부산대학교 도서관

Immunisation is a preventive element of primary healthcare that ensures protection of children against infectious diseases through the use of vaccines. Immunisation has been found to be a cost effective preventive health intervention strategy for children. This article reviews the Botswana Expanded Programme on Immunisation (EPI) which began in 1979. The immunisation strategy is discussed and then critiqued on its role in ensuring that vaccines are effective, efficient, safe and available to the target group. The following documents were reviewed; with regards to EPI policy, EPI related reports -- National Certification committee reports, national programme assessment reports, Botswana report from the Africa Regional Certification Commission, World health Organization (WHO) and United Nations International Children's Emergency Fund (UNICEF) documents and literature on immunisations in general. Personal communication was also used. Results of the review outline that, during the period 1980-1994, immunisation rates for vaccine-preventable diseases ranged from 40-63%. As years passed, the immunisation coverage improved to 80% and above for most antigens. While the national immunisation coverage is impressive, some districts have lower than recommended WHO and national coverage rates. Contributory factors to low immunisation coverage in some districts include inadequate human and material resources, geographical factors, religious beliefs, negative attitudes by some farmers, provision of multi-dose vials for vaccines and poor communication between practitioners and clients. Recommendations for improvement of the programme at facility, community, district and national levels are outlined.