Attending to the need of hard to reach riverine communities with essential health services is one of the biggest challenges that has been faced by Ghana Health Service. Yet, these communities have the biggest need for these services. One of such is the delivery of vaccines to protect children.
In the Banda District of the Bono Region of Ghana, health workers have devised an ingenious strategy to get the RTS, S vaccine to riverine communities. The strategy, according to Mr. Moses Nantamba, Disease Control Officer and Malaria Focal Person for the district, is by making the Chief Fisherman and other community leaders as Health Volunteers. This way, they are motivated and use their canoes and boats to transport health workers to these communities to vaccinated children due for the vaccine.
The Banda District was carved out from Tain District in 2012. The District shares boundaries with the Bole District (SavannaRegion) to the North, Tain District to the south, La Cote D’Ivoire to the West and Kintampo South to the East. Banda Ahenkro, the District capital is 126 kilometres away from Sunyani. In terms of land area, the District covers a total of 2,298.35 kilometres square out of the regional size of 39,558 kilometres square. The District which is entirely rural has a population size of about 26,308 people who reside in 33 main land communities- and 30 more new riverine ones which sprung up after the completion of the BUI Power Generation Station. These 30 new are made up of fisherfolks who have to relocate and build homes along the banks of the Black Volta for fishing.
Thirty years in the making, RTS, S, also known by its brand name, Mosquirix, targets Plasmodium falciparum, the most common and most lethal of four malaria parasite species.
Ghana is one of three African countries (alongside Kenya and Malawi) that is carrying out the pilot Malaria Vaccine Implementation Programme (MVIP) with support from the World Health Organization (WHO) and in collaboration with partners, including PATH, a non-profit organization, and GSK, the vaccine manufacturer.
The aim is to vaccinate at least 120,000 children per year for three years in the selected areas and to:
·Determine how best to deliver the required four doses of the vaccine in routine settings
·Assess the vaccine’s full potential role in reducing childhood deaths; and
·Establish the vaccine’s safety profile in the context of routine use.
The programme includes areas of Brong Ahafo, Central and Volta Regions. Within these regions, some districts are receiving the vaccine, while others are expected to receive the vaccine at a later date.
In Ghana, the Expanded Programme on Immunization (EPI) is leading the phased introduction of the malaria vaccine in targeted parts of the country where malaria transmission is highest. This phased introduction is meant to allow the programme to learn about the impact of the vaccine on preventing severe malaria and deaths in children and about whether parents bring their children on time for all four doses.
The Malaria Vaccine Implementation Programme (MVIP) much as other health interventions are not without challenges. The common challenges identified across all implementing Districts are the difficulties in accessing hard to reach areas such as riverine communities.
According to Mr. Moses Nantamba, “parents who default in bringing their children to continue with the RTS, S doses used to be our biggest challenge until we operationalized a home visit plan. But that plan was also in short fall because about 30 communities are riverine- which means traveling on a canoe or boat for about two hours to reach the children. Haven been faced with this problem, we devised a strategy to bring on board the chief Fisherman. We made hm a Health Volunteer and trained him, had discussions with him on the need for children in these communities to vaccinated. He agreed and also recruited other community leaders to come on board, they would usually help to convey the nurses on their canoes and boats to these communities on appointed dates to do our catch-up vaccination strategy”.
He added, “we also use another strategy- which is that, when we dedicated Bongase market days as vaccination days. We know the parents will obviously come to market, because we use an updated register for the RTS, S vaccination, we usually will know the defaulters and look for them in the market and get the children vaccinated”.
So far, out of a target of 1,025 children, 842 has received the first dose, 786 second dose, 801 third dose 301 fourth dose. Asked about the fluctuation in the difference in dose uptake, Mr. Nantamba says it is primarily due to relocation of parents to non-implementing districts and initial hesitance (due to misinformation).
When this reporter visited the Banda Health Centre, a facility in the municipality, some women expressed joy about the vaccination exercise. Cecelia Boatemaa, who is a Nurse and parent, said her fifteen-month-old child experienced only one malaria incident after taking the first, second and third dose and is waiting for the fourth and final dose when he turns two years.
According to Mr. Simon ADAMS, District Director of Health Service, so far, the malaria vaccine acceptance is almost hundred percent.
The reporter visited the Banda District Health Directorate for an exclusive interview with Nurses as part of the National Malaria Control Programme (NMCP) and the African Media and Malaria Research Network’s (AMMREN) intervention to campaign for a malaria-free environment by 2030.
CREDIT: MODERN GHANA