DOH: Facing the challenges in

attaining the global standards for

immunization

@erictayagsays
 Mirror, Mirror on the Wall

• AIDS, TB, Malaria

• Vaccine preventable diseases
• Childhood Illnesses and Nutrition
• Maternal Health
• Neglected tropical diseases
• Emerging diseases
• Non-communicable diseases
• Accidents, Injuries and Trauma
• Mental Health, Substance abuse
• Disasters and Extreme Emergencies
Disparities and Inequalities
“Of all forms of inequality,
injustice in health care
is the most shocking,
and inhumane.”
- Martin Luther King
 Save the Children

Child Deaths, Philippines, NDHS, 1998-2013

 Consider These

Deploy human resources for

health to doctorless barrios,
GIDA, IP communities
Enroll poorest households in
Philhealth and implement no balance
billing in government facilities
Enhance LGU capacity on
governance and leadership to
implement and finance primary
health care
Deliver multiple vaccines to all
children through a simple schedule
of child health visits
Secure multi year budget for
infrastructure development at all
levels of health care
Why bother with Immunization?

“Routine immunization is the

foundation through which
countries provide access to
lifesaving vaccines and control
and eradicate vaccine-
preventable diseases.”
 Vaccines Do Not Save Lives

Estimated Measles Incidence per Million Population and Percentage of MCV1 and Measles SIA
Reported Coverage
Philippines, 1980 - 2014**

1,428.5
1,424.0
1,600.0 120

1,400.0

1,202.7
1,158.9

100

1,142.0
1,063.8

1,200.0

80
1,000.0
849.0
718.8

693.1

800.0 60
604.7
564.7

2011
554.9

SIA
600.0
457.4

9-95M
(84%) 40

400.0 1998 2004 2007

NID SIA SIA
(94%) (95%) 9-48M

147.2
20

127.2
126.7
113.4

(95%)

92.8
91.7
200.0

86.5

68.8
68.1
56.2
44.2

39.2

37.9
35.9
26.7

16.0

15.9
6.0
3.8
1.4
0.1
-

- 0

* Years DOH required fully immunized child (FIC) reporting only. 1996 has no report. Est. Incidence MCV1 Coverage MCV2 Coverage
** as of May 2014
 Decade of Vaccines

Meet Global and Regional Elimination

Goals

Meet Vaccination Coverage

Existing Global and Regional Immunization
Goals

Maternal and Neonatal

Tetanus Elimination

Rubella Elimination

Introduction of New Vaccines

8 Critical Components of Immunization
 Wanted: National Immunization Program Manager

• develop immunization standards and guidelines;

• secure vaccine supply and distribution
• prepare training materials and supervisory tools and
conduct training
• developing and carry out communication strategies
• plan the introduction of new vaccines
• organize immunization campaigns
• collect, analyze, and provide reports on vaccine
coverage, disease surveillance, and budget execution
• maintain relationships with external agency counter-
part
 Many worry about Costs with Vaccination,
We should worry more about Costs Without It.
 Not One Less

Waisbord and Larson (2005) identified 4 key

challenges confronting immunization program:

1. Children do not get vaccinated if caregivers do not

know the value of vaccines, when children need to be
immunized, and where vaccines are administered.
2. Children do not get vaccinated when communities are
excluded and beyond the reach of immunization
services.
3. Children do not get vaccinated if caregivers do not
trust the safety of vaccines.
4. Children do not get immunized when vaccines are not
available.
 Changing Mindsets

We should shift from focusing on the barriers

and constraints facing immunization
programs into thinking more about
strengthening the overarching systems, so
that we are reaching every child with a
package of sound, practical interventions.
Not One less