGEN SCHEDULE
TT1 Any time at first contact
TT2 One month after the first visit(TT1)
TT3 Six months after TT2
TT4 One year after TT3
TT5 One year after TT4
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Programme constraints

• In the implementation of immunization activities,
  there are various constraints, which affect the
  performance and sustainability of the program.
  These constraints include
• 1.Inadequate funds for funding all planned
  activities
• 2.Delay in disbursement of funds from both
  government and Development partners.

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• 3.Receiving fewer funds as compared to pledges
  from different sources.
• 4.Delays in the procurement process.
• 5.Lack of adequate and qualified staffs
  especially at the facility level.

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EPI Strategies 2007-2015

• To Strengthen the delivery of safe and effective
  vaccine.
• To have adequate monitoring system supplies and
  performance.
• To support hard to reach/low coverage districts
• To strengthen outreach services
• To involve local governments in planning
• To ensure availability of CFC free cold chain
  equipments by 2010.
• To ensure proper coordination between EPI and
  other partners
• To strengthen managerial capacity at national
  level.
• To strengthen reporting system at all level
• To strengthen active surveillance for polio
  measles at all levels.
• To ensure implementation of mass campaign for
  measles control and polio eradication.
• To ensure polio free status is maintained.
• To strengthen community surveillance
• To establish hib/pneumococci/rota disease burden.

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• Thank you for your attention