THE INTEGRATED ADVANCED STRATEGY: AN EFFECTIVE APPROACH TO CATCH-UP VACCINATION AND THE FIRST 1,000 DAYS CARE PACKAGE
Reaching children living in the most remote areas is made possible through the implementation of UNICEF’s advanced and integrated strategy. This strategy results from a technical and financial partnership between UNICEF, GAVI, and the French Ministry of Europe and Foreign Affairs. It enables a package of interventions to be delivered to the most remote and hard-to-reach villages. In the eastern region, the advanced and integrated strategy has made it possible to catch up with children who were not up to date with their vaccinations (zero-dose and under-vaccinated children).
On a morning in the village of Adinkol, Mandjou commune of the Eastern Region, news spread like wildfire. A team of multi-skilled Community Health Workers (CHWs) had travelled to this remote village to offer its 1,000 inhabitants a rare opportunity to benefit from a package of services including immunization, antenatal consultations, birth registration, malnutrition care, and advice on essential family practices. This progressive, integrated strategy, the result of a partnership between UNICEF, GAVI, and the French Ministry of Europe and Foreign Affairs, targets children, adolescent girls, and pregnant women. About a hundred women and their babies crowded around the multipurpose community health workers in the cramped shelter where the vaccinations occur. They were busy sorting the children and referring them to the health workers for various services (ANC, vaccination, vitamin A, malnutrition treatment, etc.).
During the hustle and bustle, where the crying of babies adds to the impatience of mothers, a woman in a white and purple checked hijab waits her turn.
The wrinkles on the dry face of Fadimatou, 45, betray a worry that has lasted 4 months. Her grandson, Mohamadou, the object of her concern, is wrapped in a white towel and sleeping peacefully. Since his birth, he has never received any vaccinations or other post-natal care. Mohamadou is a ‘zero dose’. On this day, ten of them were vaccinated for the first time. After weighing, vaccinating and advising Mohamadou, Fadimatou, who lives 12 km from the Boulembe health centre, relaxes and smiles.
« Mohamadou was born at home and his parents were never properly informed about the importance of vaccines and the vaccination calendar. When I heard this morning that a medical team was coming to vaccinate the children, I didn’t hesitate. I’m relieved that Mohamadou has been vaccinated and I’ll be keeping a close eye on what happens next. »
After the immunisations, Mohamadou Lawal, 57, ASCp, talks to mothers about the importance of exclusive breastfeeding for up to 6 months.
Don’t give water or artificial milk to babies under 6 months. They risk getting sick,’ he insists.
A few minutes later, he took the children’s measurements including weight, brachial circumference, and height. Ten (10) children suffering from acute malnutrition were identified and treated immediately. Additionally, around thirty teenage girls are receiving the human papillomavirus vaccine, and pregnant women are receiving their doses of the anti-tetanus vaccine and intermittent preventive treatment against malaria.
Thanks to the progressive and integrated strategy, the number of unvaccinated children has been significantly reduced. According to SAFANA, the CHW coordinator, this approach, particularly in a commune-like Mandjou, has enabled more than 300 children to catch up since the project began, including almost 50 children who had not received any doses.
Before the advanced strategies organised in the communities with the support of our partner UNICEF, a large number of children were not being reached (…) Since the integrated advanced strategy was put in place in 2023, we have gone from 1,570 zero dose children to 520 zero dose children in the first half of 2024 >>,says Gaspard ENGAMBA, health data manager for the Expanded Programme on Immunisation in the Eastern Region of Cameroon.
Written by Abraham Diboum, Dr Noël Vogue and Marie Guy Bandolo
