Remmy Nweke in this report examines the merits of taking immunization in Nigeria very seriously by all strata of the society, including the grassroots community-based organisations to cover the hard-to-reach areas.
Preamble
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| A child receiving immunization |
A spot at Maryland junction in Lagos is where
Aisha Usman, a 28-year-old specially challenged lady graduate of microbiology, always
stations herself with the help of a brother, Adamu. Aisha’s predicament was
traced to the inability of her parents to heed to the calls for Nigerians to
take immunization seriously.
Both Aisha and Adamu managed to transport
themselves from northern Nigeria to Lagos in the west to beg for alms, an
occupation they have engaged for over a year and in fact, it afforded them the
luxury of now using a wheelchair to move Aisha around.
After a chat with them on if their parents
had immunized Aisha particularly, her situation should not have been the same
today. Like every other girl of her age, Aisha should have gained employment which
has eluded her due to her disability.
In all honesty, Aisha confessed that she will
get immunized, if she has powers to tune the hands of time and even become an
advocate for immunization, especially for children whose parents take decision
for them at tender age.
Aisha’s predicament represents several
Nigerian children who may have missed out on basic vaccines, due to religious
believes or absolute misinformation on the importance of immunization. As at press
time, the World Health Organisation (WHO)
says that Immunization currently averts an estimated 2 to 3 million deaths
every year. But an estimated 22 million infants worldwide are still missing out
on basic vaccines.
Immunization time table:
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| A nurse doing what she knows best ... courtesy Leadership |
NaijaAgroNet gathered that based on WHO’s outline, at birth, antigens vaccines must be given,
particularly the BCG, OPV0, HepB0, and six weeks for OPV1,
Pentavalent 1, PCV 1; 10 weeks later is for OPV2, Pentavalent 2, PCV 2, then
followed by OPV3, Pentavalent 3, PCV 3, which must be taken at 14 weeks, and 9
months for measles and Yellow Fever to be well
monitored, even as Pentavalent vaccine comes in two forms Liquid and Liquid +
Lyophilized. Liquid + Lyophilized will be used in Nigeria.
Immunization, a protection process:
An
official of the National Primary Health Care Development
Agency (NPHCDA), Dr. I.E
Ukpong informed
NaijaAgroNet, while addressing
participants at the Association Of General Private Nursing Practitioners
(AGPNP) annual scientific conference at Lagos Airport Hotel, recently, that immunization
is a process
whereby an individual is made immune or
protected from a particular infectious or disease agent, which could be passive or active.
Stressing that passive
immunity is of relatively short duration induced by administration of antibody-containing
preparation like antiserum or by transfer of maternal antibodies.
The medical practitioner noted that active
immunity is usually of a longer duration and could be acquired through
introduction of antigenic material into an individual body leading to
development of specific protective antibodies or cellular immunity.
Thus, Ukpong said immunization is a
cost-effective intervention which prevents suffering, disability and death,
with its benefits universal in nature, comprising improvements in health, life
expectancy and positive social and economic impact at the global, national and
community levels.
Dwelling on Immunization in Nigeria:
Challenges and Way Forward, Dr. Ukpong listed some global achievements through
immunization to include eradication of smallpox, reduction in global incidence
of polio by over 99 per cent, reduction in illness, disability and death from
diphtheria, tetanus, pertusis and measles.
Nigeria and
Under-five infant mortality:
In Nigeria, Dr. Ukpong noted that from 2000
and 2008 the national coverage for all antigens was between 10 per cent and 50
per cent. Consequently, the Under-Five (U5) mortality rate and the Infant mortality rate (IMR) for year 2003 were 201 per
1,000 and 100 per 1,000 respectively. While in 2008, U5MR number was at 157 per
1000 and IMR counted for 75 per 1000.
Experts have defined the IMR
as the number of deaths of children less than one year of age per 1,000 live
births, just as Under-five mortality rate (U5MR)
is the probability of dying between birth and before their fifth birthdays.
Further, Dr. Ukpong
outlined some challenges facing the Primary Health Care (PHC) in Nigeria,
namely weak
health and PHC system in most parts of the country, poor funding of the PHC
system, low political will and commitment, poor cold chain system, shortage of
vaccines and high turnover of health workers at the local administrations.
Additionally, the medical expert pointed out
that weak and passive surveillance systems, false contra-indications – Fear of
side-effects in patience, missed opportunities, whereas the under-served and
hard-to-reach communities were part of the reasons immunization has not been
successful as anticipated.
However, Dr. Ukpong proffered some solutions
to include that inter-sectoral collaboration in PHC with involvement of the
private health sector, should increase, while sustaining advocacy to political
leadership for support.
Community
mobilization imperative:
Community mobilization and sensitization
through workshops, social clubs, markets, schools and health facilities, he
said, should be sustained, even as increased funding for the PHC system, cold
chain system strengthened, provision of transport logistics, solar
refrigerators, whilst improvement of health care services through daily
vaccinations of eligible women and children as at when due, plus disease
surveillance would ensure that data obtained thereof would be used to improve
service delivery.
Advocacy, Ukpong suggested should be taken to
political, traditional and religious leaders for ownership and endorsement.
Political
will:
This option may have motivated the likes of
Bill Gates Foundation to institute a grant initiative for the Nigeria Governors
Forum (NGF), for any state that scales through its threshold on immunization to
win some grants among others.
