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ABSTRACT
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The successes and challenges of the expanded programme on immunization (EPI) among households within Malali low-cost area of Kaduna, Nigeria was investigated in this report. The research study used survey method through administration of questionnaire to find out the level of awareness acceptability belief and the level of enrolment to the population under study with a view to recommending ways to ensuring total success for EPI among the residents.
Results from the survey shows that there were high levels of success/acceptance of the EPI programme for the attributes assessed. Success scores in all were in the range of 55% minimum to as high as 100%. Further steps on how to improve the level of successes were highlighted as recommendations in the report.
TABLE OF CONTENTS
Title Page
Approval page
Declaration
Dedication
Acknowledgment
Abstract
Table of Contents
CHAPTER ONE
1.0Â Â Â Introduction
1.1Â Â Â Alliance to Improve Immunization Systems
1.2Â Â Â Polio in Kaduna Nigeria
CHAPTER TWO
2.0Â Â Â Literature Review
2.1Â Â Â Aims and Objectives of EPI
2.2Â Â Â Reaching Every District (Red)
2.3Â Â Â Challenges
2.4Â Â Â EPI AND NPI
2.5Â Â Â Poliomyelitis and Vitamin A Supplements
CHAPTER THREE
3.0Â Â Â Research Methodology
3.1Â Â Â Questionnaire
3.2Â Â Â Conversation
3.3Â Â Â Observation
CHAPTER FOUR
4.0Â Â Â Result Analysis
4.1Â Â Â Discussion
CHAPTER FIVE
5.0Â Â Conclusion and Recommendation
5.1Â Â Â Conclusion
5.2Â Â Â Recommendations
Reference
Appendix i
Appendix iiÂ
CHAPTER ONE
1.0Â Â Introduction
The expanded programme on immunization (EPI) in Nigeria started in 1976 with pilot projects organized and implemented with the assistance of the world health organization (WHO) and the United Nation children’s education fund. A 10years plan of operation (1979-1989) was drawn up detailing strategies, objectives and targets.
After four years the strategies were reappraised by federal ministry of health, UNICEF who survey in five local government areas showed that only 10% coverage has been achieved indicating that things were going wrong and that probably one basic strategy was wrong.
Among the key factors that constrained the smooth implementation were problems of supply or logistic maintenance of the cold chain, unreliability of electricity supply, inadequate management and supervision, ineffective management information systems and a low level of public understanding that could create and sustain a demand for immunization.
It was decided to carry out an experiment on the use of fixed facilities with on reach extension rather than the mobile approach. This experiment was implemented at one of the local government areas from August to July 1984, it was an action oriented operational research project rather than a pilot project.
Within one year, coverage increased from 9% to 83% and the hypothesis was confirmed that vaccine utilization can be substantially increased with the use of fixed facilities and outreach extension and most importantly with involvement of the community.
In 2002, the reaching every district(RED) approach was developed and introduced by world health organization, the United Nation’s children’s education fund (UNICEF) and other partners on the global alliance for vaccines and immunization (GAVI).
1.1 Alliance to Improve Immunization Systems in Areas with Low Coverage
Far from being just a programme or separate initiative, the approach outlines five operational components that are specifically aimed at improving coverage in every district. Reestablishment of regular outreach services, supportive supervision, on-site training community link with service delivery, monitoring and use of data for actions, better planning and management of human and financial resources.
The reaching every district (RED) approach encourages countries to use coverage data to make analysis of the distribution of unimmunized infants, and thereby prioritize districts with poor access and utilization of immunization, while districts are encouraged to make micro plans to identify local problems and adopt corrective solutions.
1.2Â Â Polio in Kaduna Nigeria
Kaduna, 11th February 2012, has kicked-off the polio free torch campaign as part of ongoing efforts to promote polio immunization and shore up stake-holder’s commitment to make Nigeria polio-free by the 2012 London Olympics. Even though the country has been free from polio since 2009, the fight against polio in Kaduna is not yet over, this is because Kaduna State is surrounded by polio infected states and there is still some resistance to polio immunization programmes in 2012, fifteen new cases of the wild polio virus were recorded in Kaduna State.
Routine immunization remains low in this state and none of the state’s district reached their 35% target. At the national level, routine immunization coverage also remains below 8o% with suboptimal performance in Northern states.
Providing every infant with vaccines against common childhood diseases remains a challenge in Nigeria. Persistent community resistance to polio immunization programmes profoundly impacting progress. Caregivers in Nigeria still refuse to vaccinate their children more frequently especially in the north. Nigeria is the only polio-endemic country remaining in Africa.
The countries north are the main source of polio infection in Nigeria and neighboring countries. However vaccine refusal on the part of parents has increased from 23.4% in November to 25.8% in December 2012.
The aims and objectives of this work is to assess the various challenges (i.e successes and failures of the programme) with particular attention on polio and vitamin A administration in Malali low cost area of Kaduna north local government area in Kaduna state.
To
Assess the level of success of the EPI
Assess the level of failure of the EPI
To offer meaningful recommendations to both the government and the general public towards a more successful, EPI.
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