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  • Title: EPI in the Americas: a regional overview.
    Journal: EPI Newsl; 1983 Oct; 5(5):1-4. PubMed ID: 12267943.
    Abstract:
    This article discusses the 5 major areas of Pan American Health Organization (PAHO) involvement in the World Health Organization's Expanded Program me on Immunization (EPI): 1) training of health workers, 2) purchase of vaccines and related supplies through the operation of a Revolving Fund, 3) development and implementation of the cold chain, 4) development of immunization information systems, and 5) comprehensive program evaluation and operational research. Between 1979-82, almost 10,000 health workers received EPI training. Over 25 technicians have been trained in cold chain repair and maintenance. A cooperative study to determine the best age for measles immunization in Latin America has been initiated. Operational research has been initiated with regard to the morbidity and mortality associated with measles and neonatal tetanus, and the cost-effectiveness of different strategies for vaccine delivery is being analyzed. The value of vaccines ordered in 1979-82 exceeds US$18 million. To enable the expansion of the immunization program in the Americas, it is hoped to increase capitalization of the EPI Revolving Fund to US$4 million. PAHO has developed a comprehensive multidisciplinary evaluation methodology. Preliminary evaluations indicate that most countries have made substantial progress in staff training, vaccine supply, the cold chain, program planning, and administration. However, the levels of immunization in children under 1 year of age have either remained the same or increased only slightly in most countries in the region. Very high dropout rates have been noted from the 1st to 3rd doses of multiple-dose vaccines and coverage of pregnant women with tetanus toxiod vaccine remains below 10%. Moreover, morbidity rates for the EPI target diseases have not shown any dramatic declines since 1977.
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