INTRODUCTION
The Swaziland Expanded Programme on Immunization was established by the Government of Swaziland in 1979 jointly with Save the Children Fund and World Health Organization. The programme was later supported by UNICEF, Canadian Public Health Association, Rotary International and USAID. The programme was officially launched in 1980 following a Lameness Survey in 1979 which indicated many cases of post polio lameness in the country with high numbers of measles and neonatal tetanus. It has a well established delivery system and uses two main strategies that is outreach and fixed (health facility) strategy through which not only routine immunization services but other child survival interventions are made accessible to communities.
Currently, EPI forms part of child survival programmes under the Ministry’s Directorate guidance and enjoys full Government support for the procurement of vaccines, injection equipment, payment of staff salaries and carrying out of some planned activities. The programme focuses on preventing childhood vaccine preventable diseases namely poliomyelitis, measles, hepatitis B, diphtheria, pertussis, tuberculosis and Haemophilus Influenza Type B diseases. It has further spearheaded the integration of other child survival interventions such as Vitamin A supplementation and de-worming of children less than 5 years. The programme is planning to introduce new vaccine such as pneumococcal (PCV13) and Rota (prevention against diarrhea) between the years 2012 to 2016.
With new developments in vaccine preventable diseases affecting all age groups, the programme will soon be extending its services beyond the traditional target depending on ongoing trials for malaria, cancer etc.
COMPONENTS
EPI is composed of five (5) components:
1. Programme Management
2. Service Delivery
3. Disease surveillance & control
4. Vaccine supply and cold chain
5. Advocacy, communication and social mobilization
GOAL
In line with the National Health Policy document, the programme’s goal is to reduce morbidity and mortality due to vaccine preventable diseases amongst children less than five years.
STRATEGIES
The programme’s has adopted all UN strategies to facilitate its contribution towards the achievement of Millennium Development Goal 4.
1. High routine immunization coverage of > 90% for all antigens
2. EPI Disease surveillance for suspected polio, measles and maternal neonatal tetanus
3. Periodic Supplementary Immunization Activities (immunization campaigns)
4. Mopping up activities
OBJECTIVES
1. To increase and sustain routine immunization coverage from 67% in 2006 to 90% in 2011 and reduce dropout rate below 10%
2. To strengthen integration of other child survival interventions with EPI services
3. To strengthen vaccine management and logistics at all levels
4. To introduce new and underused vaccines
5. To sustain high quality polio, measles and neonatal tetanus surveillance performance indicators.
The Expanded Programme on Immunization (EPI) is one of the components of Primary Health Care in Swaziland. The programme focuses on vaccine preventable childhood communicable diseases. Currently, SEPI is using traditional vaccines with the inclusion of Hepatitis B since 1995 and Haemophilus influenza type B (Hib) which was introduced in June 2009, Pneumococcal Conjugate vaccine (PCV13) in April 2014 and Rotavirus vaccine in May 2015. The programme has over the years contributed tremendously in reducing the Infant Mortality Rate (IMR). The goal of the EPI programme is to reduce morbidity, disability and mortality due to vaccine preventable diseases amongst children under five years – this is in line with the national health policy.
Currently EPI has a five year Comprehensive Multi Year Plan (cMYP), 2012 – 2016 from which an annual plan is derived. The key strategies used to deliver routine immunization services are health facility static sites and outreach services to reach the targeted population.
Table 2.1. Performance On Routine Immunization And Disease Surveillance And Control
| Indicator name | Thematic area | Target | Actual Output | Highlight colour |
| Routine Immunization | ||||
|
Routine immunization coverage | 80% | 82.6% | |
|
Routine immunization coverage | 80% | 80.7% | |
|
Routine immunization coverage |
80% |
81.5% |
|
| Disease surveillance and control | ||||
| AFP | Disease surveillance and control |
2/100 000 population ( 10 cases) |
12 |
|
| Measles | Disease surveillance and control | 1/1000 population per region |
54 |
|
| Neonatal Tetanus | Disease surveillance and control | 1/1000 live births |
0 |
|
| Paediatric Bacterial Meningitis (Pneumonia) |
Disease surveillance and control |
100 cases |
106 |
|
| Rotavirus (Diarrhoea) | Disease surveillance and control | 100 cases |
177 |
|
Programme Manager Nomsa Dube
Tel: +268 2404 1911