Updates in Philippine Expanded Program on Immunization in Region 3

by Zero Mella MD, Sajorda River Park, Iba, Zambales — The Expanded Program on Immunization has been around since the 70’s when the WHO implemented it on our country. There is now a move to incorporate EPI for children and mothers with adult and elderly immunization. This will be managed by the National Immunization Committee of the DOH. This will be implemented in the future.

EPI, or the free vaccines given by the Philippines Department of Health (DOH), covers the following

  • Tuberculosis;
  • Diphtheria, tetanus and pertussis;
  • Poliomyelitis;
  • Measles;
  • Mumps;
  • Rubella or German measles;
  • Hepatitis-B;
  • H. Influenza type B (HIB)

Lailani Mangulabnan MD, Region III Director for EPI, states that since 2009, the DOH has been monitoring and supervising aggressively the barangay and provincial centers regarding implementation of the EPI. With the help of the CDC, the office of Dr. Mangulabnan have found major problems regarding implementation in some remote barangays including:

  • improper training
  • Injection issues
    • use of prefilled syringes
    • improper use of aspirating needles
  • improper disposal
  • improper temperature monitoring of cold storage

Related Story: Rotavirus Vaccine Integration in the EPI hopes to reflect US Data

Despite these problems identified, EPI in region 3 has been able to provide 97.9% coverage in 2011 which is very satisfactory.

Recommendations

Dr. Mangulabnan was able to create recommendations for the provincial, regional, and city health offices for Region 3. These include:

1. Strengthen Stock Management

This would include proper inventory keeping and reporting to the EPI office; proper use and training for cold chain storage , and proper utilization and disposal techniques.

2. Eliminate Dropouts and Missed Opportunities

The office of Dr. Mangulabnan has found certain regional and provincial hospitals with provisional requirements for the EPI and have found a lot of missed opportunities for education and implementation of the EPI. Philhealth coverage may provide some incentive in private clinics as it covers first doses of the immunization. The suggestion is still to utilize every visit to update both maternal and child immunizations.

3. Target outreach and community mobilization to depressed areas

The EPI target coverage is still 100%. Doctors, Nurses, and Midwives are called to utilize the various barangay health workers to educate the unimmunized population. The vaccines are free and are life-saving.

4. Ensure all health facilities receive at least quarterly intensive supervisory visits and are trained in REB

Supervisory visits provide a way to create standardization of care in every barangay. REB is a program of the EPI to educate hard-to reach communities. The goal is to educate them to utilize the various free vaccines provided by the government.

5. Strengthen data management and surveillance

Reporting is crucial in managing the day to day decisions and budgeting of the EPI. To ensure continuous supply of vaccines, local municipal and city health offices must provide correct data flow regarding inventory, coordinator programs and activities.

The EPI Regional Office hopes to ensure that by 2012 we will be able to reach the targets and reconcile the deficiencies found in the present.


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Post script:
Many people may have been drawn to this post due to the recent introduction of Pentavax and Rotavirus in EPI. It will be discussed in a future article.

Pentavax will replace DPT, Rotavirus is only free for certain programs of the DOH.

– appended, Nov 18 2012

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