Module 32: Immunisation (IMS

1202)
Unit 1: Immunisation Systems,
Operations, Policies, Norms, and
Standards
 Learning Objectives
• Define and explain key terms in immunisation.
• Describe the Expanded Programme on
Immunisation (EPI) and its evolution in Kenya.
• Analyse operational and supportive
components of an immunisation system.
• Discuss external environmental influences on
immunisation services.
• Describe immunisation-related policies.
• Identify norms and standards in immunisation
programmes.
Key Terms: Cold Chain & Combined
Vaccine
• Cold Chain: Temperature-controlled vaccine
supply system.
• Combined Vaccine: Multiple antigens in one
shot (e.g., Pentavalent).
 Key Terms: Coverage & Dropout
Rate
• Coverage: % of target population vaccinated.
• Dropout Rate: % starting but not completing a
vaccine series.
 Key Terms: Micro Plan & Indicator
• Micro Plan: Local action plan for
immunisation.
• Indicator: Measurable variable for programme
performance.
 Key Terms: Logistics, Strategy,
Support Supervision
• Logistics: Planning, procurement, distribution
of vaccines.
• Strategy: Plans/methods to reach
immunisation goals.
• Support Supervision: On-site training and
mentoring.
 Expanded Programme on
Immunisation (EPI)
• Initiated by WHO in 1974.
• Adopted in Kenya in 1980.
• Aims to reduce vaccine-preventable diseases.
 Kenya’s EPI Vaccines
• BCG, OPV, DPT-HepB-Hib (Pentavalent), IPV,
Measles, Rotavirus, PCV.
• Recent additions: HPV, IPV.
 EPI Achievements in Kenya
• Increased vaccine coverage.
• Introduction of new vaccines.
• Improved cold chain and surveillance systems.
 External Environment Factors
• Geographic: Accessibility in remote areas.
• Socioeconomic: Poverty, beliefs, education.
• Political: Government commitment and
support.
 Global Health and Emergencies
• WHO/GAVI influence through support and
funding.
• Pandemics/outbreaks disrupting schedules.
Operational Components: Planning
• Target population estimation.
• Session scheduling.
• Resource allocation.
Operational Components: Logistics
• Vaccine forecasting and procurement.
• Cold chain storage and distribution.
 Operational Components: Service
Delivery
• Static, outreach, and mobile services.
• Integration with maternal/child health.
 Operational Components:
Monitoring
• Use of tally sheets and registers.
• Supervision and quality assurance.
 Cold Chain Equipment
• Refrigerators, cold boxes, vaccine carriers.
• Monitoring: VVMs, thermometers.
 Supportive Components: HR and
Training
• Training of vaccinators and health workers.
• Continuous professional development.
 Supportive Supervision
• Mentoring, feedback, coaching during field
visits.
 Advocacy & Communication
• Social mobilisation.
• Community Health Volunteers (CHVs).
• Tackling vaccine hesitancy.
 Partnerships
• MOH, WHO, UNICEF, GAVI, NGOs, local
leaders.
 Health Information Systems
• Use of HMIS/DHIS for reporting and feedback.
 Immunisation Policies: Global
• WHO Immunisation Agenda 2030.
• GAVI priorities and support.
 Immunisation Policies: Regional
• Africa Regional Strategic Plan.
• Regional planning and coordination.
 Immunisation Policies: Kenya
• MOH EPI Policy 2013.
• Cold chain and new vaccine guidelines.
 Policy Goals
• Equity and universal coverage.
• Quality, safety, and sustainability.
 Norms & Standards: Participation
& Integration
• Community involvement in planning.
• Integration with other health services.
Norms & Standards: Accessibility &
Quality
• Targeting vulnerable populations.
• Safe injection practices and disposal.
 Coordination & Regulatory Issues
• MOH leadership with partners.
• Vaccine regulation and safety monitoring.
 Summary
• Immunisation systems = operations + support.
• Guided by policies, norms, and standards.
• EPI remains a key public health strategy.
 Discussion Questions
• What are the challenges of cold chain in rural
areas?
• How can nurses improve immunisation
coverage?
• Why is integration with other health services
important?
 References
• MOH Kenya. (2015). Immunisation Manual for
Health Workers.
• WHO. (2015). EPI Prototype Curriculum.
• GAVI and WHO – Immunisation Agenda 2030.
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