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Expanded programme on immunization

Making every child count

Our mission is to ensure every Somali child has access to life-saving vaccines at the correct time that protect them against vaccine-preventable diseases.

Who we are

WHO’s Expanded Programme on Immunization (EPI) partners with health authorities to vaccinate Somali children against eight vaccine-preventable diseases: childhood tuberculosis, diphtheria, haemophilus influenzae type B, hepatitis B, measles, pertussis, polio and tetanus.

We support routine vaccination against these diseases in 607 health facilities in 117 accessible districts out of a total of 123 districts, by encouraging families with babies to visit their nearest health facility five times before their child(ren) reaches 1 year of age. Most of these health facilities, such as mother and child health clinics, are managed by nongovernmental organizations and the Somali Government. Gavi, the Vaccine Alliance, supports all components of immunization activities in 25 accessible districts and provides vaccines and cold-chain equipment in every accessible district.

To make the best use of resources, the EPI programme works with Somalia’s polio eradication programme during vaccination campaigns to reach children using existing systems, assets and infrastructure, such as human resources and cold-chain systems.

What we do

In collaboration with health authorities, we support routine childhood vaccination primarily through the following actions:

Maximize the reach of and sustained access to childhood vaccination

We support health facilities to vaccinate children younger than 1 year of age against common, preventable diseases. We team up with partners, such as the polio eradication programme, to roll out vaccination campaigns to reach children living in hard-to-reach areas. This work also includes developing and implementing district microplans for accessible regions that allow teams to search for and vaccinate every eligible child.

Monitor prevalence of diseases

We carry out surveillance of diseases such as measles, to be able to tackle any outbreaks in a timely manner and prevent further spread.capacity. We help build the capacity of staff from the health authorities at all levels and the polio teams in immunization practices and measles surveillance.

Build strong health systems

We deliver vaccines to children, which also contributes to delivering essential health services. Delivering vaccines to households establishes a point of contact between families and primary health care services at least five times during the first year of a child’s life. Thus, by improving immunization services, we also contribute to building strong health systems.

Monitor progress

We carry out monitoring and supervision activities, such as regular EPI reviews and field visits, including during immunization campaigns, to maintain high standards of service delivery. We update the EPI policy regularly to meet the needs of Somali children. We manage and analyse information, hold review meetings and disseminate updates to partners through weekly polio technical updates.

Our impact

Working with the Somali Ministry of Health and partners

  • Delivery of vaccines to Somali children increased every year to safeguard them from eight of the most common childhood diseases
  • More health workers empowered every year to deliver essential health services to children
  • Disease outbreaks in children rapidly controlled and spread of diseases reduced, such as the measles outbreak of 2017 and 2018
  • Vaccination coverage increased and sustained compared with previous years
  • Strong partnerships formed with Somali health authorities, WHO programmes and other health partners to immunize more children

What we have achieved

Developed capacity of health staff in Somalia

In 2019, we trained staff from 722 health facilities in immunization practices and 176 staff from health authorities in surveillance of measles.

Strengthened disease surveillance

At least one sentinel site was established in health facilities in each district to search for measles cases regularly.

Reduced the prevalence and burden of vaccine-preventable diseases by reaching more children than before

  • Controlled the measles outbreak that broke out in 2017 by vaccinating 4.49 million children under 10 years out of a target of 4.8 million children in 2018.
  • In 2019, the number of cases of measles decreased compared with 2018. More than 400 000 children aged under 1 year were vaccinated against measles through routine immunization; just over 300 000 of these children received their first dose of the measles vaccine. About 4.5 million children received one additional dose of the measles vaccine during a nationwide measles campaign.
  • More than 345 000 infants (73% of the target) received the Bacille Calmette– Guérin (BCG) vaccine to protect them against tuberculosis in 2019.
  • Through routine immunization, more than 380 000 children (84% of the target) received the first dose of the penta 1 vaccine to protect them against five diseases (diphtheria, Haemophilus influenzae type B, hepatitis B, tetanus and whooping cough).
  • More than 1 260 000 doses of the penta vaccine were administered in 2018; about 333 100 children (74% of the target) received the third dose of this vaccine.
  • More than 2,9 million under 5 years children received vaccines against measles, polio and vitamin A & deworming tablets during integrated campaign.

Provided support to refine national strategies and policies to support immunization.

  • Somalia’s EPI policy was revised and standard operating procedures for minimum standards of service delivery were developed.
  • Two interagency coordination committees for immunization were formed in Mogadishu and Hargeisa to strengthen immunization policies and activities.
  • Planning started on introduction of a second dose of the measles vaccine and injectable inactivated poliovirus vaccine for children.

What is next

WHO’s EPI team is striving to meet and exceed targets for vaccination by reaching more children and providing immunization services in more districts. With support from the Ministry of Health and partners, the following activities are planned during 2021–2025:

  • Resume and sustain vaccination coverage during and after COVID-19.
  • Conduct a comprehensive review of the EPI situation in the country.
  • Carry out an EPI coverage survey to assess the coverage of all antigens and determine the reasons for low coverage of eligible children and bottlenecks in reaching them.
  • Develop a comprehensive multiyear planning tool for 2021–2025.
  • Introduce a second dose of measles for children aged 15 months.
  • Conduct a midlevel management training course for EPI managers.
  • Implement an urban immunization strategy in three highly-populated cities – Mogadishu, Hargeisa and Bossaso.
  • Introduce an electronic immunization register on a pilot basis to track children who have missed vaccinations and inform parents when their child’s visit is due. This register will improve defaulter tracing.
  • Roll out data quality improvement plans to overcome data management problems from the grassroots health facility level to the national level.

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