ETHIOPIA NATIONAL EXPANDED PROGRAMME ON …

1 ETHIOPIA NATIONAL EXPANDED PROGRAMME ON. IMMUNIZATION. COMPREHENSIVE multi - multi -YEAR PLAN 2016 - 2020. Federal Ministry of Health, Addis Ababa April, April, 2015. 2015. A. TABLE OF CONTENTS. TABLE OF CONTENTS _____ I. LIST OF TABLES _____ III. LIST OF FIGURES _____ IV. ACKNOWLEDGMENT _____ V. LIST OF ACRONYMS _____ VI. EXECUTIVE SUMMARY _____ VIII. CHAPTER ONE _____ 12. COUNTRY INFPORMATION _____ 12. General profile and demography _____ 12. Administrative profile and Governance _____ 2. Socio-economic Situation _____ 3. General Health Status _____ 4. Health System Organization _____ 5. EPI Services Delivery _____ 6. Justification for the development of new cMYP _____ 6. CHAPTER TWO _____ 8.

2 SITUATIONAL ANALYSIS _____ 8. The EXPANDED PROGRAMME on Immunization in ETHIOPIA _____ 8. NATIONAL Immunization Policy_____ 9. Immunization Service Delivery _____ 10. Implementation of cMYP 2011 -2015 _____ 10. Routine Immunization _____ 10. Reaching Every District (REC) Approach _____ 13. Populations at risk of missing immunization services _____ 13. Supplemental Immunization Activities _____ 14. Polio SIAs: _____ 14. Measles SIAs:_____ 15. Maternal and Neonatal Tetanus Elimination _____ 16. Men A Elimination campaign _____ 17. Disease Surveillance and Accelerated Disease Control_____ 19. Disease surveillance _____ 19. Surveillance for New Vaccines_____ 27. Accelerated Disease Control _____ 29.

3 Laboratory Services _____ 31. GAVI support _____ 32. New Vaccines Introduction _____ 32. GAVI HSS _____ 32. GAVI CSO support _____ 32. Immunization logistics _____ 33. NATIONAL Cold Chain Equipment inventory _____ 33. Effective Vaccine management Assessment _____ 34. The cold chain Rehabilitation Plan _____ 34. Rehabilitation Plan: Implementation _____ 35. I. Transition Plan _____ 40. Available storage capacity _____ 43. Injection Safety and Waste Disposal _____ 47. Vaccine, Supply and Quality _____ 47. AEFI surveillance and monitoring _____ 48. EPI Advocacy, social mobilization and program communication _____ 48. management and Human resources _____ Error! Bookmark not defined.

4 PROGRAMME management _____ Error! Bookmark not defined. Human Resources for EPI (HRE) _____ Error! Bookmark not defined. Summary of the situation analysis _____ 54. Strengths, weaknesses, opportunities and threats _____ 60. CHAPTER THREE _____ 65. GOALS, OBJECTIVES, KEY ACTIVITIES AND MILESTONES NIP 2016-2020 _____ 65. Introduction _____ 65. Goals of the cMYP _____ 65. PROGRAMME Objectives _____ 66. Strategic Areas/Approches _____ 67. Anticipated Coverage Targets _____ 70. Planning by immunization system component _____ 79. CHAPTER FOUR _____ 91. COSTING, FINANCING AND FINANCING GAPS _____ 91. Macroeconomic Information _____ 91. Methodology for costing the cMYP _____ 91. Costing of cMYP 2016-2020 _____ 93.

5 Vaccines and injection equipment _____ 93. Personnel costs (EPI specific and shared) _____ 94. Cold chain equipment procurement and maintenance _____ 94. Operational costs for campaigns _____ 94. Costs for immunization by components cMYP (2016-2020)_____ 95. CHAPTER FIVE _____ 97. MONITORING AND EVALUATION _____ 97. Indicators for monitoring the cMYP _____ 98. Financial Indicators _____ 98. PROGRAMME Indicators _____ 98. Surveillance System _____ 98. Monitoring and Evaluation framework cMYP _____ 100. Immunization PROGRAMME Annual work plan for 2016 _____ 104. II. LIST OF TABLES. Table 1: Immunization Schedule .. 9. Table 2: Immunization Coverage in ETHIOPIA 2004-2014 .. 11. Table 3: Polio SIA in Somali Region outbreak of WPV in the HOA from June, 2013 to November, 2014.

