ACCELERATING CHILD SURVIVAL AND DEVELOPMENT 2009

Uganda’s Battle Against the Top Childhood Threats

© UNICEF Ugnada/ChulhoHyun

PROTECTING AGAINST
IMMUNIZABLE DISEASE
SITUATION SUMMARY
Preventative primary health care is the key to child
survival. Achieving MDG 4 (reduction of child mortality
by two thirds) is impossible without a well-functioning
Expanded Programme for Immunization (EPI) consis-
tently reaching 90% coverage for measles and other
vaccine preventable diseases.
Uganda has made significant strides since the intro-
duction of the National EPI programme in 1983. Mor-
bidity due to measles has declined by over 90% com-
pared to 2000 with no confirmed deaths in 2004 and Only about 1 per cent of deaths among children under-five have
2005; the number of meningitis cases due to Heamo- unknown causes and two thirds of them are entirely preventable.
philus influenzae type b (Hib) has declined by 95%
since introduction of Hib vaccine in 2002; and neonatal
tetanus cases declined by 83%. In addition, Uganda • Decreased social mobilization (due to lack of pay-
has been polio free since 1996 and has no reported ment to mobilizers);
whooping cough or diphtheria. • Lack of attention to information systems manage-
ment (lack of training and support leads to late and
However, a recent stagnation and decline in routine incomplete reports).
immunization threatens to reverse progress. In 2004,
routine delivery of measles was just under 90%. In UNICEF SUPPORT TO IMMUNIZATION
2005, the level stabilized at 87% and then dropped to INDICATIVE BUDGET FOR 2009
79% in 2006, rising to 85% in 2007. District variability
UNICEF works at the national level and in 23 focus
exists with some districts failing to achieve the set tar-
districts to enhance the Government’s capacity to de-
gets for immunization and surveillance.
liver life-saving services. UNICEF aims to ensure that:
National level challenges include sustaining availability • Adequate resources for the EPI are mobilized, allo-
of current vaccines offered by the programme and cated and prioritized at various levels;
planning for introduction of new vaccines (adequate • Children in all districts are protected against vaccine
cold chain capacity); planning for and maintaining high preventable diseases by supporting strategies to
immunization coverage in the context of a rapidly scale up and sustain high immunization coverage
growing population; and maintaining a high quality and including building capacity for health facilities to
sensitive disease surveillance system at all levels. identify and reach their catchments populations;
District level challenges include: mop-up activities in those districts not attaining 90%
measles and OPV coverage; and engaging in social
• Stock-outs, decreased potency and/or spoiled vac-
mobilization activities to boost attendance at routine
cines (due to late arrival of drugs, lack of gas for de-
immunization. A follow up measles campaign is
livery and operation of generator);
planned in 2009
• Closures of facilities and irregular/inadequate out-
• Communities enjoy consistent access to vaccines
reach (due to lack of funds for transportation, super-
and essential medicines (supporting a drug supply
vision and mobilization, operation);
chain assessment and monitoring programme);
• High staff vacancy/attrition rate and low motivation
• Uganda as a whole benefits from an improved EPI
(lack of incentives, support, supervision, training);
system (through revitalization of the cold chain; ad-
UDHS 2006: U5 Im m unization Coverage vocacy with Government to address recurrent costs
and solve the problem of insufficient transportation
DPT3 Measles All Basic Vaccines
and fuel; capacity building for support, supervision
100
and information management).
80
60
Budgetary Requirements: 6 million USD.
40 FOR MORE INFORMATION
20
0 Dr. Claudia Hudspeth Karen Allen
IDPs North Karamoja Western Chief, Child Survival Deputy Representative
chudspeth@unicef.org kallen@unicef.org