Dr Aza
 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.
 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.
 Vaccine
preventable diseases in Tanzania
that are currently addressed by
immunization programme include:
􀂃 Polio,
􀂃 Measles,
􀂃 Neonatal Tetanus,
􀂃 Diphtheria,
􀂃 Pertusis,
􀂃 Tuberculosis
􀂃 Hepatitis B.
 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
 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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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.
 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.
 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.
 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.
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.
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
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
 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.
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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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.
Thank you for your attention