In Chad, anatomy of a vaccination campaign
By Laure Poinsot
WEST MONGO, Chad, 10 Jan 2013 - Four of Toma Mamout’s seven children died young, one from polio. Her loss became Ms. Mamout’s calling – working to encourage mothers in Chad to vaccinate their children.
Ms. Mamout is a community outreach volunteer for the Expanded Immunization Programme in Chad.
Low immunization rate
“Vaccination is an effective, low-cost public health intervention that significantly reduces infant mortality,” says head of the UNICEF Polio Section in N’Djamena Gianluca Flamigni. Nevertheless, in Chad, the percentage of children immunized during their first year of life, excluding for hepatitis, is estimated at five per cent.
According to Mr. Flamigni, this worryingly low vaccination rate “results from the country’s deep poverty, but also the long years of political instability which left behind a weak health system.”
Volunteering close to home
With support from UNICEF, Chad’s Expanded Immunization Programme is seeking to reach more and more children.
Volunteer workers like Ms. Mamout are critical in the campaign.
Ms. Mamout has worked both in a hospital and at the West Mongo health centre. At the health centre, she runs the day-to-day work of the programme – from vaccinating children to holding education sessions with mothers.
In nearby villages, she talks on vaccinations, basic hygiene and the use of mosquito nets to prevent malaria. “We advise mothers to bring their children to every vaccination drive and to stick to the calendar,” she says.
A push further afield
In remoter areas, there are formidable challenges to expanding the campaign. In particular, it is difficult to secure reliable cold storage to keep vaccines at the correct temperature so that they arrive in good condition, says Head of UNICEF Sub-office in Mongo Claude Ngabu.
Another challenge is community resistance. According to Ms. Mamout, on her rounds to the more distant villages, the semi-nomadic local communities “refused until recently to allow their children to be vaccinated, out of ignorance and fear.”
Her work there is part of a broad communication for development (C4D) strategy spearheaded by UNICEF. UNICEF C4D employs a mix of social mobilization, advocacy and behaviour and social change activities to involve local authorities and people to make simple changes in their daily lives.
Ms. Mamout also meets regularly with authorities and health organizations that cooperate in setting up polio campaigns and routine vaccination drives. “Mobilizing communities themselves is the best chance for making improvements, because Chad’s health system is still too weak,” she explains. “For low-cost training and awareness efforts, UNICEF supports an effective and engaged outreach network – community outreach volunteers, vaccinators and supervisors – in which everyone is truly a champion of vaccinations.”
The communication and education efforts are already paying off, says Mr. Ngabu.
Hitting the airwaves, reaching community leaders
Radio is also essential to these efforts, reaching far more people than any other media in Chad. Broadcasts and advertisements “get people ready for the vaccination campaigns. Families quickly understand the need to vaccinate their children,” says Editor in Chief of the community radio station in Mongo Djimet Khamis Zaouri.
According to Mr. Zaouri, who is also a teacher and youth activist, “But the government needs to work harder to put more people on the ground to raise public awareness.” One of the best ways to do that, he says, is for authorities to “educate district and village leaders, who will then mobilize neighbourhood leaders, who will tell all their families. That makes it easier for vaccinators to do their job and costs almost nothing.”
Women’s groups also provide crucial support, which is tapped through the Information and Liaison Unit of Chad Women’s Associations (CELIAF), an umbrella body with 74 groups across the country.
Its leader in Mongo, Maïmouna Moussa, regularly brings together women leaders to discuss and promote awareness messages. “This is an effective network that acts on prevention and multiplies its effects,” she says. “If vaccination allows us to prevent children from getting sick, we can save entire communities. By changing our behavior, we can change our living conditions and really change things.”
“Polio is everyone’s business, from government down to families,” said Raabi Diouf, Deputy Director of Communication and Vaccinations in Mongo.
Making major strides
The polio campaign has already made major strides, working with such partners as the World Health Organization, the United States Centers for Disease Control and Prevention, Rotary International and the Bill and Melinda Gates Foundation.
“In 2011, Chad had 132 cases of wild polio,” says Mr. Flamigni. “This year the number is five, thanks to all the vaccination campaigns undertaken. These results give hope that the vaccination coverage will sustainably increase in the years to come.”
According to Mr. Flamigni, the programme is using a polio vaccine drive as a springboard with an eye to covering other diseases such as measles, meningitis and cholera – all major public health concerns in Chad.