COMMUNITY HEALTH NURSING -II B.SC NURSING IV YEAR UNIT-6 PULSE POLIO IMMUNIZATION PROGRAMME

1. NATIONAL HEALTH
PROGRAMMES
PRESENTED BY,
MRS.M.JOSEPHIN DAYANA,
TUTOR.

2. EXPANDED PROGRAMME ON
IMMUNIZATION
POLIO ERADICATION: PULSE
POLIO PROGRAMME

3. LESSON OBJECTIVE
At the end of the class the learner
should be able to:
1. Explain in detail Universal
Immunization Programme
2. Explain It’s focus and
implementation strategies
3. Enumerate the preventive
measures for preventing
Vaccine Preventable Disease

4. OVERVIEW
 History
 Vaccine Preventable Diseases
 Expanded Programme on Immunization
 Universal Immunization Programme
 Pulse Polio Immunization Programme
 Expected Questions
 References

5. IMMUNIZATION
PROGRAMME
IN INDIA

6. EDWARD JENNER

7. HISTORY
14 May 1796 - Jenner inoculated
James Phipps, an 8 yr old boy with
cowpox lymph taken from Sara
Nelms, a milkmaid.
Boy recovered after a brief illness

8. Jenner inoculated pus taken from a small pox
patient.
Boy showed no reaction.
Jenner recommended vaccination for prevention
of smallpox

9. Smallpox vaccination being a safe, simple,
effective and inexpensive procedure, gained
universal acceptance.
Main instrument for eradication for smallpox at
global level.
Small pox has since been eradicated but Jenner
lives for ever.

11. SMALL POX

12. Small pox eradicated in 1977.
IMMUNIZATION MOST POWERFUL & COST
EFFECTIVE TOOL.

13. The first vaccine having been sent by jenner
himself and used in bombay in 1802.
The pilot projects began during 1960.
WHO certified India to be free of smallpox in
march 1977.
The global eradication of smallpox is arguably
the greatest achievement of twentieth century
medicine

14. VACCINE
PREVENTABLE
DISEASES

15. VPD
An infectious disease for which an
effective preventive vaccine exists.
If a person dies from it, the death is
considered a vaccine-preventable
death.

16. 8 TARGETED VPDS
Diphtheria
Hepatitis B
Measles
Pertusis
Poliomyelitis
Tetanus
Tuberculosis
JE

17. DIPHTHERIA

18. PERTUSSIS

19. PERTUSIS

20. TETANUS

21. POLIO

23. TUBERCULOSIS

24. MEASLES

25. MEASELS

26. MUMPS

27. CHIKEN POX

28. FULLY IMMUNIZED CHILD
A child who received One dose of
BCG, Three doses of DPT and OPV
One dose of measles before one year
of age.
This gives a child the best chance for
survival

29. MILESTONES IN THE
IMMUNIZATION PROGRAM IN
INDIA
1978: Expanded Program of Immunization (EPI)
introduced after smallpox eradication: BCG, DPT,
OPV, Typhoid.
Limited to mainly urban areas

30. 1985 : Universal Immunization Program (UIP)
introduced; Expanded to entire country; Measles
added.
1990 : Vitamin-A supplementation.
1992: Child Survival and Safe Motherhood
Program.

31. 1995: Polio National Immunization Days.
1997: Reproductive and Child Health
Program (RCH I).
2005 : RCH-II and the National Rural Health
Mission (NRHM).

32. EXPANDED PROGRAMME ON
IMMUNIZATION 1974
 1974-

33. EXPANDED…
Adding more disease controlling antigens
to vaccination schedules.
Extending coverage to all corners of a
country.
Spreading services to reach the less
privileged sectors of the society

34. 1978 – PRIMARY HEALTH
CONCEPT
ALMA – ATA declaration included
immunization as one of the strategies
for achieving HFA by 2000 AD.
WHO named this immunization
programme as EXPANDED
PROGRAMME ON IMMUNIZATION.

35. 1985 – UNICEF re named it as “UNIVERSAL
IMMUNIZATION PROGRAMME”.
There is no difference between both the prog.

