Expanded Program on Immunization
1. Contact Information:
Program Head: Sidat Fofana
Office Address: Kotu Central Medical Stores, Kotu Power Station Junction
Email Address: sidatfofana@gmail.com
2. Background
The Gambia started vaccination as early as 1967 with the Smallpox vaccination headed by Dr. P. J. N’Dow. This was a country-wide mass vaccination with a coverage of 93% based on the presence of a scar (> 3 months old).
The Gambia EPI was established in 1979 with the following six traditional antigens (BCG, Diphtheria, Pertussis, Tetanus Toxoid, Measles, OPV). These were followed by the introduction of Yellow Fever (1978), Hepatitis B (1990), HIB (1997), the switch from DPT to Penta valent (2009), pneumococcal conjugate (2009), Rotavirus (2013), MenAfricvac (2019), Inactivated Poliovirus vaccine (2015), the switch from Measles to Measles- Rubella (2017), HPV (2019), and more recently COVID-19 vaccines (2023).
The program at the time of inception had only one team that covered the length and breadth of the country monthly. It was a mobile team visiting one community to the other. In 1982 EPI services integrated with MCH services where mothers and caregivers meet monthly for maternal and child health services delivered primarily through static and outreach strategies. The Gambia’s immunization Programme has contributed to the reduction of infant and childhood morbidity and mortality.
Initially, the program had a single mobile team covering the entire country on a monthly basis. In 1982, EPI services were integrated with Maternal and Child Health (MCH) services, promoting monthly gatherings where mothers and caregivers could access immunization and related health services through static and outreach strategies.
Today, The Gambia’s EPI continues to play a significant role in reducing infant and childhood morbidity and mortality.
3. Organizational Structure
The EPI Program operates under both the Directorate of Health Services and the Directorate of Public Health. It is responsible for planning, monitoring, and evaluating immunization activities nationwide.
4. Key Functions and Responsibilities
- Provision of immunization services, including outreach and Supplementary Immunization Activities (SIAs)
- Disease control through eradication and elimination of vaccine-preventable diseases (e.g., Polio, Measles, Maternal & Neonatal Tetanus)
- Introduction of new and under-utilized vaccines (Pentavalent, Pneumococcal, Rota, IPV, Measles 2nd dose)
- Dropout and wastage reduction (e.g., monthly Pentavalent-3 monitoring, wastage tracking systems)
- Vaccination of zero-dose and under-immunized children
- Conducting operational research and leveraging relevant technologies
- Training service providers on safe injection practices
5. Services Provided
- Routine vaccination services
- Issuance of vaccination certificates
- Public education on immunization and vaccine-preventable diseases
Ongoing Programs:
- FPP (Full Portfolio Planning):Gavi’s integrated support model covering cold chain, health system strengthening (HSS), and technical assistance to achieve national immunization goals.
- CDS3 (COVID-19 Delivery Support):Supports rollout and scale-up of COVAX-funded vaccines, while also enhancing health systems and immunization programs.
6. Policies, Guidelines, and Reports
Key Policies:
- Draft EPI Policy
- SOP: Vaccine Arrival
- SOP: MyChild System
- SOP: Immunization Service Delivery Point Registration
Guidelines:
- National Immunization Strategy (NIS)
- Communication Plan
- HPV Vaccination Guidelines
- Urban Immunization Strategy
- SOPs for Cold Chain and Vaccine Management
- MEAL Plan
- Surveillance Guidelines
Reports:
- Effective Vaccine Management Assessment (EVMA)
- External Surveillance Review
- Routine Immunization Cluster Survey
- Post-Campaign Evaluations
- SIA Reports
- Annual Polio Update
7. Collaboration and Partnerships
The EPI does not have all the required capacities as a program; however, the program works closely with other partners and departments both within and outside the country to enhance the collective technical expertise. It collaborates with WHO, UNICEF, Gavi, PATH and others in the planning, coordination, and implementation of its activities. Locally at operational levels, EPI also works with Civil Society Organisations through TANGO; entities like MRC; academic institutions (University of The Gambia); other government departments such as the Ministry of Basic and Secondary Education (MoBSE), and Gambia Bureau of Statistics (GBoS); media houses (state-owned and private): Gambia Radio and Television Services (GRTS); private online platforms). Under the MoH, the EPI collaborates with programmes under the following Directorates
- Directorate of Health Services
- Directorate of Public Health
- Directorate of Human Resources for Health
- Directorate of Nursing Services
- National Pharmaceutical Services
- Regional Health Directorates
- National Public Health Laboratories
- Directorate of Planning and Information
- Directorate of Health Promotion and Education
Sidat Fofana
Program Head
Overview
The Gambia started vaccination as early as 1967 with the Smallpox vaccination headed by Dr. P. J. N’Dow. This was a country-wide mass vaccination with a coverage of 93% based on the presence of a scar (> 3 months old).
The Gambia EPI was established in 1979 with the following six traditional antigens (BCG, Diphtheria, Pertussis, Tetanus Toxoid, Measles, OPV). These were followed by the introduction of Yellow Fever (1978), Hepatitis B (1990), HIB (1997), the switch from DPT to Penta valent (2009), pneumococcal conjugate (2009), Rotavirus (2013), MenAfricvac (2019), Inactivated Poliovirus vaccine (2015), the switch from Measles to Measles- Rubella (2017), HPV (2019), and more recently COVID-19 vaccines (2023).
The program at the time of inception had only one team that covered the length and breadth of the country monthly. It was a mobile team visiting one community to the other. In 1982 EPI services integrated with MCH services where mothers and caregivers meet monthly for maternal and child health services delivered primarily through static and outreach strategies. The Gambia’s immunization Programme has contributed to the reduction of infant and childhood morbidity and mortality.
Initially, the program had a single mobile team covering the entire country on a monthly basis. In 1982, EPI services were integrated with Maternal and Child Health (MCH) services, promoting monthly gatherings where mothers and caregivers could access immunization and related health services through static and outreach strategies.
Today, The Gambia’s EPI continues to play a significant role in reducing infant and childhood morbidity and mortality.
The EPI Program operates under both the Directorate of Health Services and the Directorate of Public Health. It is responsible for planning, monitoring, and evaluating immunization activities nationwide.
• Provision of immunization services, including outreach and Supplementary Immunization Activities (SIAs)
• Disease control through eradication and elimination of vaccine-preventable diseases (e.g., Polio, Measles, Maternal & Neonatal Tetanus)
• Introduction of new and under-utilized vaccines (Pentavalent, Pneumococcal, Rota, IPV, Measles 2nd dose)
• Dropout and wastage reduction (e.g., monthly Pentavalent-3 monitoring, wastage tracking systems)
• Vaccination of zero-dose and under-immunized children
• Conducting operational research and leveraging relevant technologies
• Training service providers on safe injection practices
- Routine vaccination services
- Issuance of vaccination certificates
- Public education on immunization and vaccine-preventable diseases
- FPP (Full Portfolio Planning):Gavi’s integrated support model covering cold chain, health system strengthening (HSS), and technical assistance to achieve national immunization goals.
- CDS3 (COVID-19 Delivery Support):Supports rollout and scale-up of COVAX-funded vaccines, while also enhancing health systems and immunization programs.
