1. IMMUNIZATION IN UGANDADan WamanyaUSAID/Uganda

2. 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

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

4. PERCENT OF CHILDREN AGED 12-23 MONTHS RECEIVING IMMUNIZATIONS

5. 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

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

7. 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

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

9. 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

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

11. MOH & USAID/UGANDAFOCUS 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

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

13. 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

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

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