Immunization coverage scoring over 90%
-16,000 children on register
By Iana Seales
November 28, 2006
Within the last three years Guyana's Expanded Programme on Immunization (EPI) has maintained over 90 percent coverage for all vaccines for children under one with the exception of a few hinterland areas which pose major challenges to the programme being rolled out countrywide.
Around 16,000 children are currently on the health register as having benefited from the programme during the period of its steady increase while new strategies are being implemented to target children in the hard-to-reach areas.
Several villages in regions 1, 7, 8 and 9 pose difficulties for the programme because of inclement weather and problems that health workers face in accessing boats. Though the numbers in some villages are not that high a major focus is being placed in these regions given the challenges.
EPI provides coverage against tuberculosis, yellow fever, hepatitis B, influenza type B and diphtheria - the pentavalent and MMR - measles, mumps and rubella.
EPI Director, Dr. Janice Woolford recently told Stabroek News that human resource is as much a problem for the programme as it is in various other areas in the health sector yet EPI was able to notch up some significant achievements within the last decade.
When the programme commenced in the 1970s vaccine-preventable diseases such as polio and yellow fever were major public health problems. Dr. Woolford noted that Guyana was granted polio free status by the Pan American Health Organisation/World Health Organisation (PAHO/WHO) in 1994 and there has not been a reported case of measles, yellow fever or polio for more than a decade and in the case of some diseases, more than three decades.
She said that of much significance is the fact that there have been no reported cases of neonatal tetanus, diphtheria, whooping cough or measles over the last five years. However, there has been a small incidence of the rotavirus which is one of the more common causes of diarrhoea and which in the past has been linked to some child deaths.
Just over two years ago rotavirus surveillance was set up at the Georgetown Public Hospital to estimate the burden of the disease in children under five years. Woolford noted that the surveillance extended to the New Amsterdam Hospital and over that period of time they were able to detect a few positive cases.
"Surveillance is an integral part of our work at EPI. We have managed to strengthen surveillance in hospitals and at our borders over the years and we have seen results", Woolford noted.
She explained that the EPI programme is integrated into the Maternal Child Health programme of the Ministry of Health and that in 2001 it became a beneficiary of the Global Alliance on Vaccine and Immunization (GAVI) and has since been receiving support through the provision of pentavalent vaccines, supplies and infrastructure.
Woolford noted that border surveillance is one of the areas that demand much attention, adding that Guyana has an aggressive surveillance system in place at the borders. She said there is a threat of yellow fever and measles from Venezuela and Brazil, and health workers in those areas often work beyond the call of duty to ensure that infected persons do not enter Guyana.
With Cricket World Cup fast approaching, Woolford said, EPI is considering "herd" immunity for Guyanese citizens. She said it is critical that persons be vaccinated against the major threats which are yellow fever, MMR, diphtheria and tetanus. According to her, persons should be protected because a number of visitors from various parts of the world are expected. She said persons should visit the nearest clinic in their area and get the necessary vaccines.
EPI recently won a PAHO award for its outstanding immunization coverage over the last two years. Woolford said the recognition was a result of hard work and commitment. She said there are nurses in the programme who would check the register and visit the homes of persons who stay away from clinic.
"We have persons on staff that go the distance. If a telephone call goes unanswered they go to areas and visit homes and vaccinate children right there. It is this kind of commitment that has given us the steady increase and have allowed us to maintain the coverage", Woolford said.
Back in 2001 the EPI programme received an award from PAHO for striving to maintain high standards in the area of surveillance. Woolford noted that such recognition boosts staff morale and encourages them to continue pressing forward.
Woolford who heads both the EPI and the Maternal Child and Health Department at the Ministry of Health has been in the health sector for over 27 years.