2. Background
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The National Immunization Programme is a high
priority programme (P1) of Government of
Nepal. Immunization is considered as one of the
most cost-effective health interventions. It has
significantly contributed to reduce the burden of
vaccine preventable diseases and child
mortality.
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Nepal is one of the countries on track to achieve
the Millennium Development Goal on Child
Mortality reduction. National immunization
Services cover all the districts, municipalities
and Village Development Committees of the
country and is provided free of cost.
5. 1. Anon. Routine Immunization and NID Coverage survey report,1998.
Child Health Division, Department of Health Service,Kathmandu.
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Nepal initiated (EPI) in the fiscal year 1978/79. By the
next decade the programme was expanded to all the
75 districts of the country. due to various structural
changes, the programme lagged behind and the
national coverage of immunisation to around 80%
could be reached by the year 2000 only.
By 2004, some VPD, namely neonatal
tetanus, diphtheria and poliomyelitis are reported to
be reduced drastically. However, despite good
coverage, measles and tuberculosis still remain
prevalent. it is stated that approximately 18% of
under-five children’s death in Nepal results from
Vaccine Preventable Diseases.
6. 2. EPI vaccination in Nepal
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(Jha, Kannan et al. 2001)Jha, N., A. T. Kannan, et al. (2001). "EPI vaccination in Nepal."
Southeast Asian J Trop Med Public Health 32(3): 547-52.
Objective:
To evaluate the immunization coverage of the Expanded
Program on Immunization (EPI) vaccines in the Sunsari
district of Nepal
Methods
A number of surveys, small or large, have been undertaken
by various agencies for coverage evaluation of immunization
programs. The most commonly used design is the WHO-30
cluster sampling method. Other new methods are the Institute
for Refresh Medical Statistics (IRMS) New Delhi method and
the lot quality assurance sampling method. A total number of
3,332 respondents (69.4% females and 30.6% males) were
interviewed regarding the immunization status of their
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Results
The children with complete immunization
(BCG, measles and three doses of DPT and
OPV) were 65.7%. The individual coverage by
EPI vaccines (except OPV III and measles)
was more than 80%.
Conclusion
The result shows that there is positive
relationship between immunization coverage
and educational level of the respondents.
8. 3. A cluster survey for determination of
regular vaccination coverage among
children
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Shah, H. (2008). "A cluster survey for determination of regular vaccination
coverage among children." JNMA J Nepal Med Association 47(170): 91-3.
objective
To determine the coverage of immunization among
children 12-23 months of age in Rautahat District of
Nepal.
Methods
A cross-sectional method was applied with the 30-
cluster sampling method followed by taking a sample
of 210 children. The structured questionnaire
requesting information about socio-economic
characteristics, vaccination, history of
vaccination, doses of vaccines, and vaccination
records were used for collecting data.
9. Results
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The coverage responses according to history
from mothers for BCG, DPTHb-3, Polio3 and
Measles immunizations were
96.7%, 90.0%, 97.6% and 78.1% respectively.
By analyzing the records of the sampled Village
Development Committees (VDCs), the coverage
for the same vaccines was
88.1%, 78.1%, 79.0, 73.8% respectively. The
drop-out of BCG versus measles was also very
high. The District Health Office reports were
remarkably higher than the coverage of
immunizations obtained by the survey, showing
additional number of the target children.
10. 4. Awareness about a national immunization day
programme in the Sunsari district of Nepal.
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N. Jha, S. Pokhrel & R. Sehgal (1999) “Awareness about a national immunization day programme in
the Sunsari district of Nepal”Bull World Health Organ”.; 77(7): 602–606.
The study was carried out during the first NID (6
December 1996) to evaluate the local population's
awareness of the programme and the impact of the
media on such awareness.
A total of 843 respondents were interviewed, 39% of
whom were illiterate.
Two important aspects of the mass campaign (whether a
child previously immunized should be immunized again
in the NID, and whether children should be brought to
the next NID) were clearly understood by the majority of
the people (93.1% and 98.8% of the
respondents, respectively).
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although only a small proportion (24.4%) of
individuals understood the purpose of the
programme. Radio was the single most effective
means of providing information, education, and
communication about NIDs.
12. 5. Rapid Assessment of Perceptions, Knowledge, and
Practices Related to Immunization Injection Safety in
Nepal
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M. D. Bhattarai,1 P. Adhikari, Dr. M. D. Bhattarai, A. Kane, T. Uprety, S. Wittet
Aim
To study perception, knowledge and practices regarding to
immunization injection safety in Nepal
Methods
During March–May 2001, key informant in-depth interviews
and direct observations were conducted with 78
immunization providers and managers. Altogether, 42
immunization venues were visited. Twelve focus group
discussions (FGDs) also were conducted with 122 mothers.
Respondents came from 16 districts across the country and
represent Nepal's ethnic and geographic diversity.
