Implementation of the Expanded Program on Immunization (EPI): Understanding the Enablers and Barriers in a Health System

Abstract

Much has been written about the issues, challenges and constraints in the implementation of immunization program. However, there is a need to better understand the health system barriers as well as enablers that influence the progress. This chapter aims at bridging the information gaps about system-level factors that currently are impeding the optimal delivery and uptake of immunization services to the children through the Expanded Program on Immunization (EPI). This chapter draws its thematic content from a critical review of the EPI-related international and national reports. In addition to this, this chapter consulted government reports, surveys, and publications on health system. Themes generated from the literature review included financing, governance, service delivery, human resources, information system, and supplies and vaccines. Findings suggest that certain areas in the larger health system are to be improved for a more coordinated implementation of EPI. It is imperative to understand community's behaviors and perceptions as well as demand side issues in order to achieve the desired results. For a better immunization coverage, EPI operations and performance must be improved. Implementation research could definitely help in developing an even finer understanding of the system-wide factors influencing the efficiency of the program.