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research-article |
A 10-year Review of Morbidity from Childhood Preventable Diseases in Nigeria: How Successful is the Expanded Programme of Immunization (EPI)?
Department of Community Health, College of Medicine, University of Lagos Lagos, Nigeria
Morbidity and mortality in children from developing countries are primarily due to preventable infections diseases such as measles, poliomyelitis, whooping cough (pertussis), tetanus, diphtheria, and tuberculosis. By 1990 WHO hopes to have every child in the world immunized against these six diseases. To accomplish this, WHO has initiated the Expanded Programme of Immunization (EPI). In Nigeria, the Federal Ministry of Health, in collaboration with WHO and UNICEF, launched a Pilot phase of the EPI in Ondo and Oyo States in 1975–76. In 1979 a nationwide execution of the programme began.
Analysis of disease trends shows that apart from tuberculosis and acute poliomyelitis there has been no clear reduction in morbidity from the EPI target diseases. Nonetheless, the programme has been able to administer several thousand vaccine doses to children who probably would not have otherwise been reached. The EPI in Nigeria has been expanded even further to include cerebrospinal meningitis. Programme evaluation is not a simple task. In fact, evaluation may be one of the most chellenging and frustrating aspects of the whole programme. Although several tools may be employed to evaluate the efficiency of EPI, its final success will still be measured by how much it has been able to reduce morbidity and mortality. Thus far, EPI in Nigeria is short of this goal.