Sri Lanka

Health System and EPI Program

In Sri Lanka, both public and private sectors provide health care. The public sector provides free health care for nearly 60% of the population. The Department of Health Services and the Provincial Health Sector, Ministry of Healthcare and Nutrition, encompass the entire range of preventive, curative and rehabilitative health care provision. The Expanded Program on Immunization (EPI) has been in operation since 1978.

Sierra Leone

Health System and EPI Program

Following a 2008 decentralization program, primary health care services in Sierra Leone are the responsibility of 19 local councils (12 district councils, 5 town councils, the Freetown City Council and the Western Area Rural Council).


Health System and EPI Program

Nigeria's public health infrastructure consists of a Federal Ministry of Health, six health zones, 37 state health ministries and about 1,300 health centers serving 774 Local Government Areas. The Federal Ministry of Health directs Nigeria's essential public and curative health functions including laboratories, disease surveillance and 53 Federal Tertiary Hospitals. The Ministry generates national health policies, plans and norms and translates national policy to state and local levels.


Health System and EPI Program

Immunization is an essential component of Nepal’s Second Long‐Term Health Plan 1997‐2017. The Child Health Division of the Department of Health Services, Ministry of Health and Population, is the home of Nepal’s National Immunization Program (NIP). The federal NIP team provides leadership, normative and managerial support. Implementation is the responsibility of EPI sections in the five regional and 75 district Health Directorates.


Health System and EPI Program

Before independence, the Mongolian health care system was entirely financed out of the central budget, and all services were provided free of charge. The system is still primarily owned and funded by the Government, although the latter looks forward to an increasing share and role for the private sector as a strategic objective sector.


Health System and EPI Program

Liberia’s National Health Policy and Plan 2007‐2011 identifies immunization as one of the key programs in the essential child health package. Liberia launched its Expanded Program on Immunization (EPI) in 1978. The Program is located in the Preventive Services Division, Health Services Department, Ministry of Health & Social Welfare. A National EPI Manager and the network of Country Health Officers oversee and coordinate all EPI‐related activities.


Health System and EPI Program

In 2008, the Ministry of Health and Sanitation was split in two: The Ministry of Medical Services and the Ministry of Public Health and Sanitation. A Health Sector Coordinating Committee is alternately chaired by the permanent secretaries of the MoMS and MoPHS.


Health System and EPI Program

Ethiopia’s health infrastructure consists of about 15,000 health posts (kebeles), 819 district health offices (woredas), 98 health zones and 11 health regional bureaus. The Expanded Program on Immunization (EPI) was introduced in 1980. It was formerly located in the Family Health Division in the Ministry of Health. There is an EPI focal point in each health region.


Health System and EPI Program

The Government initiated decentralization efforts in 2004. The MoH was one of the first four ministries to begin decentralizing. Decentralization was implemented by Presidential decree on 1 January 2010.


Even if political will exists, legislative guarantees of publicly provided vaccination are sometimes lacking or insufficient, and few countries have up-to-date legislation. Ideally, a vaccination law should contain a range of provisions, including means of EPI financing, vaccine procurement mechanisms, vaccination regulations.


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