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IMMUNIZATION IMMUNIZATION IN UGANDAIN UGANDA
Dan WamanyaDan WamanyaUSAID/Uganda
PROBLEMS WITH IMMUNIZATION
Low immunization coverage rate over the past 12 years
Decline in immunization coverage in all the districts of the country over the last 5 years
High immunization drop out rate
PERCENT OF CHILDREN PERCENT OF CHILDREN FULLY IMMUNIZEDFULLY IMMUNIZED
38.147.4
31
0
20
40
60
80
100
1988/89 1995/5 2000/1
Source: DHS 1989/95/2000
PERCENT OF CHILDREN PERCENT OF CHILDREN AGED 12-23 MONTHS AGED 12-23 MONTHS
RECEIVING IMMUNIZATIONSRECEIVING IMMUNIZATIONS
60
82 85
61
8277
31
59 57
46.1
33
61.1
0
20
40
60
80
100
1988/9 1995 2000/1 1988/9 1995 2000/1
POLIO 1 POLIO 3 DPT 1 DPT 3
CAUSES OF LOW COVERAGE
Poor communication strategies resulting in low demand for immunization services
Inadequate management of challenges related to health sector reform
Disruptions of routine immunization resulting from eradication campaigns
CAUSES OF LOW COVERAGE Con’t
Inadequate involvement of the private sector in the delivery of immunization
Vocal opposition to immunization by some opinion leaders and FM radio stations
UGANDA IMMUNIZATION
PARTNERS USAID/AFR funds WHO & UNICEF SOSDisease SurveillenceRoutine ImmunizationsSupplemental Immunization Activities
BASICS IIAdvisor with UNEPI Models for Routine ImmunizationLinks to IMCI
UGANDA IMMUNIZATION PARTNERS Con’t
DELIVERLogistics
DISH IIIEC/BCCIMCI
GAVI
PARTNER COORDINATION
ICC was formed in 2000
Provides policy and oversight of resource need and implementation
Meets every three months, is chaired by MOH, and all donors attend
Gives high level attention to immunization
MOH & USAID/UGANDAFOCUS AREAS
New Integrated Strategic Plan – Use of Universal Primary Education to implement health interventions
Making decentralization work for health, especially the delivery of immunizations.
MOH & USAID/UGANDAFOCUS AREAS Con’t
Improve access to EPI services through opening of new outreaches
Use IMCI, SOS and child health days to reduce missed opportunities
A strong advocacy and social mobilization strategy for EPI
MOH & USAID/UGANDAFOCUS AREAS Con’t
Investing in functional and sustainable disease surveillance systems
Conducting Supplemental Immunization Activities (SIAs)
- Polio eradication- Measles control- MNT elimination
CHALLENGES AND LIMITATIONS
Scaling up at the national level to cover all 56 districts
Engaging the private sector in immunization
Limited communication with USAID/Uganda about USAID/W funded activities
CHALLENGES AND LIMITATIONS Con’t
Introduction and the cost of new vaccines
Continued supplemental immunization campaigns
Increasing urban and peri-urban populations
POSITIVE DEVELOPMENTS & OPPORTUNITIES
Good EPI infrastructure exists
Regular supply of adequate potent vaccines
Experience gained through successful NIDs
Improvement in funding levels