Immunization

ACCELERATING CHILD SURVIVAL AND DEVELOPMENT 2009 Uganda’s Battle Against the Top Childhood Threats © UNICEF Ugnada/ChulhoHyun

PROTECTING AGAINST IMMUNIZABLE DISEASE SITUATION SUMMARY Preventative primary health care is the key to child survival. Achieving MDG 4 (reduction of child mortality by two thirds) is impossible without a well-functioning Expanded Programme for Immunization (EPI) consistently reaching 90% coverage for measles and other vaccine preventable diseases. Uganda has made significant strides since the introduction of the National EPI programme in 1983. Morbidity due to measles has declined by over 90% compared to 2000 with no confirmed deaths in 2004 and 2005; the number of meningitis cases due to Heamophilus influenzae type b (Hib) has declined by 95% since introduction of Hib vaccine in 2002; and neonatal tetanus cases declined by 83%. In addition, Uganda has been polio free since 1996 and has no reported whooping cough or diphtheria. However, a recent stagnation and decline in routine immunization threatens to reverse progress. In 2004, routine delivery of measles was just under 90%. In 2005, the level stabilized at 87% and then dropped to 79% in 2006, rising to 85% in 2007. District variability exists with some districts failing to achieve the set targets for immunization and surveillance. National level challenges include sustaining availability of current vaccines offered by the programme and planning for introduction of new vaccines (adequate cold chain capacity); planning for and maintaining high immunization coverage in the context of a rapidly growing population; and maintaining a high quality and sensitive disease surveillance system at all levels. District level challenges include: • Stock-outs, decreased potency and/or spoiled vaccines (due to late arrival of drugs, lack of gas for delivery and operation of generator); • Closures of facilities and irregular/inadequate outreach (due to lack of funds for transportation, supervision and mobilization, operation); • High staff vacancy/attrition rate and low motivation (lack of incentives, support, supervision, training); UDHS 2006: U5 Im m unization Coverage DPT3

Measles

All Basic Vaccines

100

Only about 1 per cent of deaths among children under-five have unknown causes and two thirds of them are entirely preventable.

• Decreased social mobilization (due to lack of payment to mobilizers);

• Lack of attention to information systems management (lack of training and support leads to late and incomplete reports).

UNICEF SUPPORT TO IMMUNIZATION INDICATIVE BUDGET FOR 2009 UNICEF works at the national level and in 23 focus districts to enhance the Government’s capacity to deliver life-saving services. UNICEF aims to ensure that: • Adequate resources for the EPI are mobilized, allocated and prioritized at various levels; • Children in all districts are protected against vaccine preventable diseases by supporting strategies to scale up and sustain high immunization coverage including building capacity for health facilities to identify and reach their catchments populations; mop-up activities in those districts not attaining 90% measles and OPV coverage; and engaging in social mobilization activities to boost attendance at routine immunization. A follow up measles campaign is planned in 2009 • Communities enjoy consistent access to vaccines and essential medicines (supporting a drug supply chain assessment and monitoring programme); • Uganda as a whole benefits from an improved EPI system (through revitalization of the cold chain; advocacy with Government to address recurrent costs and solve the problem of insufficient transportation and fuel; capacity building for support, supervision and information management).

80 60

Budgetary Requirements: 6 million USD.

40

FOR MORE INFORMATION

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IDPs North

Karamoja

Western

Dr. Claudia Hudspeth Chief, Child Survival [email protected]

Karen Allen Deputy Representative [email protected]