From Fred Ezeh, Abuja
Years of sustained efforts by the government andstakeholders to improve the health of Nigerian population particularly at thefoundational level (primary health) seem to be yielding the desired result.
Ideally, babies are supposed to be given different antigenvaccination, notably, BCG, HEP B-0, OPV, OPV, PCV, Penta, Rota, IPV, amongothers, to build their bodies and immunity against diseases. But many newbornsare rarely presented to the clinics for basic vaccines, perhaps, due to theignorance on the part of their parents or inability to access the vaccines.
As a result, lots of the babies come down with ailments thataffect their immunity, mental and physical development, thus limiting theirability to contribute to the society.
However, the sustained push, perhaps, resulted in expansionof routine immunization and significant improvement in coverage over the years,thus resulting in a healthy population built with strong immunity to drive theeconomy and other activities of the country.
Health experts have maintained that a country with a healthypopulation stand better chance to compete globally in physical and mentalactivities, hence they’ve intensified campaign for improved immunizationcoverage at PHC level and other services at secondary and tertiary levels.
They confirmed that obvious improvement in longevity (lifespan) and general wellbeing of current generation of Nigerians (thoughdebatable) was a result of the quality of vaccines and childcare they receivedat the PHCs, which were not available for previous generations.
The development could also be attributed to improved healthcare services, advancement in science and medicine, knowledge, equipments,capacities and skills at health care facilities particularly at the PrimaryHealth Care (PHC) centres that deal with the issue of early care for the child,administering vaccines that are critical to the survival and well-being of thechild
However, Federal Ministry of Health, perhaps, through theNational Primary Health Care Development Agency (NPHCDA) has also intensifiedcampaign and enlightenment for improved immunization records at ruralcommunities using different platforms.
Few years ago, NPHCDA reinvigorated its relationship withtraditional and religious leaders that were used to fight and defeat wildpoliovirus, perhaps, to amplify campaign for public acceptance of COVID-19 andHPV vaccines being the latest introductions into the routine immunizationsystem.
The Agency believes in the fact that the traditional andreligious leaders command massive loyalty and followership among the people,hence they leverage on that to propagate the message of immunization.
However, despite the strong resistance of the vaccines insome quarters, the benefits, short and long term, are beginning to convince thedoubters that adequate childhood vaccines are safe and effective, and theyprotect children from common childhood illnesses, and by implication, producinghealthy adults for the nation.
There are strong predictions that Nigeria might enjoy morehealthy population that would drive its economy in future because of theefforts being put in place to strengthen immunization and other child careservices, thus protecting the future population from vaccine-preventablediseases that could affect the health of people.
Thirty to forty years ago, there were severalvaccine-preventable diseases, notably, diarrhea, measles, diphtheria, yellowfever, meningitis, among others, that were killing children (0-5 years orbeyond), in addition to diseases like that Guinea worm, Noma, Elephantiasis,sleeping sickness, river blindness among others that were later classified asNeglected Tropical Disease (NTD), that were also killing adults, even thoughmany have been eradicated.
Mythand misconception of vaccine
Sadly, despite several campaigns on the benefits ofchildhood vaccines to the individual and the nation, many parents stillskeptical to present their newborns to clinics for immunization, as waswitnessed in the recent outbreak of diphtheria among zero dose vaccine childrenin some communities.
Hajaratu Abdullahi, a mother of nine months old boy, saidshe deliberately refused her second child the opportunity of vaccinationbecause the first child allegedly died of complications fromimmunization.
She said: “My son, Saleem, is nine months old. Wedeliberately refused to present him for immunization because of the experiencewe had with my first child, his brother, who died few days to his firstbirthday, after complications from immunization he received earlier.”
Hajaratu said she noticed some reactions from the child fewdays after he was given the injection. “I had no idea of what was given tohim. But before we could know what was happening, he passed out. I believe theinjection caused his sudden death. So, I don’t want repeat of that horribleexperience.”
But health workers and bystanders at the PHC located somewherein Abuja, quickly disagreed with her, and educated her on what she should do inthe future if there’s reactions as a result of vaccine.
She was, however, advised by the health workers not toengage in self-medication but always submit her child to the nearest PHC incase of any reaction to whatever vaccine given to the child.
Similarly, Sofiya, a mother of one year, eight months oldboy, also displayed ignorance to childhood immunization which has beenconfirmed to be safe for children.
