Immunization Program Evaluation in Guyana

In September 2008, a team conducted an international evaluation of Guyana’s immunization program (EPI) to assess its strengths and weaknesses, and its capacity to accommodate new vaccine introduction. This evaluation also assessed the achievements that have occurred since the first EPI evaluation conducted in May 2000. Guyana is divided into 10 administrative regions. Four of them are classified as interior or hinterland regions. They are mostly rural, hard-to-reach, and sparsely populated. The remaining regions are coastal areas. The role of Guyana’s Ministry of Health (MOH) includes policy formulation, standard setting, evaluation, financing, and managing health programs. Government expenditure on health was estimated to be 4.5% of GDP in 2003, representing a steady increase from 2.7% in 1998. The primary source of health sector financing is government taxation. For the years 2001-2005, Guyana received major funding from the Global Alliance for Vaccines and Immunization (GAVI) for the introduction of pentavalent (DTP/Hep B/Haemophilus influenzae type b) vaccine in the immunization schedule. Since 2006, the country has assumed the full payment of the vaccine (1). No case of polio or yellow fever has been confirmed in Guyana since 1962 and 1968, respectively. No case of laboratory confirmed measles has been reported since 1991. The last case of rubella was reported in 1998. Two new antigens (hepatitis B and Hib) were fully introduced into the routine vaccination schedule in 2001. Between 2005 and 2007, the Tdap, inactivated polio (IPV), and pneumococcal vaccines have been introduced for selected populations. Pneumococcal and rotavirus vaccines will be administered to all infants starting in 2009. Vaccination coverage of all antigens has increased: DTP3 coverage rose from 83% in 1999 to 93% in 2006 (Figure 1) and BCG from 91% to 96% in the same period. IMMUNIZE AND PROTECT YOUR FAMILY