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Progress towards meeting EPI targets
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Progress towards meeting EPI targets
The global eradication of polio
An estimated 2 billion children have now been immunized through polio eradication initiatives. National immunization days have been carried out in 82 countries, and over 140 countries now conduct surveillance for cases of acute flaccid paralysis in children.
All countries involved in polio eradication have undertaken mass campaigns using OPV, followed by “mopping-up” activities, such as house-to-house visits, in areas where cases persist. The incidence of polio has followed a downward trend, and an increasing number of areas in the world are becoming free of the disease. Whilst success is in sight, zones and countries where there is armed conflict remain difficult to implement effective immunization programmes
The elimination of neonatal tetanus
Since the early 1980s major progress has been made towards the elimination of neonatal tetanus. In 1989, the World Health Assembly declared its commitment to the global elimination of neonatal tetanus by 1995. In 1994 it was estimated that around 733 000 deaths due to neonatal tetanus were prevented and 48% of pregnant women were immunized with at least two doses of tetanus toxoid. The EPI has promoted the administration of the tetanus vaccine to either pregnant women or all women of childbearing age. Five doses of vaccine given to a mother provides full, life long protection, but even two doses given in pregnancy provide good protection to newborn infants against neonatal tetanus. Unfortunately immunization coverage has remained unacceptably low in many countries.
WHO and UNICEF have established a new goal to eliminate maternal and neonatal tetanus as a (For further information on skin testing and screening of high-risk groups such as contacts with tuberculosis and new immigrants, see Module 5). Now carry out Learning Activity 4. The disease control era of EPI Since the 1980s, the focus of the EPI has changed. While the implementation of immunization programmes in all countries remains a key goal, the actual control or elimination of major childhood diseases is now the focus. The challenges include: the global eradication of poliomyelitis, the elimination of neonatal tetanus, and a reduction in cases of and deaths from measles. Diagram 3. Site and technique for BCG immunization Page 50 Module 2 public health problem by 2005. A key component of this strategy is the routine immunization of all women in antenatal clinics. Clean delivery practices (a complementary strategy) have improved in recent years although most babies in developing countries are still born at home without the assistance of a trained attendant. The reduction in neonatal tetanus deaths is the result of impressive progress in certain high-risk counties.
A reduction in cases of and deaths from measles
In 1998 it was estimated that the global coverage of the measles vaccine had reached 75%, and the number of reported cases fell from 4 billion (4 thousand million) in 1980 to fewer than 1 billion in 1998 and is now 900 000 deaths per year. The global strategic plan aims at reducing mortality by 50% by 2005