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  • Title: Expanded programme on immunization and primary health care.
    Author: Basu RN.
    Journal: J Commun Dis; 1982 Sep; 14(3):183-8. PubMed ID: 7183716.
    Abstract:
    The ultimate objective of the Expanded Program on Immunication, better known as EPI, is to reduce the morbidity of the diseases for which vaccine is available. The EPI is a key component of the country effort to provide Health for All by the year 2000. It is planned that by 1990 immunization services will be available for all infants against diphtheria, whooping cough, tetanus, tuberculosis, and poliomyelitis and for all school children for diptheria, tetanus, and typhoid, and for all pregnant women against tetanus. The immunization services will be a part of the comprehensive health care and will be integrated with all hospitals and dispensaries in urban areas and primary health centers/subcenters in the rural areas. Outreach operations are encouraged to bring these services as close to the mother and children as possible. Steps have already been taken to make the country self-sufficient in the production of different quality vaccines to meet the program requirements. New vaccines will be added where found to be epidemiologically necessary and administratively feasible. The vaccination program is effective only if given at the right age. A national immunization schedule has been prepared which emphasizes vaccination of all infants with 1 dose of BCG, 3 doses of DPT and polio at a minimum interval of 1 month, by the 1st birthday. School entrants are given a booster dose of DT and 2 doses of typhoid vaccine at an interval of 1 month. The children leaving primary school and leaving high school are given 1 booster dose of tetanus toxoid. In case of history of tetanus toxoid immunization in the earlier preganancy, 1 booster dose is adequate. Important components of management of EPI are cold chain maintenance, record keeping and evaluation, uniform vaccination coverage standards, and communication with the public through various media. A table gives the number of children/women proposed to be covered with full course of vaccine during each year of the 6th Plan. Disease surveillance is necessary to mark out priority areas and plan strategies of operation. The government of India supplies all vaccines free of change to the States and the Union territories. At the beginning of the year, on the basis of annual operational vaccination targets, the manufactures are identified to supply different vaccines. Involvement of the community is essential for acceptance of the immunization program. Vaccination coverage assessment surveys are being conducted to determine the immunization of the eligible population. The survey helps to know how many were vaccinated at the right age group and completed the immunization schedule. The surveillance system needs to be strengthened for the collection of data on EPI target diseases for measuring the impact of immunization on reduction of morbidity, mortality, and disability.
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