IMMUNIZATION IN UGANDA Dan Wamanya IMMUNIZATION IN UGANDA Dan Wamanya USAID/Uganda

PROBLEMS WITH IMMUNIZATION Low immunization coverage rate over the past 12 years Decline in immunization coverage in all the districts of the country over the last 5 years High immunization drop out rate

PERCENT OF CHILDREN FULLY IMMUNIZED Source: DHS 1989/95/2000

PERCENT OF CHILDREN AGED MONTHS RECEIVING IMMUNIZATIONS

CAUSES OF LOW COVERAGE Poor communication strategies resulting in low demand for immunization services Inadequate management of challenges related to health sector reform Disruptions of routine immunization resulting from eradication campaigns

CAUSES OF LOW COVERAGE Con’t Inadequate involvement of the private sector in the delivery of immunization Vocal opposition to immunization by s ome opinion leaders and FM radio stations

UGANDA IMMUNIZATION PARTNERS USAID/AFR funds WHO & UNICEF SOS Disease Surveillence Routine Immunizations Supplemental Immunization Activities BASICS II Advisor with UNEPI Models for Routine Immunization Links to IMCI

UGANDA IMMUNIZATION PARTNERS Con’t DELIVER Logistics DISH II IEC/BCC IMCI GAVI

PARTNER COORDINATION ICC was formed in 2000 Provides policy and oversight of resource need and implementation Meets every three months, is chaired by MOH, and all donors attend Gives high level attention to immunization

MOH & USAID/UGANDA FOCUS AREAS New Integrated Strategic Plan – Use of Universal Primary Education to implement health interventions Making decentralization work for health, especially the delivery of immunizations.

MOH & USAID/UGANDA FOCUS AREAS Con’t Improve access to EPI services through opening of new outreaches Use IMCI, SOS and child health days to reduce missed opportunities A strong advocacy and social mobilization strategy for EPI

MOH & USAID/UGANDA FOCUS AREAS Con’t Investing in functional and sustainable disease surveillance systems Conducting Supplemental Immunization Activities (SIAs) - Polio eradication - Measles control - MNT elimination

CHALLENGES AND LIMITATIONS Scaling up at the national level to cover all 56 districts Engaging the private sector in immunization Limited communication with USAID/Uganda about USAID/W funded activities

CHALLENGES AND LIMITATIONS Con’t Introduction and the cost of new vaccines Continued supplemental immunization campaigns Increasing urban and peri-urban populations

POSITIVE DEVELOPMENTS & OPPORTUNITIES Good EPI infrastructure exists Regular supply of adequate potent vaccines Experience gained through successful NIDs Improvement in funding levels