Tagged Governors’ Immunization Leadership
Challenge, the initiative challenges governors under the aegis of NGF to
deliver an improve polio and routine immunization for the populace and any
governor whose state passes a pre-defined threshold to
improve routine immunization coverage and end polio will be awarded a $500,000
grant from the Bill & Melinda Gates Foundation to support their top health
priorities.
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| Gov. Mimiko and wife, attending to a baby recently |
According
to Bill Gates, leaders are critical to making Nigeria polio free and their
renewed commitments will make an important difference. Stressing, “As
Nigeria’s partner, the Gates Foundation is committed to doing what we can
support their efforts to end this terrible, but preventable, disease.”
Gates challenges Nigerian governors:
Also,
NaijaAgroNet gathered that the
award would support winning governors’ priority initiatives in public health,
such as malaria and tuberculosis, improving immunization, HIV prevention and
treatment, or safe drinking water and hygiene promotion.
The
grant, would also enable those governors who achieved the goals to receive
special recognition from Mr. Gates for their contribution to the elimination of
polio. Winning governors will be highlighted in foundation communications, such
as Mr. Gates’ annual letter or the foundation’s annual report, social media
materials and Mr. Gates’ public engagements globally.
“As
governors push hard over the next year … to end polio, I want to ensure their
efforts are acknowledged and that the governors are simultaneously supported to
tackle other key health problems they face in their states,” said Mr. Gates.
For
the Governor of Rivers State and Chairman of the Nigeria Governors’ Forum,
Chibuike Rotimi Amaechi, they want to stop polio and improve routine
immunization to protect Nigeria’s children against preventable diseases.
His Imo State colleague, Mr. Rochas
Okorocha, declared that the issue of polio is embrassing to Nigeria and needs
urgent steps to curb.
Eradicating
polio by 2016:
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| Visible effect of polio in Nigeria |
Chief Executive Officer, NPHCDA, Dr.
Ado Muhammad recently maintained that the agency would set priorities in the
areas of polio eradication and strengthen routine immunization, activate save-
one-million-lives initiative, integrate and ensure a programming of HIV/AIDS
intervention, as well as health accountability measures and efficient
communication approach to name a few, promising that 2016 is targeted year for
eradication of most of these ailments.
Dr. Muhammad said his agency recently
achieved successful innovations such as capacity building and deployment of
over 7,500 health care workers to 1,500 health facilities through the National
Midwifery Scheme and Maternal and Child Health project of the Subsidy
Re-investment Programme (SURE-P) in that order.
Conclusion:
The United Nations Children Education Fund (UNICEF)
recent reports that the unprotected children under one year of age who did not
receive Diphtheria-tetanus-pertussis (DTP3) immunization vaccine worldwide,
amounts to 22.4 million in 2011 compared to 21.1 million in 2010. Whereas over
70 per cent of these children live in 10 countries, namely Afghanistan, Chad,
Democratic Republic of the Congo, Ethiopia, India, Indonesia, Nigeria, Pakistan,
Philippines and South Africa; calls for an urgent action by African Union (AU)
whose members made up five out of the 10 countries mostly affected.
Equally important in ensuring that Nigerian society,
mostly the children enjoy an improved public health, especially routine
immunization, media participation and consistency in enlightenment cannot be
over emphasized. Hence, it was most demeaning when some elements who claim to
be media practitioners at a radio station up northern Nigeria, was using a
public medium to pass negative information concerning the efficacy of
immunization and future of country like Nigeria.
Thank God, the National Broadcasting Commission
(NBC) promptly banned the programme and ensured that it is off-air, at least,
as deterrent to future occurrence and goes far in reiterating government’s
determination to attain a polio-free state.
Although WHO cautioned that annually, about
400,000 Haemophilus influenzae type b (Hib)
associated diseases occur in under five years bracket in Nigeria. Noteworthy,
is that Hib vaccines protect against Haemophilus
influenzae type b, but do not prevent diseases caused by other types of Haemophilus influenzae, such as bronchitis,
otitis, and sinusitis. They do not prevent meningitis and pneumonia
caused by other agents.
The
National Primary Health Care Development Agency (NPHCDA), therefore, must ensure that immunization are administered
according to WHO schedule which states that at birth antigens vaccines must be
given, particularly on what to take and when, are well
monitored in Nigeria.
Parents, especially
fathers’ inclusion will make the subject a family affair, so that in a case
where a mother forgets, the father can remind her.
Taking enlightenment
to village squares, market places, schools, age-group associations and village
heads, while not leaving out the collaboration of grassroots community-based organizations
to reach the under-served
and hard-to-reach communities should be
involved as Public-Private Partnership (PPP).
Other states in
Nigeria, should as a matter of urgency, emulate the kind gesture of the Ondo
State governor, Olusegun Mimiko, who provided pregnant
women with free 100,000 mobile phones, to assist them in reaching out to health
personnel and act as calendar reminder for immunization, in addition to
offering tips on family health in general, despite studies which canvassed
against its use by pregnant women.
It is imperative to
state that though Information and Communication Technology (ICT) tools like
mobile devices should be used with caution, its advantages for a better health
care cannot be ruled out entirely, because a healthy nation is a wealthy nation.
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