A 10-year review of morbidity from childhood preventable diseases in Nigeria: how successful is the Expanded Programme of Immunization (EPI)?

Abstract

Morbidity and mortality in children from developing countries are primarily due to preventable infectious 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 6 diseases. To accomplish this WHO has initiated the Expanded Program 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 program 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 program 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. Program evaluation is not a simple task. In fact evaluation may be one of the most challenging and frustrating aspects of the whole program. 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. (authors)