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© UNICEF/MOZA-01451/G.Pirozzi

Progress in immunisation coverage

When it comes to reducing child deaths, immunisation is one of the most successful and cost-effective public health interventions.

In Mozambique, significant progress has been made in increasing vaccination coverage against the major vaccine-preventable diseases – polio, diphtheria, tuberculosis, pertussis (whooping cough), measles and tetanus – but there is still room for improvement.

Routine immunisation coverage is estimated at around 71 per cent, but this figure masks huge disparities. For example, 74 per cent of children living in urban areas are fully immunised against only 55 per cent in rural communities. Similarly, children in poor households are half as likely to be fully vaccinated as children in best-off households.

Immunisation provides an opportunity to bring other life-saving interventions to children. Since a high percentage of children under five in Mozambique suffer from vitamin A deficiency and anaemia, immunisation services are integrated with health activities such as vitamin A supplementation and de-worming.

Supplementary immunisation

Mass child health campaigns conducted over the past two years in Mozambique have reached hundreds of thousands of children who had not been reached by routine immunisation.

In 2009, two Child Health Week campaigns reached over 3 million with vaccination against measles, vitamin A, iodine supplements, deworming medicine and long-lasting insecticide treated mosquitos nets.

These Child Health Weeks will make it possible to sustain gains from an earlier nationwide measles campaign held in 2005, which resulted in a 90 per cent reduction of measles cases and deaths, bringing the country closer to achieving the Millennium Development Goal of reducing child mortality by two-thirds by 2015.

© UNICEF Mozambique/T.Delvigne-Jean

What is being done

As part of the Expanded Programme on Immunisation, UNICEF supports the Ministry of Health to strengthen routine immunisation services and supplementary mass vaccination campaigns. The aim is to establish immunisation programmes that will function smoothly year after year as part of a solid primary health care system.

To achieve this, UNICEF and its partners support health authorities to improve the planning and supervision of immunisation activities and ensure a regular supply of vaccines, including training for health workers. Another crucial component of this work is to educate communities and promote immunisation through local leaders and local media.

Expanded Programme on Immunisation

The Expanded Programme on Immunisation uses a two-pronged approach: routine immunisation services as part of the regular primary healthcare system and supplementary immunisation activities to further boost immunity and prevent the outbreak of epidemics.

Reach Every District is a strategy being employed to bring routine immunisation to hard-to-reach and under-served areas. The approach uses strategies and simple tools to strengthen the capacity of district authorities so that they can improve immunisation coverage in their districts. The district focus also allows for making practical links with other health activities such as malaria control and nutrition.

Monthly Health Days are another effective means of reaching vulnerable children with life-saving health interventions. The Health Days approach has been developed as a result of poor access to health services in rural areas.

Monthly Health Days involve a mobile health team visiting a village or locality where they immunise children, administer vitamin A capsules and de-worming medication, conduct health education sessions and meet with community members to help them analyse and find solution to health problems.

Child Health Weeks are also part of an accelerated child survival and development strategy which aims to deliver a package of basic interventions proven to be highly effective in reducing mortality rates and improving child health.

These week-long campaigns complement routine health services and Monthly Health Days by ensuring that basic services reach all children – wherever they live, even the most remote communities – through fixed health units and mobile brigades. 

The way forward

From 2009 to 2011, UNICEF will continue to support the Ministry of Health and other partners in three main areas to scale up immunisation activities nationwide, with a focus on the 66 districts with the lowest coverage.

Strengthening capacity of care givers, including families and health staff

  • Support the implementation of communication initiatives to promote increased dialogue with service providers and encourage people to adhere to routine and campaign immunisation activities.

Strengthening planning and service delivery capacity at district level

  • Strengthen provincial, district and health facilities’ capacity for better financial and programme management of immunisation activities at local level.

  • Support the expansion of the Reach-Every-District approach in order to reach every newborn and child in every district with vaccination services and other health interventions, such as nutrition, malaria, and maternal health.

Supporting national policy development, coordination

  • Strengthen central-level capacity to plan, manage and staff the Expanded Programme on Immunisation, as well as develop policy guidelines and national implementation plans;

  • Provide technical support to the Ministry of Health for routine and supplementary immunisation activities.

  • Support and strengthen the logistical capacity of the Ministry of Health, including an efficient cold chain system.

  • Expand Monthly Health Days, reinforce the nation-wide Child Health Weeks and outreach activities for hard-to-reach communities.

  • Provide support to supplementary immunisation activities, and collaborate with the Ministry of Health and WHO in epidemiological surveillance for polio, measles and maternal and neo-natal tetanus.

  • Support the introduction of new vaccines. 



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