Expanded Program on Immunisation (EPI)

Infant mortality and under five mortality rates in Ethiopia are among the highest in the world. Diarrhoeal diseases, vaccine preventable diseases (VPDs) and malnutrition are responsible for a majority of childhood deaths in Ethiopia.
The Expanded Program on Immunisation (EPI) started in Ethiopia in 1980 with the intention of increasing the immunisation coverage by 10% annually and reach 100% coverage in 1990. At this point, the immunisation coverage figures vary largely between regions, from more than 80% DPT3 coverage in Tigray to less than 5% in Somali and Afar regions, resulting in a national DPT3 coverage of about 50% (DPT3 = 3 doses of diptheria, pertussis and tetanus). The long-term goal of the Ministry of Health EPI Strategy is to achieve 90% DPT3 coverage in all regions.
Ethiopia is a very diverse country, with a need for development of specific strategies for reaching each area. By the implementation of new approaches called Reaching Every District (RED) and Sustainable Out-reach Services (SOS), the present target is to increase the coverage in certain priority areas by 10% and in others by 5%, giving a total national immunisation increase of 6% in a year. The objective set in 1980 was not met because of factors such as poor health infrastructure, low number of trained manpower, high turn over of staff and lack of donor funding. The same factors still affect the program today.
The EPI program is run by the Ministry of Health (MoH) in close cooperation with WHO, UNICEF and other partners and implemented in each region by the Regional Health Bureaus. WHO provides technical assistance to the Ministry of Health and assists in planning, resource mobilisation and social mobilisation.
The six vaccine preventable diseases included in the EPI program in Ethiopia are measles, diphteria, pertussis, tetanus, polio and tuberculosis. Ethiopia has long term plans to introduce “new” and under-used vaccines, such as hepatitis B (HepB) and hemophilus influenzae type b (Hib). All vaccines are provided for free.



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