With the endorsement of the Addis Declaration on Immunisation, African leaders demonstrated their commitment to life-saving immunizations. The Declaration names a number of components – ten, in fact – crucial to realizing the full benefits of immunization. But there are many more pieces in the day-to-day work of getting vaccines to children. These are the pieces I think about as I do my part in reaching global vaccine goals.
Depending on the day, I’m thinking about things like this:
These are all pieces of a puzzle – just like the political will generated by the African Union — needed to fulfil the promise of immunising every child in my province of Niassa. Niassa is Mozambique’s most sparsely populated province, with an estimated 1.7 million people. Trucks carrying vaccines must travel 4,583 kilometers a month on average, or 230 kilometers each day to reach the 171 health centers. So trucks are important. When they aren’t available, or properly maintained that’s a problem for us. The same is true with data. Without sufficient data, we had limited insight into what vaccines were needed at what health centers. I’m very proud of the fact that we now have data available and reported from nearly 90% of our health units on a monthly basis. This data provides valuable insight and helps us adjust stock as needed. We also need refrigerators and other cold chain equipment to keep our vaccines cold. With health ministry and Gavi support, we now have a working refrigerator at 97% of our 171 health units.
There is no single requirement to immunize every child. A system of many components is involved, each of them important to the whole. Over the past couple of years, we have worked diligently on developing a flexible system, one that increases efficiency and can help us respond to stresses on the system, both good (like new vaccine introductions) or bad (like disease outbreaks and emergencies). We are helping Niassa to break out of incremental improvements and ensure regular availability of vaccines and related supplies all the way to the health facility level – and ultimately to children.
This is not easy work, but it is important. We are grateful that the entire African Union has made this a priority.
Dr. Ramos Mboane coordinates all health activities, including immunization, in Niassa, one of 11 provinces in Mozambique. His work includes monitoring changes and trends of health indicators, oversight of epidemiologic control activities, all logistical activities encompassing medicines, as well vaccines, lab and medical care supplies, implementation of routine EPI, pharmacovigilance, and community mobilization activities taking place at a provincial level.