Title: Monitoring EPI indicators
Course: Level 3 - Immunization > Section: Plan and monitor an immunisation program

By the end of one year, every child should be fully immunised taking all the vaccine to make the immunisation effective in preventing and reducing vaccine-preventable diseases. A fully immunised child is a child who has received all doses of EPI vaccine (BCG, OPV, Pentavalent, PCV10, and Measles) before the age of one year.

Internationally there are two main EPI indicators used to monitor whether your immunisation service has the potential to reduce the target EPI vaccine-preventable diseases. These are; immunisation coverage rate for each vaccine and drop our rates from completion of scheduled immunisation.

Immunisation Coverage Rates

Immunisation coverage is the percentage of eligible fully immunised infants compared to the total number of surviving children in the target population. The immunisation coverage rate is measured by comparing the number of doses given and the number in the target population of surviving infants under one year of age (these are the eligible infants). The result is expressed as a percentage. The equation below shows you how to calculate immunisation coverage rate in your kebele.

Immunisation coverage rate (for a particular vaccine) = number receiving all doses ÷ number in the target population x 100% where:

- Number receiving all doses: is the number of surviving infants under one year of age receiving all the required doses during the previous 12 months for the selected vaccine.
- Target population is the total number of eligible children under one year of age (or a total number of surviving infants) at the start of that reporting period.

Dropout Rates

It is the difference between the number of children who started vaccination and who finished it in percentage. Common ways to measure dropout rates are:

- The dropout rate between infants receiving the first dose of pentavalent vaccine (Penta1) and the third dose (Penta3).
- The dropout rate between receiving the first dose of pentavalent vaccine (Penta1) and the single dose of measles vaccine.

Pentavalent 1 to Pentavalent 3 dropout rates is calculated by:

Penta1 to Penta3 dropout rate = (Penta1 - Penta3) ÷ Penta1 × 100%

Where:

- Penta1 is the number (or percentage) receiving the first pentavalent vaccine dose.
- Penta3 is the number (or percentage) receiving the third dose.

Note that, If an infant fails to complete the schedule of three doses of pentavalent vaccine, it indicates that there is an access problem for the parents, i.e. they have difficulty in getting to (accessing) the immunisation sessions for the second or third doses.

Pentavalent 1 to Measles dropout rates is calculated by taking Penta 1 given at six weeks of birth and measles at nine months of age as:

Penta1 to measles vaccine dropout rate = (Penta1 - measles) ÷ Penta1 x 100%

Where:

- Penta1 is the number (or percentage) of infants receiving the first pentavalent one dose
- Measles is the number (or percentage) of infants receiving the measles vaccine.

Note that, if there is a high dropout rate between Penta1 and the measles immunisation, it suggests that there is a problem for parents of utilising (making use of) the health services. A dropout rate of more than 10% indicates that the particular Health Post has a utilisation problem i.e. many people are not using the services on offer.

Calculating the number of unimmunised infants (those infants who have not completed any of the scheduled immunisation) can be done by:

Number of unimmunised infants = target population - fully immunised infants.

Where:

- The target population is the total number of eligible infants in the target age group for immunisation (under one year)
- Fully-immunised infants are the number in the target age-group who have received all doses of all the EPI vaccines.