Child mortality: How Katsina traditional rulers help in uptake of routine immunisation

December 21, 2022 7 min read 

– News Agency of Nigeria (NAN)

Undoubtedly, children below five years in African countries like Nigeria are lagging behind in vaccine uptake during child immunization compared to their counterparts in the developed nations.

Unimmunized children risk high morbidity and mortality. Such children are more exposed to attack by vaccine preventable diseases like diphtheria, tetanus, pertussis, influenza and measles among others.

According to studies, immunisation helps children to grow up healthy, happy as well as enable them to walk, play and learn.

Experts identified many factors responsible for lower coverage of immunisation, some of which included misconception about the vaccines, distance, and security challenges, among others.

In order to boost wider coverage, government at all levels, and other relevant stakeholders, continue to collaborate to boost coverage for the betterment of children.

In Katsina state, the government has been up-and-doing to ensure that all eligible children received the required doses of the vaccines.

One of such initiative is the involvement of traditional rulers in the exercise to ensure wider coverage.

The State Immunisation Officer, Hajiya Sahura Muhammad, said that District and Ward Heads are being given feedback on regular basis to know performance of their Local Government Areas in terms of coverage.

“Where we need their support, we usually engage them to support our vaccination teams in their areas for wider coverage, and we have been making progress,” she said.

According to her, Katsina has 1,636 facilities, which is the state with the highest number of facilities offering immunisation services in the country.

Muhammad further said that the state has signed a Memorandum of Understanding (MoU) with Global Alliance for Vaccines and Immunization (GAVI) on conducting outreaches, dialogues, and data quality assessment on routine immunisation.

“We usually have technical committees that go to the LGAs and take necessary action,” she said.

Impact of involving traditional rulers in the system

The State Immunisation Officer said that the traditional rulers’ engagement has contributed immensely in boosting coverage, which resulted in improving the child healthcare services and consequently reduced infants’ mortality.

To buttress that, the UNICEF Chief of Kano Field Office, Mr Rahama Mohammed-Farah, said that Katsina has reduced under-five mortality by 29 per cent between 2011 and 2021.

He said that was shown in the Multiple Indicator Cluster Survey (MICS), 2021, launched on Dec. 5, 2022, in Katsina.

Though the state has made progress in that respect, he said there was still a need to do more to enhance child healthcare services in the state.

Immunisation town hall meeting

Furthermore, an investigation by the News Agency of Nigeria (NAN) on routine immunisation in Kankia local government area, indicated that Tafashiya community is among the wards with the highest immunisation coverage.

Alhaji Sani Yusuf, the Ward Head of Tafashiya, said that the efforts of the state government have contributed immensely in reducing high child morbidity and mortality.

He said that they met with Imams and village heads on regular basis to educate them on the importance of antenatal and child healthcare services.

“There is a great improvement unlike before, both child morbidity and mortality has reduced drastically compared to five years ago.

“Here, we recorded cases of these child killer diseases on daily basis, where parents spend a lot of money to treat their children, and sometimes, the illnesses lead to the children deaths.

“We now hardly record cases of child mortality in our entire community.

“Our people are now enlightened, husbands give their wives money to travel to Kankia for antenatal or child care services like routine immunization.

“Even today, there was a woman who asked me to find out for her in Kankia, about the antenatal service being conducted.

“We don’t have this before, but now everybody is aware of the importance of both antenatal and child healthcare services,” he said.

Yusuf revealed that in the first instance, husbands sponsor their wives to Kankia for antenatal care because several tests would be conducted on them.

He said that they would later come back to Tafashiya health centre for regular antenatal service, unless if there is need for going back to Kankia.

According to him, there is a meeting on a monthly basis to discuss issues relating to women and children healthcare.

The meeting, he said, involved health experts, traditional leaders and other stakeholders, including Traditional Birth Attendants (TBAs) and other stakeholders to discuss the way forward, and that has been yielding positive results.

Moreover, Malam Ibrahim Adamu, a resident of the community, said that he has a better understanding of the importance of child Immunisation.

He said that before now, they have been battling with child killer diseases and spending a lot on treatment.

Adamu said that since they embraced the exercise through the involvement of traditional rulers in the area, child morbidity and mortality have reduced drastically.

“Hardly now you hear case of child killer diseases outbreak or deaths as a result of such vaccine preventable diseases in our community,” he said.

Routine Immunisation in enhancing child healthcare

According to the World Health Organization (WHO), immunisation is the foundation of the primary healthcare system and an indisputable human right.

It said there are now vaccines to prevent more than 20 life-threatening diseases, helping people of all ages to live longer.

According to the WHO, in spite of the tremendous progress in the area, many people around the world – including nearly 20 million infants each year, have insufficient access to vaccines.

Experts say that insufficient access to vaccines is among factors responsible for high morbidity and mortality rate.

According to the available data from the UNICEF, infant mortality in Nigeria currently stands at 69 per 1,000 live births, while for under five, it rises to 128 per 1,000 live births.

More than half of the under five deaths, 64 per cent – result from malaria, pneumonia or diarrhoea.

According to the Multiple Indicator Cluster Survey, Katsina state also made a significant improvement in Penta 3 coverage of 41 per cent.

Also, the state immunization officer said that, the state was able to exceed the set target of 90 per cent coverage in the vaccines with the exception of three antigens.

“The only areas we are having problem are Hepatitis B, IPV 2 and Measles 2.

“We recorded less than 80 per cent coverage unlike the other vaccines where we recorded up to 100 per cent and above,” she said.

She explained that a child was supposed to start immunization immediately after delivery, or before reaching two weeks.

“If a child is brought two weeks after delivery, it means that child has missed some level of protection against vaccinated diseases, and as such, will be among unimmunized children,” she said.

Challenges encountered

The immunization officer said that IPV2 was introduced recently, but up to now, some mothers and caregivers are not bringing back their children to receive the second dose.

Also, measles second dose is given after a child reached 15 months, “the chance of bringing back their children to receive the second dose is low.

“That is why we have been telling our service providers to enlighten caregivers during Antenatal care to start immunization immediately after delivery,” she said.

Moreover, security challenges in some local governments are another major problem, because the vaccination teams cannot reach many communities in such LGAs, and they may have IDPs.

Muhammad further revealed that whenever people are displaced, there are tendencies of having a lot of vaccine preventable diseases outbreak such as cholera, gastroenteritis and whooping cough among them.

Again, sometimes there is a problem of supply of some antigens. This one is a nationwide problem.

“If caregivers come to our facilities and we tell them that we don’t have vaccines, go and come back after some times, they usually fail to come back,” she said.

Addressing the challenges

Muhammad said in terms of security challenge, they cannot do anything on their part.

However, she said, “I know there are efforts being put in place by the government and other stakeholders to address the situation.”

She also said that the Georgetown Global Health Nigeria was in Katsina to support the LGAs in terms of immunisation and other healthcare services for both women and children in the front line areas.

“We are even going to start outbreak response in the 11 LGAs. We list the settlements not being reached through our efforts.

“They will engage Red Cross International and local people who can deliver services to women and children in such communities. So, this is part of our mitigation plans,” she said.

Muhammad also said that they have what they called “hit-and-run strategy” in partially accessible communities in the state.

According to her, the vaccination teams deliver services in such areas and come back within a short period of time.

If such efforts are sustained, the state would have a wider coverage in routine immunization where its children would grow up healthy, happy and educated as well enable them contribute positively to the development of the society in the future. (NAN)

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