Breath­ing new life for im­mu­niza­tion pro­gramme

Daily Trust - - BUSINESS - By Toyin Saraki

Nigeria is one of the fastest grow­ing na­tions in the world. With a cur­rent pop­u­la­tion of over 190 mil­lion peo­ple, the pop­u­la­tion is es­ti­mated to reach 263 mil­lion by 2030, over­tak­ing coun­tries like the United States of Amer­ica. Yearly, 6 mil­lion chil­dren are born in Nigeria. Un­for­tu­nately, 1 in 15 of th­ese chil­dren will die be­fore their first birthday and only 1 in 8 will sur­vive to see their fifth birthday due to dis­eases that can be eas­ily pre­vented by a shot of vac­cine.

Im­mu­niza­tion, a process whereby you are in­jected with a vac­cine, to de­velop im­mu­nity against a dis­ease is one of the safest and most cost-ef­fec­tive pub­lic health in­ter­ven­tions till date; sav­ing mil­lions of chil­dren every­where from life-threat­en­ing child­hood ill­nesses. Ac­cord­ing to the World Health Or­ga­ni­za­tion (WHO), 2 to 3 mil­lion deaths are averted yearly around the world as a re­sult of im­mu­niza­tion. Beyond its im­pact on health, im­mu­niza­tion also averts med­i­cal costs and time spent by par­ents to care for sick chil­dren, al­low­ing them more time to be pro­duc­tive and con­trib­ute to na­tional eco­nomic growth. For every US $1 in­vest­ment on vac­ci­na­tion, US $16 is yielded in re­turn.

Un­for­tu­nately, im­mu­niza­tion cov­er­age re­mains very low in Nigeria. NDHS 2013 re­ported only 21% of 12 - 23 mon­thold chil­dren re­ceived all the re­quired vac­cines be­fore their first birthday. In ad­di­tion, the re­port from the Min­is­te­rial Con­fer­ence on Im­mu­niza­tion in Africa (MCIA) held in 2016 in Ad­dis Ababa ranks Nigeria among the low­est, with only 66% cov­er­age on im­mu­niza­tion with the diph­the­ria-per­tus­sis­te­tanus vac­cine (DPT3) - a strong indi­ca­tor for im­mu­niza­tion strength in a coun­try. Coun­tries like Gam­bia (96), Ghana (98) and Rwanda (99) were among the high­est on im­mu­niza­tion cov­er­age. The poor cov­er­age of im­mu­niza­tion in Nigeria stems from so many rea­sons, in­clud­ing weak pri­mary health­care sys­tem, in­ad­e­quate fund­ing, and min­i­mal or no lo­cal pro­duc­tion of vac­cines. How­ever, to im­prove cov­er­age to every el­i­gi­ble child and max­imise the health and eco­nomic im­pact of im­mu­niza­tion in Nigeria, the gov­ern­ment needs to in­crease its spend­ing on vac­cines and im­mu­niza­tion pro­grammes.

Like many coun­tries in Africa, Nigeria has en­joyed tremen­dous fi­nan­cial sup­port from Gavi both in the ar­eas of vac­cine sup­port and non-vac­cine sup­port such as health sys­tem strength­en­ing, ac­cru­ing to over US $690 mil­lion since 2001. But the time has come for us to in­crease own­er­ship and re-strate­gize on how to self-fi­nance and sus­tain im­mu­niza­tion in Nigeria, as the coun­try has en­tered its 5-year tran­si­tion phase out of Gavi sup­port be­gin­ning 2017. As of June 2017, Nigeria will need to spend US $1.644 bil­lion between 2017 and 2020 to meet her im­mu­niza­tion tar­gets. In ad­di­tion, a fund­ing gap of about US $855 mil­lion needs to be re­al­ized for the same pe­riod.

As pledged by the Health Min­is­ters at the MCIA in 2016, it is time for Nigeria to in­crease and sus­tain its do­mes­tic in­vest­ments and pro­duc­tion of vac­cines, in­crease fund­ing al­lo­ca­tions and adopt in­no­va­tive fi­nanc­ing mech­a­nisms to fill the gaps in vac­cine pro­cure­ment and op­er­a­tional im­ple­men­ta­tion of im­mu­niza­tion ac­tiv­i­ties. The time has come for the gov­ern­ment, non-gov­ern­men­tal or­ga­ni­za­tions, civil so­ci­ety, com­mu­ni­ties and in­di­vid­u­als to come to­gether and map a course to fi­nance im­mu­niza­tion and in­crease its cov­er­age.

As an in­te­gral part of the health sys­tem, strength­en­ing all the build­ing blocks of the pri­mary health care sys­tem and in par­tic­u­lar, the hu­man re­source for health which is at the core of the build­ing blocks - is es­sen­tial to im­prov­ing cov­er­age and up­take of rou­tine im­mu­niza­tion. Tra­di­tion­ally, mid­wives and nurses play the piv­otal role in ad­vis­ing par­ents about im­mu­niza­tion es­pe­cially dur­ing the an­te­na­tal pe­riod, when mothers and fam­i­lies are ed­u­cated on the im­por­tance of ma­ter­nal im­mu­niza­tion against tetanus and child­hood im­mu­niza­tion un­til the child is 5 years. Sup­port­ing them and max­i­miz­ing their skills in ed­u­cat­ing fam­i­lies and de­liv­er­ing rou­tine im­mu­niza­tion is es­sen­tial to ef­fec­tive de­liv­ery and cov­er­age of rou­tine im­mu­niza­tion. The Well­be­ing Foun­da­tion Africa, Ma­macare An­te­na­tal and Post­na­tal Cur­ricu­lum is cur­rently tak­ing the lead in en­sur­ing mothers and fam­i­lies at­tend an­te­na­tal care, are well equipped with in­for­ma­tion on the need for rou­tine im­mu­niza­tion in chil­dren, and are fur­ther fol­lowed up in the post­na­tal pe­riod to en­sure ba­bies are vac­ci­nated timely.

Fi­nally, mon­i­tor­ing data at both the lo­cal and na­tional level is crit­i­cal to help­ing coun­tries pri­or­i­tize and tai­lor vac­ci­na­tion strate­gies and op­er­a­tional plans to ad­dress im­mu­niza­tion gaps. The client-held Per­sonal Health Record (PHR) in­tro­duced by the Well­be­ing Foun­da­tion Africa, is a vi­tal tool held by mothers and fam­i­lies to em­power them with in­for­ma­tion they ought to know about their child’s care in­clud­ing track­ing and record­ing of the child’s im­mu­niza­tion his­tory. Beyond this, it also serves as a data col­lec­tion tool that can be used dur­ing sur­veys.

Mrs. Saraki is the Founder of the Well­be­ing Foun­da­tion and Chair of the Pri­mary Health­care Re­vi­tal­iza­tion Sup­port Group.

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