IMPROVING VACCINATION COVERAGE - THE EXPERIENCE OF THE EXPANDED PROGRAM ON IMMUNIZATION IN VANUATU

This paper looks at the success of measures adopted to improve vaccina tion coverage of infants in the Republic of Vanuatu. In 1982 the Depar tment of Health introduced an Expanded Programme on Immunization (EPI) . Since the republic has over 80 inhabited islands, a scattered popula tion, rough terrain and a lack of transport and communications infrast ructure, achieving a high vaccination coverage rate proved difficult. Coverage of infants remained low until 1987. From that year onwards va rious strategies were employed to increase coverage, including 1) adop ting the WHO-recommended diphtheria-pertussis-tetanus (DPT) and oral p olio vaccine (OPV) vaccination schedule (6, 10 and 14 weeks) instead o f the former schedule (3, 6 and 9 months); 2) improving the training, support and supervision of staff delivering maternal and child health (MCH) services; and 3) improving community involvement through social mobilization activities in areas of low coverage. Data on vaccination coverage of infants for the period 1984 to 1990 were compared. Over th is period coverage of infants with 3 doses of DPT rose from 29 % to 76 %, with 3 doses of OPV from 29 % to 78 %, and with measles vaccine fr om 19 % to 66 %. These dramatic improvements have largely occurred sin ce 1987. The results demonstrate the success of the measures adopted, and the experience of Vanuatu offers lessons in improving vaccination coverage for other countries in the region.