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Title: EPI review in Maldives
Authors: World Health Organization, Regional Office for South-East Asia
Issue Date: 2007
Publisher: WHO Regional Office for South-East Asia
Place of publication: New Delhi
Language: English
Abstract: Description: The Government of Maldives has initiated several reforms in the Ministry of Health (MoH), including transfer of some departments and units within the MoH and also to other ministries. New vaccines are becoming increasingly available in the market at costs affordable to developing countries. In Maldives measles, mumps and rubella (MMR) vaccine has been introduced in the routine immunization programme in 2007; new equipment was purchased with tsunami relief funds and new policies are being developed by the Ministry of Environment, Water and Sanitation on the way healthcare waste is managed. These changes may have an impact on the immunization programme. In this changing environment, the Ministry of Health requested WHO's assistance to conduct a national EPI review to identify problems and prepare an activity plan to implement solutions to improve and maintain the performance of the immunization programme in Maldives. Teams constituting of international EPI experts from the IVD section of the WHO Regional Office for South-East Asia, UNICEF, Centre for Disease Control and Prevention (CDC), Atlanta, USA, and the Ministry of Health, Sri Lanka, along with national EPI experts conducted the EPI review from 11 to 19 December 2006. Using questionnaires to guide the interviews, the teams collected data in six areas of the EPI programme: a) planning and management of immunization; b) immunization policies and vaccination schedule; c) immunization coverage, including reporting procedures; d) vaccine preventable diseases surveillance; e) immunization safety, vaccine management and immunization waste disposal; f) advocacy and communication. The samples for data collection concerned four regional hospitals, six atoll hospitals, 18 health centres and several health posts which represented health facilities at each level of the health infrastructure: islands, sub-atoll, atoll, regional and central. Three teams were constituted to visit health facilities, including regional and atoll hospitals and health centres and health posts. The findings of the review teams confirmed that Maldives has been successful in providing immunization services to the population with a high level of coverage being maintained. In most facilities visited the health staff was found to be well informed about planning, budgeting and safe vaccine handling and injection practices. The issues of top priority to be addressed in the Maldivian immunization programme are the following: " Establish an expert group to develop national EPI guidelines that outline policies and procedures for planning and budgeting within the decentralization of health services; " Review the current immunization schedule to: - reduce number of contacts, - introduce fourth dose of diphtheria-containing vaccine, - replace tetanus toxoid (TT) with tetanus diphtheria (Td). " Develop a systematic standard procedure for collection, transport and testing for suspect measles cases need to be developed along with appropriate guidelines to help health workers; " Develop a national in-service training programme with implementation plans and budgets; and " Ensure vitamin A is administered every six months to children aged nine months to five years old;
Gov't Doc #: SEA-EPI-146
Appears in Collections:SEARO Publications

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