Achievement & Success of

Bangladesh EPI in Integrating NUVI

Dr. Md. Tajul Islam A. Bari

Program Manager

EPI & Surveillance, DGHS

EPI Structure of Rural Area

EPI HQ

District District

Upazila

Union

Ward

Stored in

Cold Room

Stored in ILR

Ward Ward

Immunization Site Each site active

once a month

On day of

vaccination

activities

Stored in ILR

or freezer

64 Districts, 482 Upazila, 140,000 Immunization Sites

Vaccination site

• 140,000 EPI outreach sites

• 45,000 regular field workers and 21,000 first line supervisors

• PLUS NGO, community workers and volunteers

Urban Primary Health Care Service Delivery

Project (UPHCSDP)

A PROJECT

OF

MINISTRY OF LOCAL GOVERNMENT, RURAL

DEVELOPMENT & CO-OPERATIVES

Implemented by

1 1 City Corporations & 4 Municipalities

Vaccination Schedule

Vaccine Age at Vaccination

BCG At Birth

DPT-HepB-Hib W6, W10, and W14

OPV W6, W10, W14, W38

MR MSD

W38 15m-18m

TT (PW & CBAW) MR

Y15, +M1, +M6, +Y1 and Y1 Y15

Vaccine Arrival

Activities Performed During NUVI Activity Hep B Hib MR

1. Disease burden study √ √ √

2. Strategy & POA √ √ √

3. EPI Assessment √ Cold Chain

(CC) only

CC

4. Revised record keeping &

reporting forms

√ √ √

5. MLM Training & vaccinator

training

√ √ √

6. Advocacy meetings √ √ √

7. IEC activities √ √ √

8. Regular review meetings at

the upazila & districts

√ √ √

9. Post introduction

assessment

√

Vaccination coverage by one yr. age

959495

98 99 99 99

98

95

66

69

72

77

8487

86

8990

6465 69

71

78

81

8385

86

63

56

52

64

71

75 75

7980

2001 2002 2003 2005 2006 2007 2009 2010 2011 2012

Percentage

BCG DPT3/Penta3 Measles Fully Vaccinated

Hep-B

Introduction

Pentavalent

Introduction

Measles follow-up

campaign

Measles

catch-up

campaign

Introduce MR vaccine at

9m and MCV2 at 15m

Source: CES-2011

Cold Chain Improvement

NUV Introduction

• Well accepted by the service providers & the

community

• Introduction was smooth

• Supply of cold chain & logistics was well planned

• Training of HWs before introduction; provided

opportunity to improve the staff skills ay all level

• Vaccine wastage is minimal

• No major safety concerns

18

1

10

5

29

16

1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006* 2007 2008 2009 2010 2011 2012 2013

Nu

mb

er

of

Ca

se

sPolio Cases, 1996-2013*

No Wild Polio

*Data as of 24th Feb 2013

No Wild Polio

A New Vaccine: 'bivalent oral polio vaccine'

71%

49%

86%

53%

0

10

20

30

40

50

60

70

80

90

100

tOPV bOPV tOPV bOPV

Pro

tec

tio

n a

fte

r 2

do

se

s (

%)

Type 1 polio Type 3 polio

Validation of NT Elimination

It was documented in 2008 that Bangladesh already

successfully ELIMINATE NEONATAL TETANUS

from the country

Vaccine Preventable Disease Surveillance

NT Cases

152 121 117 98 72

206257

748

390

341336

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Numb

er of

Case

s

Measles Cases in Bangladesh

2660718 788

5625

21892924

6192

9743

4067

25935

3484

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Nu

mb

er

of

Ca

se

s

Hib Vaccine Impact Assessment on Meningitis us ing S entinel s ite and Defined P opulationP opulation S urveillanc e around S entinel S ite: Inc idenc e (

HBsAG Prevalence

Pre vaccine era vs vaccine era

Before introduction

HBsAG prevalence

1.1% among pre-vaccine

era children (born from

April 1, 2001 to March 31,

2002)

After Introduction

HBsAG prevalence

0% among vaccine era

children (born from Nov 1,

2005 to Oct 31, 2006)

Central Cold Chain Improvement

Global Recognition For Achievement in Reducing Child Mortality

Thank you so much

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