Vanguard News Nigeria

Immunisation: Putting an end to vaccine-preventable deaths

By Josephine Agbonkhese & Anino Aganbi

NEWBORNS inherit specific antibodies from their mothers, which help them fend off a galaxy of diseases. Experts however say that from six months of age, these antibodies start to diminish and by the time a child is one-year-old, would have completely disappeared.

In the ideal situation, babies should start to make their own antibodies, as they increasingly become susceptible to diseases such as poliomyelitis, measles, diphtheria, serotype b infection, hepatitis, meningitis, mumps, pertussis, rebella, tetanus, tuberculosis, yellow fever, ad nauseam.

Hence the need to immunize them with vaccines that would strengthen this immunity, especially as immunisation has been identified as the most effective intervention for protecting babies from infectious diseases, after access to clean water and breastfeeding.

Unfortunately, approxi-mately 30% of children who are signed up for routine immunization from birth, in Nigeria, never complete the schedule. Not to mention the millions of children born out of hospital, who never get signed up.

Needless deaths

This hasn’t been without consequences, ranging from life-changing diseases and impairments, to even death.
Albeit progress is being made with increased awareness and more children maintaining their schedules, the gap already created still remains outrageously wide and as such, Nigeria still remains the second largest contributor to under–five mortality rate in the world.

According to the United Nations Children Fund, UNICEF, the country loses about 2,300 under-five year olds every single day with 22 per cent of these deaths caused by vaccine-preventable diseases.

Why mothers shun, skip immunization

It is not exactly clear why some mothers do not adhere religiously to their child’s immunization schedule even though these vaccines are said to be administered free-of-charge, thanks to international and local NGOs and the Nigerian government itself. However, factors such as ignorance, religious belief, and poor access to health facilities (in the case of rural dwellers) seem to play a major counter-productive role against aggressive immunisation campaigns done over the years.

“I once had a friend who was advised by her mother not to immunize her children because she believed government was using it to check child-bearing”, a middle-aged woman who spoke on anonymity told Lipstick.

But in the case of urban dwellers, ‘negligence’ caused mostly by ‘forgetfulness’, takes the upper hand, as a literate fabric merchant confessed.

“Most times, I forget the date of immunisation. When my child was three-month-old for example, I entirely did not remember she was due for immunisation, and the date passed. I eventually took her for that vaccine the following month.

“I’ve however learned to keep her immunisation card within reach, so I don’t forget.”

50% of mothers interviewed also revealed to Lipstick that they had missed at least two immunisation schedules.

An intervention by current President Muhammadu Buhari is however working to ensure 100% compliance by deploying a software, Wemunize. Wemunize is an automated immunisation scheduling and notification platform which reminds and persuades mothers (and their relatives) to keep to their child’s immunisation schedule using sms and robocalls. Its level of reach and reliability however remain to be ascertained, especially as access to mobile phone, and even telecommunication network, remain big dreams for most rural dwellers, and also some urban dwellers.

Undue charges: Contrary to the Federal Government’s intention however, another mother resident in Lagos who simply identified herself as Mrs Okafor, revealed that one reason some mothers do not adhere strictly to immunisation schedules is financial constraints.

“In public health facilities, it is not totally free as claimed. I use Igando General Hospital and there, mothers are mandated to pay a N100 for hand gloves and an extra fee ranging from N100 upward for the cost of transporting the vaccines to the hospital. They claim government does not make provisions for that,” Mrs Okafor said.

Nurses’ nonchalance
The attitude of nurses is also said to be a deterrent.

A nurse and mother told Lipstick: “When you go to government hospitals and see how their nurses’ handle these things with levity, you would not be encouraged to go back for the other appointments.

Poor vaccine storage
As a trained nurse and also a nursing mother, I could not take my baby to the hospital where I work because of distance, so, I went to a nearby government hospital.

“There, I discovered that the vaccines, which should have been refrigerated, were stored in coolers without ice, which is even risky on children being immunized.

“The carelessness on the part of nurses discourages you from taking your baby for these vaccines. You would even discover that vaccines that should be given to babies between the ages of six months and above are not administered because they are not made available by God knows who.”

While there is need for further investigation into the storage of vaccines once they arrive health centres, the disposition of health personnel, however, does not negate the importance of strict adherence to routine immunisation. In fact, progress achieved with poliomyelitis stands as an excellent example of the enormous benefits of immunisation. Nigeria which was one of the only three polio endemic countries worldwide, last year, celebrated one year without a new case of the Wild Polio Virus, WPV. That’s not all. The country stands to receive the World Health Organisation, WHO, polio-free certification in a couple of months if this progress is maintained.

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