Until two years ago, Tamara Mwale from Senga Village in Traditional Authority Khosol o in Mzimba District did not value the importance of having her two under-five children vaccinated, let alone herself as a mother to prevent opportunistic infections.
She says: “I was not a believer in vaccination. I believed that it was not necessary for me and my children because of my ignorance. Now I understand that when a child receives all types of immunisation, he or she grows up healthy and protected from opportunistic infections.”
Mwale says before she started getting vaccines for her children and herself in 2019, they were falling sick regularly. This affected their development at household level because they spent most of their time at the hospital, instead of doing some productive work.
Thanks to the immunisation awareness interventions conducted in her area, Mwale says she is now a champion and a community immunisation ambassador under the Khosolo Health Centre Mother Care Group which she joined two years ago.
Khosolo Health Centre Mother Care Group chairperson Bertha Saka says the group has so far built seven houses for health surveillance assistants (HSAs) using resources generated from their communities.
She says the initiative ensures that HSAs live within the communities they work in unlike in the past when the health workers lived away from the communities they served.
According to Saka, the previous arrangement posed challenges when the HSAs had to serve the under-five clinics where the vaccines are administered.
Mother Care Group members are community volunteers who support service delivery, advocate and mobilise resources for health. Each Mother Care Group comprises 30 members and a group village head.
Their roles include defaulter tracing, conducting sensitization meetings, conducting advocacy meetings and registering newborn babies and pregnant mothers.
The interventions by the Mother Care Groups area culmination of a Health Systems Strengthening project being implemented by the Malawi Health Equity Network (Mhen) with financial support from Gavi, a global vaccine alliance, through the Ministry of Health.
The overall goal of the project is to contribute towards the achievement of the Sustainable Development Goals by 2030 which entails ending preventable deaths of newborns and children under-five years of age.
This is also in line with Malawi Growth and Development Strategy (MGDS III) key priority area number five entailing participatory health governance to ensure barriers to equitable and quality immunisation are reduced.
It is envisaged that the immunisation barriers will be reduced by enabling women, children and communities to access quality immunisation services and health care and improved quality and uptake of immunisation services.
The project seeks to strengthen the capacity o f the integrated health systems to deliver immunisation by resolving health constraints, increasing the level of equity in access to services and strengthening civil society engagement in the health sector.
Khosolo Health Centre assistant environmental health officer Sceva Chibwe , says the coming in of Mother Care Groups has led to the improvement in immunisation coverage as evidenced by 90 percent increase from about 50 percent coverage in 2019.
To vwirane Organisation project officer Fumbani Gunkha, whose institutions is a Mhen network member, said they trained the Mother Care Group women member s in Mzimba South to champion the community-led campaigns, to woo women and their children to get inoculated which cumulatively increased the uptake.
He notes that the training emphasised on the involvement of men in the immunisation process because in the past, husbands were barring their wives and children from getting immunised.
Maria Nguluwe , chairperson of Kalitubi Mother Care Groups in the area of Inkosi M’mbelwa in the same district, bemoaned long distances that women walk to access under-five clinics which has been affecting immunisation uptake.
However, she says initiatives to establish under-five community health posts has helped to bridge the gap, although infrastructure remains a challenge.
She said: “We pay as high as K15 000 to and from the Kalitubi and Kalikumbi health centres when we hire a motorcycle to transport emergency cases and not all of the people around here can afford such an amount in the village.”
Kalitubi Health Centre HSA Mayamiko Chisale admitted that in the past there was a community misconception about immunisation due to ignorance and cultural beliefs which denounced immunization but promoted use of traditional medicine.
“We need a health post to be constructed because currently we do conduct under-five clinic under a tree and when it rains or when it is sunny, it affects service delivery as only a few would brave the rains and the scorching sun to access the services,” she said.
Mzimba District coldchain technician Capson Mwale said vaccination coverage has improved a lot since the Mhen started implementing the Mother Care Group interventions in the district.
He confessed that before Mhen started implementing the Mother Care Group interventions, they were experiencing l ow immunization coverage as a district at below 60 percent but the interventions have pushed uptake to over 80 percent.
He said this means a lot for the district because for herd immunity to be achieved, and for the children to be protected fully, they needed to reach 80 percent and above of immunisation coverage. “If the percentages are too low, and a disease outbreak occurs, it affects the majority of the children, we wish Mhen inter vent ions would reach all facilities,” he says.