Besides clean water, no other intervention has been able to reduce the disease burden in the world like vaccines have- WHO
Polio immunization in Nigeria has arguably received more consistent publicity than any other disease. The focus on eradicating polio via immunization has often taken center stage in global health conversations, so it is clear why for most people immunization is often synonymous with polio vaccination. There is, however much more to routine immunization than eradicating polio.
Immunization is a comprehensive package designed to protect children and adults against certain killer infectious diseases. At birth, a child is first given the Hepatitis B vaccine which provides immunity from the deadly viral liver infection. Thirty days later, the child receives the second dose of the same vaccine along with other vaccinations such as Rotavirus, Influenza, DTaP for Diphtheria, Tetanus, and Pertussis, Pneumococcal and the Inactivated Polio Virus (IPV) Vaccine. This schedule is meant to continue until the child becomes a teenager and receives the Meningococcal vaccines.
The World Health Organisation (WHO) notes that besides clean water, no other intervention has been able to reduce the disease burden in the world like vaccines have.
Unfortunately, not all children in Nigeria receive immunization services due to factors such as cultural beliefs and not all are born in health facilities. So they may miss out on getting their first shot which may prompt the parents to follow-up on subsequent doses. In Nigeria, only 35% of births are attended to by skilled health personnel. In 2017 WHO reported that 77% of children between the ages of 12-23 months in Nigeria have not received all the routine vaccination recommended by the country’s Expanded Program on Immunization.
Borno State, one of the three North-Eastern states currently recovering from an insurgency, surprisingly has better immunization coverage numbers than several other states in the country, including states not under conflict. A Multiple Indicator Cluster Survey (MICS) released by UNICEF and the National Bureau of Statistics (NBS) shows that the state has a 47.7% immunization coverage rate, higher than any other state in the North-East (Adamawa – 37.9%, Bauchi – 18.5%, Gombe – 25%, Taraba – 16.4%, Yobe – 8.7%) and several other states, including Niger at 20% and Bayelsa at 42.6%. Even though the figures fall well below the 90% target set by Nigeria, it is still a commendable statistic in light of the humanitarian situation in the state.
Borno’s immunization effort is supported by multiple humanitarian organizations working in the state. Some of these organizations have set up clinics in and around the IDP camps in the state capital, Maiduguri. In the Bakassi IDP Camp for example, a UNICEF clinic provides comprehensive immunization coverage for children living in the camp. As a result, children such as 19-month-old Balkisu are able to access vaccinations, and that has helped prevent common infectious diseases. At the Mallah Kachalla Primary Healthcare Centre, UNICEF has set up a Community Based Management of Acute Malnutrition (CMAM) Centre to provide immediate intervention to malnourished children. The centre also provides immunization services to the children.
The CMAM center uses Voluntary Community Mobilizers (VCM) to remind parents about their child’s next immunization appointment
The use of Volunteer Community Mobilisers has proved over time to be an effective tool in many healthcare interventions across Nigeria. In Kaduna State, for example, VCMs are not only helping out in immunization, but also advocate for antenatal care and assist in birth registration. In Lagos, the use of VCMs made a significant impact during the immunization campaign in Otodo Gbame Community earlier this year. In Kebbi and Kano States they were also utilized in 2012 to help with the polio eradication drive and considered change agents. Some development partners have organized them into networks, recognizing their key roles in increasing demand for vaccination, especially in rural and hard to reach areas
There is no doubt that Volunteer Community Mobilizers play a huge part in improving immunization coverage in the communities and IDP camps in Maiduguri. However, there is no clear system through which their work can be measured. Understanding how they carry out sensitizations in people’s houses will help in ensuring that they pass accurate information. Also, having them in a unit under the supervision of community health extension workers could improve the coordination of their work.
According to the WHO, about 5.6million children under five died in 2016, with the most deaths occurring in Africa. Death among children under five is generally as a result of the six childhood killer diseases, the majority of which can be prevented through vaccination. Increasing immunization coverage in Nigeria will lead to a significant reduction in child mortality and the use of community mobilizers as evidenced in these two health centers in Maiduguri has encouraged more families to embrace the practice of immunization.
To improve her immunization coverage rate, the Borno state Government can complement the efforts of humanitarian organizations such as UNICEF, by giving the VCMs a sense of belonging through integration and training. At the end of the day, they are the ones that are closest to the people, and their work will, in the long run, bring Nigeria closer to protecting its children from killer childhood diseases.
Curled from Nigeria Health Watch