Vaccination: Rwanda's inspiring journey

Last month’s ‘African Vaccination Week’ that took place under the theme ‘Vaccination a gift for life’ provided an opportunity for countries to strengthen their immunization services and systems through advocacy, education, communication tools and activities.
A nurse immunising a baby at Kacyiru Police Hospital. (File)
A nurse immunising a baby at Kacyiru Police Hospital. (File)

Last month’s ‘African Vaccination Week’ that took place under the theme ‘Vaccination a gift for life’ provided an opportunity for countries to strengthen their immunization services and systems through advocacy, education, communication tools and activities.

While immunization rates are increasing across the developing world, the rates are falling in developed nations.

In the State of California, childhood measles is getting out of hand.

The epidemic is being fueled by growing enclaves of unvaccinated children, thanks to the work of the anti-vaccination lobby who disagree with vaccination on largely religious and philosophical (the Centre for Disease Control reports that in 2014, 79% of measles cases in the U.S. involving unvaccinated people were the result of personal belief exemptions).

As a result epidemics are spreading farther and faster than seen in decades.

Local situation

The situation in Rwanda is a mirror opposite of that found in California where immunization is optional. In Rwanda immunization is encouraged with ninety per cent (90%) of Rwandan children being immunized against preventable diseases, according to the 2010 Demographic and Health Survey (DHS).

Rwanda was one of the first developing countries to introduce the pneumococcal vaccine to prevent pneumonia in 2009; health officials attribute this pro-immunization fervor to the political leadership.

“The country has not registered any confirmed polio cases for the past two decades. The World Health Organization certified the country polio-free in 2004,” says Henry Mutabazi, an infectious diseases specialist with Medplus clinic, Remera.

In many countries, polio immunizations campaigns are often met with fierce opposition from communities that have not been well educated about the benefits. Officials at the Health Ministry say engaging the community through dedicated community health workers has made their work easy. Up to 45,000-trained community health workers countrywide ensure large turn outs at immunization centres.

Rwanda had 99% uptake of Bacille Calmette-Guérin (BCG), a vaccine against Tuberculosis, in 2012 ranking it far ahead of countries such as Poland and Portugal.

The country also boasts 86 per cent vaccination rate of newborns against tetanus, beating countries such as South Africa (74 per cent) and Philippines (76 per cent).It has also made huge strides in eradicating measles during the last decade. For instance in 2000, 2,700 measles cases were recorded, whereas in 2012, there were fewer than 80 reported cases, and zero deaths.

Health experts say that for a country with a limited health budget such as Rwanda, the will of the government in enacting relevant policies has helped reduce child mortality significantly.

According to Gerald Muhoza, the Director of Immunisation and Safety at the Expanded Programme on Immunisation in the Ministry of Health, the country has achieved its target of reducing under-five mortality by two thirds between 1990 and 2015.

“The country’s political will, the role of the community health workers and integration of technology in the health sector are the main factors that have contributed to the success of immunisation campaigns,” said Muhoza.

Rwanda was the first sub-Sahara African country to roll out measles and rubella vaccination with the support of the GAVI Alliance, WHO, UNICEF and other partners.

“Community based health workers are charged with identifying people who require vaccines and also note the types of vaccines needed before reporting to public health facilities ,” notes Catherine Mugeni,  the Coordinator of Community Based Health Workers (CBHW’s) at the health ministry.

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