She said: “I wasn’t aware of the importance ofimmunization. Besides, I gave birth to my child at a PHC that is far from myplace of residence. I was never educated on the importance of immunizationuntil my encounter with a mobilization team from UNICEF. They opened my eyes tothe benefit of immunization. My child, by virtue of his age has obviouslymissed some of the vaccines. But I must ensure that he collect the remainingones.”
Risein life expectancy in Nigeria, Africa
World Health Organization (WHO) in 2022 confirmed thathealthy life expectancy in Nigeria and Africa has risen by 10 years per personbetween year 2000 and 2019.
It explained that healthy life expectancy simply means thenumber of years an individual is expected to be in a good state of health, and itincreased to 56 years in 2019, compared to 46 in 2000.
The UN organization also confirmed a slight progressrecorded in other regions of the world which indicated that global healthy lifeexpectancy increased by five years.
WHO, however, said the improvements recorded in theprovision of essential health services, gains in reproductive, maternal,newborn and child health, as well as progress in the fight against infectiousdiseases, rapid scale-up of HIV, tuberculosis, and malaria control measures from2005 helped to achieve the feat.
It confirmed that on average, essential health care servicecoverage improved to 46 per cent in 2019, compared with 24 per cent in 2000,and the most significant achievements were in preventing and treatinginfectious diseases. “Sadly, the success was disrupted by the dramaticrise in hypertension, diabetes and other non-communicable diseases and the lackof health services targeting these diseases,” it noted.
Director, WHO Africa, Dr. Matshidiso Moeti, said the sharprise in healthy life expectancy in the past two decades was a testament to theregion’s drive for improved health and well being of the population. “Morepeople are living healthier, longer lives, with fewer threats of infectiousdiseases, and with better access to care and disease prevention services.”
She expressed fears that the health gains could bejeopardized if countries refuse to enhance measures against the threat ofcancer and other non-communicable diseases.
“However, to enhance health services and ensure theyare adequate, of good quality and accessible to all, it is crucial forgovernments to step up public health financing, and also endeavour to reducecatastrophic out-of-pocket expenditure by households.”
COVID-19and routine immunization
COVID-19 pandemic in 2020 disrupted people’s lifestyle, androutine immunization services in Nigeria resulting in several missed cases. Italso affected the gains made by the NPHCDA, United Nations Children’s Fund(UNICEF) and other global partners in the fight for the rights of children,pregnant women and young adults, who are most vulnerable to vaccine-preventablediseases and inhuman treatments.
Fear of contracting the virus neither allowed young mothersand their babies nor health workers at PHCs to visit health care facilities forimmunization or any other medical services as may be needed in thehospitals.
But soon after the lockdown was over, there were records ofyellow fever outbreaks in several states leading to several deaths. NPHCDA andpartners quickly mobilised for vaccination campaign across the affectedstates.
UNICEF also supported the effort through the launch ofRoutine Intensified Immunization Programme (RIIP) in the affected states,notably, Ogun, Enugu, Osun, and some other states, that had poor record ofroutine immunization coverage.
UNICEFintervention
UNICEF has always been supportive of interventions,particularly through immunization and other child care support programmes, thatwould improve the life of children, hence the engagement in periodic monitoringof immunization exercises in some states, to assess the compliance level andensure that young mothers are afforded the opportunity to immunize theirchildren against vaccine-preventable diseases.
UNICEF Routine Immunization Officer, who pleaded anonymity,said that UNICEF often provide supports for PHCs to engage in series ofmeetings with community leaders in their target areas, to help educate andmobilise nursing mothers to submit their children for routine immunization.
In addition to that, local town criers with megaphones areoften hired to go round the communities few days before the outreaches tomobilise nursing mothers and pregnant women for the immunization.
The officer confirmed that support is also made for everyone involved in the value chain of the exercise to enable them dedicate anddeliver the services to the benefit of the people.
GAVI, the vaccine alliance
Recently, Gavi, the vaccine alliance, through its ChiefExecutive Officer, Dr. Sania Nishtar, renewed its commitment to improvedimmunization in Nigeria, commending government’s efforts at improving maternaland child care in Nigeria, by making necessary life-saving vaccines availableat PHC centres across the country.
It said that such efforts had guaranteed opportunities fornewborns to access vaccines that would assist them enjoy healthy life, thuspromising more support for Nigeria to enable it improve access to new andunderused vaccines for children in Nigeria.