6 Error! Bookmark not defined. Table 4: Regional Polio NID Data of 2013 and 2014, ETHIOPIA .. 14. Table 5: Showing Measles SIAs Data from 2011-2013 .. 16. Table 6: TT SIA coverage 1999-2013, ETHIOPIA (High risk strategy) .. 17. Table 7: Data of phase I and II Meningitis "A" campaign in 2013 and 2014 .. 18. Table 8: Summary of AFP surveillance indicators ETHIOPIA , 2011-2014 .. 21. Table 9: Measles surveillance indicator, 2011-2014, ETHIOPIA .. 23. Table 10: Rota Virus sentinel surveillance indicators, 2007-2014, ETHIOPIA .. 28. Table 11: Situational analysis by accelerated disease control initiatives, ETHIOPIA 2011 to 2013 .. 30. Table 12: Available net storage capacity & future requirements for positive CC storage at central level.

7 44. Table 13: Location and storage capacity of currently available EPI vaccine cold rooms .. 45. Table 14: Current available & future requirements for net positive cold storage at regional level .. 46. Table 15: Situational analysis by ADS, based on previous years' data (2011-2014) .. 55. Table 16 : Situational analysis of routine EPI by system components (2011-2014) .. 56. Table 17 : SWOT 60. Table 18: Baseline and coverage targets 2016 to 2020 .. Error! Bookmark not defined. Table 19: NATIONAL problems, priority, objectives and milestones, AFRO regional and global goals .. 73. Table 20: Service delivery .. 79. Table 21: Advocacy, social mobilization and program communications.

8 81. Table 22: Surveillance .. 82. Table 23: Vaccine supply, quality and 83. Table 24: Program management /Health system .. 84. Table 25: Activity timeline .. 86. Table 26: Macroeconomic information, current and projected, ETHIOPIA .. 91. Table 27: Costs for the different cMYP components (shared and EPI specific) .. 96. Table 28: Indicator for financial monitoring .. 98. Table 29: Monitoring and Evaluation frame work for cMYP .. 100. Table 30: Immunization program annual work plan for 2016 .. 104. III. LIST OF FIGURES. Figure 1: Map of ETHIOPIA , its location in 12. Figure 2: Routine EPI coverage (Penta3& Measles) 2003 to 2014, ETHIOPIA .. 12. Figure 3: ETHIOPIA : EPI Coverage by Region, Coverage Survey, 2012.

9 12. Figure 4: Number of zones with coverage <50%, 50-79%, and 80-89% and >=90%, 2004-2009.. Error! Bookmark not defined. Figure 5: Measles SIA prioritized woredas, Sept-Nov2011, ETHIOPIA .. 15. Figure 6: Phase1, Phase2 and Phase Men A campaign sites in the country, ETHIOPIA .. 18. Figure 7: NATIONAL Disease surveillance performance, interims of completeness and time lines .. 19. Figure 8: WPV/VDPV and SIAs Response, ETHIOPIA , Jan 2010-Dec 2014, .. 21. Figure 9: Measles campaign coverage and measles incidence rate 2005-2014, ETHIOPIA .. 23. Figure 10: Distribution of confirmed Rubella cases, ETHIOPIA , 2011-2013 .. 24. Figure 11:CSF Culture results of suspected PBM cases, 2002-2014, 26.

10 Figure 12: Etiologies identified for PBM, 2002-2014, ETHIOPIA .. 27. Figure 13: Rotavirus Positivity Rate, 2007-2014, ETHIOPIA .. 28. Figure 14: Effective Vaccine management Assessment report at different levels, 2013 .. Error! Bookmark not defined. Figure 15: EFFECTIVE Vaccine management Assessment, 2013 .. Error! Bookmark not defined. Figure 16: New vaccine introduction plan and estimating the need for vaccine storage volume .. 35. Figure 17: Immunization Program projection of future resource requirements, 2016-2020 .. 92. Figure 18: Costing baseline profile of routine immunization in ETHIOPIA , 2014 .. 93. IV. ACKNOWLEDGMENT. Immunization cMYP is a key strategic and management document for NATIONAL immunization programs that provide NATIONAL goals, objectives and strategic directions that address all components of immunization system relevant to the country.