13. Results
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There were sufficient supplies of BCG, DPT, TT, polio
and measles vaccines for the expected number of
clients but lack of regular supply of other required
materials for sterilization. Many managers and field-
level staff complained of needles being repeatedly
used until blunt, causing pain and distress for clients.
A shortage of syringes and needles is seen across
the board in EPI. Respondents also reported
problems maintaining cold-chain equipment;
fortunately, polio vaccine vial monitors (VVM) were
found intact in all cases and none of them indicated
excessive heat exposure.
14. 6. Survey on immunization status in western
Nepal
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Survey on immunization status in western Nepal, with special reference to
kaski, gorkha and myagdi. By Dr. Rohit sainju, Kathmandu research center.
Objective
The study has been successful in its objective of
finding out the immunization coverage of mothers and
infants in the survey sites.
Methods:
50 mothers (with at least one child under five years of
age) were selected from one ward in each of the
three districts. Questionnaires were used to ascertain
the vaccination status of 150 mothers and 196
children under five years of age. Another
questionnaire was used for the health post in-charge
to learn about the problem of vaccination services.
15. Result
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Coverage of BCG was found to be higher than
the national figure (84.5%) in all the survey
sites.
Coverage of DPT is higher than that of the
national coverage in sardikhola kaski (85.2%
vs 76.8%.
The coverage of measles vaccine was lower
than national coverage for the same vaccine in
all three survey sites
TT coverage for the all three survey sites was
found to be far better than the national
16. Immunisation against Japanese Encephalitis in Nepal:
Experience of 1152 subjects
Maj A Henderson*,
BMedSci, MRCP, RAMC
Physician, British Military Hospital, Dharan
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17. 7. Immunization coverage of children in a semi-urban
village panchayat in Nepal, 1985
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Ahluwalia, Indu B.
Helgerson, Steven D.
Bia, Frank J.
funded by the Yale International Committee and in cooperation
with UNICEF, Nepal, used a questionnaire to survey and assess
the immunization status of children 3 years or younger in a
semi-urban panchayat.
Mothers of children ranging in age from less than 1 month to 3
years were questioned both about immunization status of their
children and their own use of health care and specific sources of
information.
54% (124/228) of the children had received at least one vaccine
and only 4% (10/228) had full coverage with the recommended
vaccines (3 doses of DPT and TOPV, one dose of measles and
BCG).
Children born at a hospital were more likely than those born at
home to have been vaccinated.
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More than 70% of the women felt that
vaccinations were good preventive measures.
The study results suggest that health education
about immunization efforts should be focused on
women and these efforts should be intensified.
19. 8. Determinants of child immunization in Nepal: The role of
women’s empowerment
Shanta Pandey, PhD , Hae nim Lee, MSW
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Objective: examined if women’s empowerment
improved child immunization using data on
1,056 mothers with young children from Nepal.
Methods: The study utilized the 2006 Nepal
Demographic and Health Survey, a nationally-
representative sample of 10,793 women from
8,707 households across Nepal. We selected all
mothers with first child between the ages of 12
and 23 months at the time of interview. This
resulted in a sample of 1,056 mothers.
20. Results:
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Among the measures of women’s empowerment, mothers’
education was significantly associated with child immunization.
The odds of being fully immunized for children of mothers with
secondary education were 5.91 times the odds for children of
mothers without any formal education.
Other measures of women’s empowerment – women’s age at
birth of first child, gap in age between spouses, women’s
knowledge about sexually-transmitted diseases, their role in
intra-household financial, health and mobility decisions, and
their perceptions toward wife beating – were not associated with
child immunization.
Among control variables, mothers who received antenatal care
were 3.31 times as likely to immunize their children as mothers
who did not receive any antenatal care. Other such barriers to
health service use such as cost of care, distance to health
services, and quality of health services were not significant.
21. ANNUAL REPORT 2065/66, Department of Health Service
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The national Immunization coverage of all
antigens in the regular EPI programme did not
improved last year. DPT/Hep-3 and Polio3
coverage has decreased by 1.0 percent and
Measles immunization has decreased by more
than 3.0 percent compared to last fiscal year. TT-
2 to pregnant women has also decreased by 6
percentage.
22. ANNUAL REPORT 2067/68, Department of Health Service
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The national Immunization coverage of all antigens in
the regular EPI programme was improved compared to
last fiscal year 2065/66 (2008/2009). BCG, DPT-Hep
B-Hib-3, Polio3 and Measles coverage has increased
by 9, 1, 2 and 11 percent respectively during last fiscal
year. TT-2 to pregnant women has also increased by
8.0 percent. Currently NIP provides vaccination against
TB (BCG), diphtheria‐pertussis‐tetanus‐hepatitis B
andhaemophilus influenza
(DPT‐HepB‐HiB), poliomyelitis (OPV) and measles
throughout the country andJE vaccine in high risk post
campaign districts through routine immunization.
