ANNUAL HEALTH BULLETIN 2004 - Ministry of Health

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Expanded Program On Immunization (EPI) The EPI was launched in the country on 15 th Nov. 1979 coinciding with International Year of Child with an objective of reducing the seven- vaccine preventable disea 'es. (TB, DiphtheIia, Pertussis, Tetanus, Polio and Measles) In December 1994, the tetanus Toxiod vaccine for pregnant women was also introduced in to the program. In Mid 1996. Hep.B vaccine for all children under one year of age was introduced as an integral component of EPI. The EPI services been full integrated in to the general public health services mainly with MCH/FP in particulars. It is delivered through existing Hospitals, BHUs and ORCs. Over all Immunization services aimed for effective coverage with all seven antigens aimed at all infants less than one year of age and to all pregnant women. Goals for 9 th Five years plan. • The goals of the EPI program is to reduce the seven vaccine preventable disease to a level at which they are no longer public health problem by maximizing opportunity, minimizing risk and increasing acceptability and reach of immunization program. Objective of Program are: • To sustain EPI coverage for all seven antigens at one above 90 percent for all children under one year. • To eradicate poliomyelitis by 2005 • 90% reduction of measles cases • 95% reduction of deaths caused by measles • To eliminate Maternal and neo-natal Tetanus by 2005 • To develop sustainability in the EPI program through national capacity building. Strategies: • Ensuring quality and vaccination safety • Establishing and strengthening surveillance for all EPI disease • Community mobilization • National capacity development for ensuring sustainability Program Status: • Immunization coverage maintained above 85% under one year of age • There are seven antigen under EPI programme. • DPT -Hep.B combination vaccine introduced in 2003 nation wide through GAVI support • AFP surveillance conducted in 22 hospital in 2003 • Open Vial Policy for DPT-Hep.B, OPV and IT vaccine were introduced in December 2003. • Reusable Syringes were replaced by Auto Disable Syringes (AD syringes) for all BPI vaccines in December 2003 through GAVI support
• EPI mid level management training was conducted for DMOs/DHSOs and primary health workers from 2003 and on going activities. • No. Cases ofMNT have been reported since 1994. AFP Surveillance: • Bhutan is a non-endemic country for poliomyelitis. The last case of clinically compatible case of poliomyelitis was detected in 1986 in Tsirang Dzongkhag. But due to its porous border with an endemic country, India, the risk of importation of poliovirus is always there. Thus, in order to control measures, acute flaccid paralysis (AFP) surveillance was initiated in later part of 1997. • Since, 1997, 18 of AFP cases were reported and investigated and discard as nonpolio by the national expert committee polio eradication. During 2003 4 AFP cases was reported and active surveillance pick up one unreported case of AFP from JDWNRH, Thimphu and stool result was inadequate because of late collection and that case was referred to Kolkota for the further treatment. Now the case has been investigated and discards as non-polio by the national expert committee. Rubella. Rubella was not a notifiable disease in the country. The new as well as the old hospital and BHU reporting forms did not include rubella for routine reporting. No. Laboratory testing facilities for rubella existed prior to April 2003. Though clinical suspicion of rubella was made; there were no supportive diagnostic facilities. Trongsa had an outbreak of febrile rash in 2003. This occurred in the municipality areas as well as in some nearby villages. A total of five schools had the outbreak which had laboratory confirmed rubella. There were six other Dzongkhags that reported similar epidemics these were laboratory confirmed as rubella epidemic. In 2003 Public Health Laboratory has received 179 sample of blood for analysis among which 35 samples tested were from pregnant women from the outbreak area in Trongsa. All were negative for rubella (IgM). These samples were tested for anti-measles IgM as well as antirubella IgM.All the samples were negative for measles IgM. Fifty-five samples tested positive for Rubella IgM among non-pregnant groups.
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ROYAL GOVERNMENT OF BHUTAN MINISTRY
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National Referral Hospital JDWNRH O
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Activities The Royal Institute of H
Page 16 and 17:
The structure for QAS has been inst
Page 18 and 19: • Establishment of goals and stra
Page 20: quality assurance activities and re
Page 24 and 25: SN Cases Male Female Total 1 New ca
Page 26 and 27: 1. The National Institute of Tradit
Page 28 and 29: Introduction The laboratory service
Page 30 and 31: • Hematology services for routine
Page 32 and 33: • Since 2000, annual intake of la
Page 34 and 35: The vision of IC&HWM program is to
Page 36 and 37: Nursing services in Bhutan is the b
Page 38 and 39: Nilme of Hospit41s/ Bed Patients lo
Page 40 and 41: Besides the routine curative care,
Page 42 and 43: Oral health is an important compone
Page 44 and 45: An X-Ray service in the country was
Page 46 and 47: History In the 1990s, radio telepho
Page 48 and 49: Some of the main constraints faced
Page 50 and 51: Perinatal medicine services are goi
Page 53: J!])cPJ, rmffil:mcPJ1Yfl il: ([J)f
Page 56 and 57: • 11 new doctors trained on Basic
Page 58 and 59: Type of -. . complications 2001 200
Page 60 and 61: Complied by: Dr. K.C Buragohain, JD
Page 62 and 63: About 30% (29.71%) of the populatio
Page 64 and 65: discontinuation. Medical side effec
Page 66 and 67: The overall CPR improved to 46% if
Page 70 and 71: Sl. District BeG Measles DPT- OPV O
Page 72 and 73: Str~gthen the DOTS component of DOT
Page 74 and 75: v. Treatment outcome (%) 2000 2001
Page 76 and 77: ~~::; ...~~.:=---- ."' 0 Diseases 1
Page 78 and 79: The National Control of Dirrhoeal D
Page 80 and 81: Background The Village Health Worke
Page 82 and 83: Donor supported vertical programme.
Page 84 and 85: • Function as coordinating body i
Page 86 and 87: SI.No Gender No. of cases 1 Male 39
Page 88 and 89: Background. The National Malaria Er
Page 90 and 91: Malaria case load contributed by f"
Page 92 and 93: 45 40 .. - . Malaria mortality 35T
Page 94 and 95: 13. Professional Human Resource Dev
Page 96 and 97: The integration of Community Based
Page 98: Establishment of Audio logy Unit at
Page 102 and 103: District ANC atte"dances Average 1s
Page 104 and 105: Child attendances Total District In
Page 106 and 107: District IUD Cycles of DMPA Male Fe
Page 108 and 109: Procedures Cases % Caesarian sectio
Page 110 and 111: District Caesarian General General
Page 112 and 113: District X-ray X-ray X-ray Ultrasou
Page 114 and 115: Outreach Clinic Tsimalakha Hospital
Page 116 and 117: Districts Hospitals Basic Health Un
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~ ICD Priority Health ProblemlDisea
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ICD Priority Health Problem/Disease
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ABER ACO AEFI AFP AGUS AIDS AN ANC
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OCP OPD OPV ORC ORT OT PEM PHC PHD
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ANNUAL HEALTH BULLETIN 2004 - Ministry of Health

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