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Championing child immunisation

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By Vincent Khonje:

SAKA—Using a bicycle is a big challenge

Chathunthu Health Post in Sub-Traditional Authority Chitanthamapiri is about 23 kilometres (km) from Kasungu Town Centre.

It is one of the hard-to-reach places in the district because of poor conditions of roads that connect it with other areas.

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The situation becomes worse in the rainy season when rivers, Nthema and Chitete, which cut across the bad roads, make it almost impossible to travel, even by foot.

In cases where the health post (Chathunthu) cannot manage to take in a person who has fallen sick, the nearest health facility is Gogode Health Centre, about 17km away.

But this health facility is of use only in the dry season, during the rainy season, the route to it is further stretched to about 23km as people have to use longer and better roads which also have better bridges.

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Before September 2019, Chathunthu area had the challenge of mothers not taking their children for vaccines because of various reasons.

One of the women in the area, Belia Banda, explains that vaccinating children was a thing that most women neglected in the area.

She says there are several reasons that made women not to take their children for a vaccine jab at the hospital.

“Most parents were not aware of the importance of vaccines to their children. They did not know if a child is not immunised properly, they are prone to some diseases,” says Banda.

She adds that there were many infants falling sick such that cases of child mortality were high in the area.

The other common reason why mothers could not take their children for immunisation was their strongly-rooted belief in cultural and religious beliefs.

Some women believed that traditional remedies were the way to go and for others, their faith forbade them from accessing any kind of vaccines.

Chathunthu is mostly populated with people working in estates who are production-focused.

This is the reason why they felt that spending more time at a health facility when one was feeling well was a waste of time.

“Despite having the health post and some mothers visiting it, vaccines could come late from Gogode Health Centre where the health post gets them. The mothers would then prefer going back home without getting the service,” Banda explains.

Despite vaccines to children being important, it appeared to people of the area that it was not. Banda says lack awareness was the reason behind the negligence.

In September, 2019, change came to the area when 30 women came together to form a Mother Care Group with the aim of promoting child immunisation.

Selected from villages that benefit from Chathunthu Health Post in Kapanira, Chintcheto, Gebulo and Njanje, the women went full throttle to preach about immunisation and its benefits.

Malawi Health Equity Network (Mhen), which promotes equity and quality in health for all, and another local non-governmental organisation, Good Health Organisation (GHO), facilitated the formation of the group.

The Mother Care Group’s Chairperson, Elizabeth Gondwe says they intensified the campaign on immunisation in the area which resulted in a positive response.

“The problem was most mothers did not know the importance of immunisation to their children. They lacked information and did not know that if a child is not managed properly, they get sick and may eventually die,” Gondwe says.

After the formation of the Mother Care Group and undergoing trainings, the group went flat out to conduct awareness campaigns in the villages.

It was a tall order because they struggled to reach out to women who had strongly-held traditional beliefs.

“At first, it was difficult because of resistance by some women. However, we intensified the campaigns and then got an overwhelming response,” she says.

The Mother Care Group has a record of all the children from surrounding villages. It follows up on any women who skip a vaccine.

The area’s Health Surveillance Assistant (HSA), Chazaso Saka, hails the intervention by the women, saying it has brought tremendous change in the immunisation of children.

He recalls how reluctant some mothers were to have their children vaccinated at the health post in the past, due to lack of information on the importance of immunisation.

However, he says there are problems that have accompanied the overwhelming positive response to call efforts by the mother care group for child immunisation.

“Getting vaccines at Gogode Health Centre is a challenge considering the poor condition of the road to the health facility. Using a bicycle is a very big problem as I get back to Chathunthu late, that is why some mothers just decide to go back home, thus skipping a particular month’s vaccine for their children,” says Saka.

He adds that there is an area called Kabamira under the health post’s catchment area, about 8.5km away which has to be served by Chathunthu Health Post.

The problem is that the health post does not keep its own vaccines, so the mothers there wait a bit longer to be served.

“If only we had a solar-powered fridge, we could have made things simple. We could have been keeping our own vaccines to serve the people around the health post,” says Saka.

With the Mother Care Group following up on cases of vaccination, if a child is found to have skipped a vaccine, it is difficult to administer it because the vaccines are not readily available at the health post.

Never t h e l e s s , immunisation in Kasungu has seen a roller-coaster progress with just a few areas not doing well.

The areas with high coverage are those that have structures like mother care groups which collaborate with traditional leaders and communities. Those without mother care groups have very low coverage.

The district health office’s Expanded Programme on Immunisation Coordinator, Joseph Chitsime, says with areas like Chathunthu, things are progressing well, though not without some problems.

Chitsime acknowledges the challenges despite women going flat out to woo others to have their children immunised.

“There are areas that are hard-to-reach, so the district provides vehicles to deliver vaccines. But it is not always that vehicles are available as sometimes they are busy with other equally important tasks.

“That is when HSAs have to go and get the vaccines themselves and it is usually on a bicycle which takes time due to bad conditions of roads,” Chitsime says.

He concurs with Saka that the need for solar-powered refrigerators would be an ideal solution while calling for traditional leaders, development structures, Ward Councillors and Members of Parliament to also come in and rescue the situation.

Through a Health System Strengthening Project in Kasungu, Mhen established Mother Care Groups in areas around eight health centres.

Apart from Gogode, which covers Chathunthu, other health centres include Kapelura, Chilowamatambe, Kaluluma, Mkhota, Kawamba, Nthunduwala and Kawamba.

Mhen is working with the district health office and Good Health Organisation in establishing Mother Care Groups around these health centres.

Despite some setbacks, Mhen is satisfied with the impact the Mother Care Groups.

The organisation’s Assistant Project Officer, Hanna Dzongo, says the initiative aims at ensuring that every child is immunised.

“We chose areas with low coverage of immunisation in the district where we established Mother Care Groups to bring awareness to mothers on the benefits of immunisation.

“Things are going on well with the intervention as there is higher coverage of vaccines in the said areas than before. Mothers are taking their children to get vaccines and those who relent are followed up,” says Dzongo.

For Chathunthu Health Post, which serves 2,004 people, about 270 children have been immunised since the Mother Care Group was formed, which has put them out of the danger of diseases.

When mothers attend under-five clinics, their children undergo Vitamin A supplementation, immunisation and de-worming.

Some of the vaccines the children get are Bacillus Chalmette-Guerin, against tuberculosis, Oral Polio Vaccine, against polio and Measles vaccine.

Others are Pentavalent, against diphtheria, tetanus, pertusis and Hepatitis B, Pneumococcal Conjugate vaccine, against bacterial pneumonia and Rotavirus, against severe diarrhoea.

With the mother care groups doing their best to woo women to have children immunised against diseases in hard-to-reach areas like Chathunthu, it is hoped that many children will be saved.

What remains is to address the few bottlenecks that affect the life-saving services.

According to Unicef, approximately 13 million children do not receive any vaccines globally, which puts them and their communities at risk of diseases and deaths.

In Kasungu and the country at large, Mother Care Groups can be the hope for child survival.—Mana

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