36.  The goal was to achieve universal immunization by 1990.
 EPI is regarded as an instrument of UPI.

37. EPI IN INDIA 1978
The Govt of India launched it’s EPI in 1978.
The objective was to reducing mortality,
morbidity resulting from VPDs.
To achieve a self sufficiency in vaccine
production.

38. EPI IN INDIA 1978
BCG, OPV, DPT & Measles- under 5
children.
TT- pregnant women.
Typhoid added.
OPV- 1979.

39. UNIVERSAL IMMUNIZATION PROG
1985 in remembrance
of then Prime Minister,
Indira Gandhi.

40. The UIP was taken up in 1986 as National
Technology Mission & became operational in all
districts in the country during 1989-90.
UIP become a part of the Child Survival and Safe
Motherhood (CSSM) Programme in 1992 and
Reproductive and Child Health (RCH)
Programme in 1997.

41. COMPONENTS OF UIP
1. Immunization of pregnant women
against tetanus.
2.Immunization of children in their first
year of life against 6 VPDs.

42. 2 COMPONENTS
OF UIP

43. 3. The aim was to achieve 100 % coverage of
pregnant women with 2 doses of TT.
 & at least 85% coverage of children under one
year (with 3 doses of DPT, OPV & one dose of
BCG, One dose of MMR) by 1990

44. UIP was first taken up in 30 selected districts &
catchment areas of Medical Colleges.
A technology Mission on Vaccination &
Immunization of Vulnerable Population was set
up to focus on all aspects of immunization
activity.

45. OBJECTIVES
To increase immunization coverage.
To improve quality of service.
To achieve self sufficiency in vaccine
production

46. To train health personnel.
To supply cold chain equipment and establish
a good surveillance network.
To ensure district wise monitoring

47. CHANNEL OF SERVICE
PROVISION
Immunization services are
provided through the existing
HCDS. (MCH centers, PHC,
HSc, Hospitals, Dispensaries).

48. Though the target was 100% coverage no country
in the world has reached the coverage figure.
Therefore it can be interpreted as “NO CHILD
SHOULD BE DENIED OF IMMUNIZATION” .

49. STATUS OF VPD -
INDIA
DISEASE 1987 2011 %
DECLINE
POLIMYELITIS 28,257 1 100
DIPTHERIA 12,952 4,233 62.3
PERTUSIS 163,786 3,909 76.13
NNT 11,849 734 93.8
MEASLES 247,519 33,634 86.41

50. PROGRAMME
IMPLEMENTATION PLAN
 PIP was set to strengthen programme
implementation

51. COMPONENTS:
1.Support for alternative vaccines
delivery from PHC to HSc & out reach
sessions.
2.Deploying retired manpower to
implement vaccination services in
urban slums & underserved areas

52. 3. Mobility support to Dist Immunization
Officer.
4. Reviewing meeting at state level with the
districts at 6 monthly intervals.
5. Training of ANM, cold chain handlers, mid
level managers, refrigerator machines.

53. MOBILITY SUPPORT

54. 6. Support mobilization by ASHAs, Self Help
Groups.
7. Printing of immunization cards, monitoring
sheets, cold chain chart vaccine inventory charts.

55. PULSE POLIO
IMMUNIZATION
1995.
Under 5 children.
Additional oral polio drops administered in
December & January.

59. STATUS FEB 2012
 INDIA is removed from the list of
“POLIO ENDEMIC COUNTRIES”

60. REFERENCES
 1.Park’s Textbook of Preventive & Social Medicine,
Banarsidas Bhanot publishers,22 Ed
 2. Basawanthappa B.T, Community Health Nursing,
Jayapee publications
 3. Neelam Kumari, Text book of Community Health
Nursing, S. Vikas Publisher, First Edn
 4. Rao.B sridhar, Book of Community Health
Nursing,AITBS publisher, New Delhi

62. EXPECTED QUESTIONS
SHORT NOTES:
 EXPANDED PROGRAMME ON
IMMUNIZATION
 PULSE POLIO PROGRAMME
SHORT ANSWER
 IMMUNIZATION SCHEDULE FROM
BIRTH TO UNDER FIVE