Gavi stressed the importance of vaccine to the health ofchildren and the future of the nation, encouraging mothers to alwayspresent their children at the PHCs for necessary routine immunization thatwould strengthen their babies’ immune system, thereby guaranteeing theirhealthy living.
The Gavi CEO said: “We are deeply committed toproviding vaccines to the world, but the efforts has to be country-led. We arehappy that the President, Ahmed Bola Tinubu, is someone that is committed tothat project. In my recent meeting with him, he highlighted some of the stepsbeing taken to improve availability of vaccines in Nigeria, to the point oflocal production.
“But in achieving the dream of local manufacturing ofvaccines, there’s need for the right institutions, manpower, political will andpolicies. Our role in Gavi is to ensure that vaccines are affordable andaccessible without compromise as regards the quality within the Africancountry.”
Vaccine preventable disease, top priority
NPHCDA Executive Director, Dr. Muyiwa Aina, maintained thatissues of vaccine preventable diseases has remained a top priority for theFederal Government, hence the unending investments and efforts in vaccineprocurement and administration.
He insisted that childhood vaccines provide strong base forthe health of any nation. “Any generation/community of people that were notproperly vaccinated is often a threat to the health of such a nation. We haveseen that happen repeatedly in Nigeria and other parts of the world.
“Recently, we had to contend with outbreak of diphtheria insome northern states, and that was as result of unvaccinated or incompletevaccination community. Health is wealth. So, a nation with unhealthy peoplewill have some limitations in terms of physical and mental engagements.
“Our routine immunization coverage is obviously gettingbetter kudos to all partners and field workers, but there’s room forimprovement. So, government is using every available opportunity to strengthenthe system for a better service to the people.
“Part of that is having access to the vaccines and systemsthat allow for safe delivering of the vaccine, and that’s where the partnershipwith Gavi comes to play. Gavi, undoubtedly, has been a long time partner ofNigerian government. They have been supporting us in terms of procurement ofthe vaccine, though not for free, but they have been subsidizing theconsignments for us.”
He said that though the Agency is facing the challenges ofvaccine distribution, but it’s using different strategies/approaches to reachout to unvaccinated children at different locations in Nigeria.”Unfortunately, there are zero dose communities in Nigeria where it was recentlydiscovered that some children there never received any immunization. So, wetarget these locations, identify the children, and ensure we effect thenecessary corrections.”
Ekiti commissioner
Ekiti State Commissioner for health, Dr. Oyebanji Filani, saidvaccine accessibility and the introduction of new vaccines into routineimmunization systems has indeed significantly increased over the years, andthis undoubtedly, have profound long-term benefits on the health of thepopulation.
Firstly, expanded access to vaccines has led to asubstantial reduction in the incidence of vaccine-preventable diseases (VPDs). Diseasessuch as polio, measles, mumps, rubella, and hepatitis have seen a markeddecline in prevalence and have resulted in fewer cases of illness,hospitalizations, and deaths.
Another primary advantage of these vaccines is their role inpreventing the spread of infectious diseases. “By immunizing individualsagainst diseases such as influenza, pneumococcal infections, and humanpapilloma Virus (HPV), we not only protect the individuals from thedebilitating effects of these illnesses but also reduced the overall burden onhealthcare systems.”
Moreover, vaccination programme contribute to increasedproductivity by reducing the number of sick days taken by individuals andcaregivers, ultimately bolstering economic growth.
Vaccines contribute to the reduction of disease transmissionwithin communities. This phenomenon occurs when a significant portion of thepopulation is immune to a particular disease, making it less likely for thedisease to spread, thereby, protecting vulnerable individuals who may not beable to receive vaccines themselves.
Undoubtedly, vaccines play a crucial role in preventing thespread of Anti-Microbial Resistance (AMR). By reducing the incidences ofbacterial and viral infections, vaccines help to curb the overuse ofantibiotics, thus mitigating the development of resistant strains of pathogens.
In addition to their direct impact on disease prevention,vaccines have long-term economic benefits. The cost savings associated withpreventing illnesses, hospitalizations, and long-term complications aresubstantial.
In conclusion, the long-time benefits of vaccines to thehealth of the population are vast. From preventing the spread of infectiousdiseases, promoting herd immunity to reducing healthcare costs, preventing thespread of antimicrobial resistance and enhancing global health security,vaccines are an indispensable tool in safeguarding public health andwell-being.