DISEASES PREVENTED BY IMMUNISATION

1. All clinics provide immunisations at least for 5 days a week and if the community desires additional periods specifically for child health promotion and prevention.

2. Every clinic has a visit from the District Communicable Disease Control Co-ordinator every 3 months to review the EPI coverage, practices, vaccine supply, cold chain and help solve problems and provide information and skills when necessary.

3. Every clinic has a senior member of staff trained in EPI who acts as a focal point for EPI programmes.

1.1 Copies of the latest editions of EPI (SA) Vaccinators Manual Immunisation That Works.
1.2 Copies of the Cold Chain and Immunisation and Operations Manual.
1.3 Copies of the Technical guidelines on immunisation in South Africa.
1.4 Copies of the EPI Disease Surveillance Field Guide.
1.5 Copies of the current Provincial Circulars on particular aspects, e.g. acute flaccid paralysis, flu virus, Haemophilus influenzae type b (HiB surveillance, Adverse Events Following Immunisation (AEFI) investigation and reporting.
1.6 Patient and community information pamphlets in appropriate languages.
1.7 Copies of the EPI Posters and other EPI disease and schedule promotional materials.

2.1 Correct needles and syringes according to Vaccinators manual.
2.2 A working refrigerator, properly packed, with thermometer and temperature recorded and a spare gas cylinder if gas operated.

3.1 An uninterrupted and monitored cold chain of constantly available vaccines as recommended by EDL.

4.1 Staff are able to :-

4.1.1 Routinely perform correct immunisation practices according to protocol. Vaccines are checked periodically to ensure no frozen DPT, HBV, TT, HIB and none out of date or indicators showing expiry.
4.1.2 Provide mothers with correct knowledge of what is needed for the child, what is given and possible side effect and when to return for the next immunisation.
4.1.3 Provide group education for mothers and antenatal care attendants.
4.1.4 Follow up suspected cases of measles at home to determine the extent of a possible outbreak.
4.1.5 Take steps to increase coverage using the self-generated vaccination coverage graph (available in the Vaccinators manual) to address progress during the year.
4.1.6 Implement correct disposal of sharps.
4.1.7 Initiate post exposure prophylaxis for HIV in case of needle stick (according to Provincial protocol).
4.1.8 Ensure all reported and notified AFP, measles, NNT and AEFI cases are reported to EPI Coordintor and followed up within 48 hours by district investigation team of which the nurse in clinic is a co-opted member.
4.1.9 Organise immunisation service as a daily component of comprehensive PHC and to minimise waiting/queuing times.
4.2 Community health committees are given the lay case definitions of acute flaccid paralysis, measles and neonatal tetanus and urged to report suspected cases immediately.
4.3 The clinic has a good relationship with the Environmental Health Officer for assistance in outbreaks investigations.
4.4 Ensure that appropriate laboratory specimens are taken for the investigation of all AFP, NNT, measles and AEFI investigations are taken or else referred to the nearest hospital where specimens can be taken.
4.5 A 24 hour toll free number for notification - (0800 111 408) is on the clinic wall.
4.6 All HIV positive children must be immunized with all vaccines except for BCG in children with symptomatic AIDS.
4.7 Clinics arrange mass immunisation or mopping up campaigns in their communities as required by the District Manager.
4.8 Remote villages have mobile outreach sessions to provide routine services and to improve coverage where necessary.
4.9 Reduce missed opportunities and ensure that ill children and women in the childbearing age are immunised as appropriate.

5.1 Children with signs and symptoms of the EPI priority diseases (AFP, measles, NNT and AEFI) are referred as in the IMCI Provincial protocols.

6.1 All clients attending clinics for immunization services receive the appropriate health education, information and support.

7.1 Patient records and patient notification forms.
7.2 Monthly immunisation statistics.
7.3 Case investigation forms for flaccid paralysis.
7.4 Case investigation forms for measles.
7.5 Case investigation forms for neonatal tetanus.
7.6 Case investigation forms for adverse events following immunisation.
7.7 Supply of child road to health charts.

8.1 Communities participate in campaigns and national health days.
8.2 Clinic staff follow up suspected cases of measles at home to determine extent of outbreak.

9.1 Staff collaborate with other departments like education and other sectors to promote immunization and improve coverage.