Damning immunisation report

Journal study examines treatment of children in O R Tambo, an NHI pilot site

THE first indication that the government’s National Health Insurance (NHI) project might be failing has surfaced, with a damning report claiming the Eastern Cape health department is failing to properly vaccinate babies.

The South African Medical Journal found the provincial health department was failing to provide adequate primary healthcare.

The journal said it had monitored the vaccinations of 470 children between April 2013 and May 2015 in the O R Tambo district.

The 470 children were born at Zithulele Hospital in Mqanduli and 10 clinics, and homes in the area.

The O R Tambo district is one of the pilot districts for the NHI project, aimed at providing essential healthcare to all citizens despite their socio-economic status.

The government has spent billions of rands on implementing the NHI.

When the project was launched in Mthatha, government officials hailed it, saying it was a solution to delivering improved healthcare services in the province.

However, the journal reported that it found that immunisation rates in the rural Eastern Cape were “well below government targets and indicate inadequate provision of basic primary care”.

“Stock-out [unavailability] of basic childhood immunisation [vaccines] are common and are, according to mothers, the main reason for their children’s immunisations not being up to date,” the report said.

Children under the age of two in the O R Tambo region are not being immunised in line with the rates dictated by the national health department, the report claimed.

However, provincial health spokesman Sizwe Kupelo dismissed the report.

“We would like to get a copy of the study. To assess the validity of the claim one has to evaluate the methods used, sample population and what data was collected.

“As the department, we use the district health barometer as credible sources of the immunisation coverage. We reject the claim that patients do not get vaccinated because there are no vaccines. The national department of health provided sufficient vaccines to cover over 85% of the estimated cohorts, which is the required level ....”

The journal said women who travelled to the hospital from outside the targeted areas for the study were excluded because of a lack of resources for regular follow-ups of women further afield.

“A total of 493 women fulfilled the inclusion criteria. There were nine sets of twins but the second twin was excluded from this analysis ... 470 mother-infant pairs were evaluated,” the report said.

“The age range of the women was from 14 to 52, and 77 of the women were under 18 years old.”

The journal’s study was conducted by researchers from universities around the world, including South African and US institutions.

The team aimed to examine the successful and timely delivery of immunisation to children during the first two years of life in a deeply rural part of the Eastern Cape.

The results came back saying 56% of women whose children did not have all their immunisations up to date blamed stock-outs for the problem. “In these cases, some participants went for immunisations and were given one, but not all, of the required immunisations for the relevant date, but were not informed that the immunisations were incomplete,” the report said.

“Others were simply unaware that they needed to go for further immunisations.” —