Nakaseke: Uganda’s vaccine coverage is rated high at about 90% with some vaccines such as BCG given against Tuberculosis and DPT against diphtheria, pertussis and tetanus covering a higher number at about 95% of the children having access. But, those figures only tell part of the story as in some areas, free vaccines are still too expensive to get. In Nakaseke, a district located just about 120kms from the capital Kampala, mothers still struggle.
In an interview with our reporter, Rebecca Nalubowa, a resident of Katooma reveals that her two year old only chanced on a measles vaccine, normally given at nine months of age, three months ago.
Nalubowa says while she understands the benefits of immunization, it became too expensive for her to save sixty thousand shillings in transport to reach her nearest Health Center III.
According to Gorrettie Mukagatare, the Secretary for Finance in the Nakaseke district local government, Nalubowa’s story is a story of many families in villages such as Rukuga, Kinaana and Kyanyamuwaluzi where mothers have to cross a seasonal lake to access health facilities.
Apart from those with skipped doses, she says they have had reports of children who have never had any vaccine at all. She says this situation has been made worse by low involvement of men in ensuring children get vaccinated.
“It’s very hard to convince a man to spend eighty thousand shillings for a journey to the hospital to just get a vaccine”, she explained.
When this was put to Dr Simon Aliga the Nakeseke District Health Officer (DHO), he acknowledged saying that they have since realized that vaccination efforts must go beyond the routine. While, vaccines are available and sometimes expire within facilities, he says the end –user arm has not been fully sorted with challenges in funding.
Aliga maintains that not until four months ago when an NGO AMREF Health Africa started funding immunization activities in the district, many families had chosen to remain in the community and yet health workers could not find them there too due to constraints in financing their transport.
The district was allocated only seven million shillings to coordinate immunization services including facilitating outreaches during the child health days. Aliga says this was only a drop in the ocean considering that they had submitted a budget of 37 million shillings to cater for all the twenty-seven health facilities.
Under their project dubbed Saving Lives and Livelihoods which among others focuses on enhancing vaccine uptake beyond infancy and ensuring access in underserved areas, AMREF offered the district an additional 30 million shillings.
Moses Mugwanya, the coordinator of immunization services says they had to choose eight most needy health facilities to utilize this money whereby apart from increasing awareness about available vaccines, they also ventured into more outreaches and training of health workers at the selected facilities.
As a result, Mugwanya says they have been conducting a total of ninety-one outreaches per month in the last four months where by apart from offering vaccines against yellow fever, human papilloma virus that causes cervical cancer and others, they have also conducted screening for key infectious diseases including hepatitis B.
Like the DHO, Mugwanya says to be able to make a difference, they need to go beyond the routine, where mothers are only expected to turn up at health facilities. He calls for more health worker training and public awareness to break the vaccine fatigue, which lesson he says they have taken in a few months that AMREF has been in the area.
“You know for long Nakaseke has not been having a funder supporting immunization so services remained crippled. When they came, suddenly VHTs picked interest, even health workers improved. This only shows that with a little boost, access can improve”.
While such interventions are being suggested, experts are worried that missed vaccination and existence of zero dose children in the community only makes them more susceptible to infectious diseases outbreaks.
Statistics by the Ministry of Health show there were an estimated 96,000 zero dose children in the community by the end of 2023, an increase from 55,000 in 2021. With the recent cuts in donor funding globally, there are worries that these numbers could increase.
Already, at the global level, the World Health Organization has warned about the resurgence of vaccine preventable diseases such as diphtheria which had long been defeated. In a statement released in April during the World Immunization Week, they also warned that outbreaks of diseases such as measles, meningitis and yellow fever are rising globally. The only way out they recommended was revamping access to vaccination services.
In Nakaseke however, experts say access to the jab alone, without attending to other issues affecting access, free vaccines will remain very expensive to get.