immunization in Bosnia and Herzegovina

The Global Vaccine Action Plan (GVAP) is a framework approved by the World Health Assembly in May 2012 to achieve the Decade of Vaccines vision by delivering universal access to immunization. One of the GVAP targets is to reach 90% national coverage and 80% in every administrative unit with all vaccines in national programmes.

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FACTORS LIMITING ACCESS TO CONTINUED IMMUNIZATION

Global changes in vaccine production and availability of vaccines

Limited targeted interventions for unimmunized children such as Roma

Lack of trust in benefit of immunization among parents

Weak planning for vaccines procurement at the country level

Ineffective mechanism for local licensing including utilizing expedited procedures for vaccines procurement

Lack of confidence in benefit of immunization among health professionals

Frequent stock out vaccines

Different vaccination schedule, types of vaccines and mechanisms for vaccines procurement in 3 Administrative Units of BiH (FBiH, RS and Brcko District)

Middle and high income countries in the European region have a strong tradition of immunization for more than a century, and have successfully introduced some of the new vaccines. Today the national immunization programs face numerous challenges, including growing costs of existing vaccines and high costs of newer vaccines, supply unavailability and new market demands as more countries move towards EU integration.

Immunization is a core component of the human right to

health and an individual, community and government responsibility.

Protected from the threat of vaccine –preventable diseases,

immunized children have the opportunity to thrive and a better

chance of realizing their full potential.

Bosnia and Herzegovina (BiH) is an immunization self-sufficient country facing increasing challenges:

FACT SHEET March 2015

68%

4%

immunization in Bosnia and Herzegovina

IMPACT ON CHILDREN

full immunization coverage for all children full immunization coverage for Roma children

Full immunization

Polio 3 coverage

Source: UNICEF MICS

Polio

Full immunization refer to children that have received a BCG vaccine and three doses of DPT and the polio vaccine by 12 months of age and the MMR vaccines by 18 months.

World Health Organization declared European region polio-free in 2002

Polio continues to be a threat, particularly due to outbreaks in neighboring countries

BiH is one of four European countries (with Romania, Ukraine and Georgia) under high risk of poliovirus importation, since only 87% of children are fully protected against poliomyelitis

Herzegovina

France

Italy

Croatia

Bosnia and

80 82 84 86 88 90 92 94 96 98 100

Source: World Health Organization

FACT SHEET March 2015

9590858075706560

Palestine

Ghana

Serbia

Zimbabve

Bosnia and Herzegovina

immunization in Bosnia and Herzegovina

FACT SHEET March 2015

Measles outbreak2012 2013

201422

10

5048Source: Official statistic of Public Health Institute of Federation BiH and Republic of Srpska

cases of measles

cases of measles

cases of measles

The outbreak started in 2014 in Middle-Bosnia Canton where immunization coverage

was only 33% in 2013

and spreaded to 40% of total BiH territory

Measles can lead to serious disease and death

FOČA

BILEĆA

TREBINJE

BANJA LUKA

Areas affected by the measles outbreak

ZVORNIK

SREBRENICA

VIŠEGRAD

BRATUNAC

LOPAREUGLJEVIK

MIDDLE BOSNIA CANTON

CANTON ZENICA-DOBOJ

CANTON TUZLA

UNA-SANA CANTON

DOBOJ

PETROVO

MODRIČA

BIJELJINA

CANTON SARAJEVO

ISTOČNO SARAJEVO

PALE

STRATEGY AND ACTION NEEDEDOne of UNICEF Country Programme Goals for period 2015-19 aims at achieving equitable access to and use of quality integrated early childhood development (IECD) services, particularly for vulnerable and excluded families with young children, such as Roma, and families with children with developmental difficulties. Immunization will be supported, particularly to reduce the risk of wild polio virus, by closing equity gaps and addressing remaining bottlenecks.

For more information, please contact UNICEF Bosnia and Herzegovina; Tel: +387 33 293600; E-mail: sarajevo@unicef.org

Policy dialogue and capacity building for sustainable immunization financing, budgeting and vaccine procurement

Assess the vaccine management practices in the country; develop Multi- Year Immunization Plan; Support government to strengthen the cold chain, temperature monitoring, logistics, sharps disposals and vaccine management practices

Development and implementation of the best model for outreach vaccination for hard to reach unimmunized children such as Roma

Awareness raising with policy makers, service providers, parents, media, CSOs on importance and values of immunization and IECD.

UNICEF activities for 2015-16 will include:

UNICEF will support the Government addressing the below priority interventions to ensure sustainable and cost effective immunization programme:

Timely plan and secure funding for vaccine procurement

Continue supply of safe and effective vaccines

Improve quality of service delivery and cold chain

Regain trust in immunization among parents and health professionals

Target interventions for all unimmunized children

TOTAL budget for two years period: US$

500,000