Tackling local health problems through Community Dialogues

By Kudzai Makoni

Members of the Apostolic sect in Ward 23, Majada Village in Gutu District are still resistant to having their children immunised and will do anything in their power to avoid it. “It is the norm that when we hear that the Village Health Workers are moving around educating us about seeking health services and other issues, we hide in the mountains for days, says Madzibaba John, a leader of the sect. “When one of our own children get sick, we pray for them and we use our holy water on them and eventually they become well again,” he added.

This information was revealed during a community dialogue session held in Gutu District in Masvingo Province by the Ministry of Health and Child Care in partnership with UNICEF and funding from the GAVI Alliance. The aim of these dialogues is to increase the number of children getting immunisation under the Expanded Programme on Immunisation.

Among the wards visited was Majada Ward 23 under Chief Chiwara, Mahira Ward 10 under Chief Serima and Matizha Ward 5 under Chief Chitsa. From the dialogues, it was noted that the key drivers of vaccine hesitancy and refusal, include socio-cultural and religious, political, and institutional factors. These influence use and non-use of vaccination services.

A lot of problems were brought up and the most recurrent ones were church policies denying the children to visit hospitals, shortage of nurses, ignorance on the benefits of EPI, few outreach points and lack of enough facilities, for example, transport to transfer nurses from certain outreach points to the others.

“Some districts in terms of EPI are on a decline as compared to the previous years. The Ministry of Health and Child Care seeks to address the decline and saw it feasible to involve the beneficiaries to identify gaps in which could be leading to the fall, hence, we have started conducting community dialogues,” said Kenneth Nhemachena, Provincial Health Promotion Officer.

He added that: “We are trying to come up with solutions to improve the programme process.”

One of the village health workers, Otilia Mugwami, from Matizha Ward 5 noted that there was this reduction because of mere ignorance. She said, “A lot of mothers ask me questions like long ago there was no immunisation or hospitals, we used to use herbs and our children survived, what is the difference with nowadays?”

She added that some young mothers note that their mother in-laws say that if since a child gets two injections for the previous immunisation period, that would cover for the next immunisation period. Some young mothers as well because of long distances they walk to health facilities, they cannot make it every immunisation period.

“I walk for over 10km to this place, I cannot be coming here every month,” purported Mary a mother to a 2 year child at Matizha village who was waiting to get help from the nurses.

Chief Chiwara from Majada village promised to take serious measures against people who do not take their children for immunisations in time. “I will do anything within my powers to make sure that children in my ward are all immunised. Even if it means using force or the police, I promise to do that,” he said. He then promised to help nurses at Majada clinic by employing manpower within the community to help build the nurses households.

The right to health is closely linked to other fundamental human rights, most notably access to potable water and adequate hygiene. All children have the right to timely access to appropriate health services. This requires the establishment of a system to protect health, including access to essential medicine.

Because of advances in medical science, your child can be protected against more diseases than ever before. Some diseases that once injured or killed thousands of children, have been eliminated completely and others are close to extinction– primarily due to safe and effective vaccines.

The Expanded Programme on Immunisation remains committed to its goal of universal access to all relevant vaccines for all at risk. The programme aims to expand the targeted groups to include older children, adolescents and adults and work in synergy with other public health programmes in order to control disease and achieve better health for all populations, particularly the underserved populations.

Immunisation is a proven tool for controlling and even eradicating infectious diseases.