Immunization Manual for Health Workers

Transcription

1 Immunization Manual for Health Workers

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3 CONTENTS FOREWORD 4 ACKNOWLEDGEMENTS 5 OBJECTIVES AND COMPONENTS OF THE UNIT OF VACCINES AND IMMUNIZATION 7 Objectives and priorities of UVIS 8 Immunization system components 9 IMMUNITY 12 VACCINE MANAGEMENT 21 Target setting 22 Vaccines forecasting 27 Monitoring the use of vaccines 50 COLD CHAIN 54 Cold chain equipment 56 Basic principles of refrigeration 64 Monitoring cold chain temperature 69 HOW TO ORGANIZE IMMUNIZATION IN THE HEALTH FACILITIES AND MOBILE/OUTREACH CLINICS 82 ENSURING THAT IMMUNIZATION INJECTIONS ARE GIVEN SAFELY 93 Safe and unsafe injection 93 Immunization waste management 100 Adverse events following immunisation (AEFI) 104 KEPI VACCINES AND TECHNIQUE OF ADMINISTRATION 112 DATA MANAGEMENT, MONITORING AND EVALUATION 129 Routine immunization indicators 130 Collecting routine immunization data 133 DISEASE SURVEILLANCE 143 Types of Disease Surveillance 144 Surveillance Activities 144 Standard Case Definitions for EPI targeted diseases 147 MAXIMIZING OPPORTUNITIES, COMMUNITY LINKAGES, AND COMMUNICATION 151 ANNEXES 166 3

4 FOREWoRD The Unit of Vaccines and Immunization Services (UVIS) is an integral part of the Division of Family Health and an important component of the Maternal and Child Health Care services within the Ministry of Health. In1980,The Ministry of Health established the Kenya Expanded Programme on Immunization (KEPI) with the main aim of providing immunization against six killer diseases of childhood,namely tuberculosis,polio, diphtheria, whooping cough, tetanus and measles to all children in the country before their first birthday. Since the inception of the program, more vaccines have been added to the infant immunization schedule, namely hepatitis B, Hemophilus influenza type B vaccine, yellow fever and most recently the Pneumococcal vaccine. These vaccines address key killer diseases for children under the age of five years. Recognizing that vaccination has been one of the most successful and cost-effective public health interventions, the Ministry of Health has consolidated all vaccination services under a single unit called the Unit of Vaccines and Immunization Services. This unit is now charged with the responsibility of managing all vaccines and related biologicals targeting people of all age groups. The main challenge for the program is to ensure that the immunization services offered in this country are of high quality, acceptable, affordable and accessible to all Kenyans at all levels. For this to be achieved it is important that communities get more involved in the planning, implementation and monitoring of immunization services. This manual therefore has been reviewed and designed to address some of these issues. It will help the health worker or other relevant person who is offering the immunization services acquire the necessary knowledge and skills to effectively carryout the immunization services. The manual covers all the basic components of EPI i.e. service delivery, vaccine quality and supply, logistics, VPD surveillance, advocacy, social mobilization and communication for immunization, management, and strengthening human and institutional resources. The health facilities offering immunization services and medical training institutions will be supplied with copies of the manual. These will serve as reference book for the health workers, tutors, and students. It is my sincere hope that the use of this Manual will help to improve the quality of immunization services throughout the country. Dr. William K. Maina, OGW Head, Directorate of Preventive & Promotive Health Services MINISTRY OF HEALTH 4

5 ACKNOWLEDGEMENTS The EPI operational level manual is a product of efforts from several partners and individuals. The Ministry of Health through the Unit of Vaccines and Immunization Services (UVIS) wishes to appreciate the support from all those who participated in the development of the manual. Special tribute goes to the Former head of DVI and the coordinator of training at Unit of Vaccines and Immunization Dr. Kamau and Pamela Ochieng respectively for spearheading the process of reviewing this manual. We would also wish to thank all those who were involved in the writing of the first edition of the manual of April Special thanks go to USAID/MCHIP, WHO, a n d N E S I for their continued technical support and funding of various activities and teams that sat to review the manual. Dr. Ephantus Maree, HEAD of UNIT OF VACCINES AND IMMUNIZATION SERVICES 5

6 LIST OF CONTRIBUTORS NAME INSTITUITION / ORGANIZATION 1. DR. TATU KAMAU DVI-MOH 2. PAMELA OCHIENG UVIS-MOH 3. DR.EVANS MOKAYA MCHIP 4 LORA SHIMP MCHIP/HQ 5. DR. ISAAC MUGOYA MCHIP 6. DR. COLLINS TABU UVIS-MOH 7. DR. JOHN OGANGE WHO 8. SUSAN OTIENO MOH 9. ERNEST SOME UVIS-MOH PETER ADEMBA UVIS MOH FLORENCE KABUGA MOH NAIROBI COUNTY 12 AMINA ISMAIL MOH -DDSR 13 EDWARD MUMBO MOH- KWALE COUNTY 14 BEATRICE KOKI MOH 15 LOUSA MUTETI MOH- MAKUENI COUNTY 16 CLEMENTINE GWOSWAR MOH MIGORI COUNTY 17 JUDITH SITI MOI UNIVERSITY 18 S.M KAMAU UVIS - MOH 19 DUNCAN SEDA UVIS - MOH 6