Eritrea maintains over 95 per cent coverage for nationwide immunization programmes

UNICEF’s support through donor funding for procurement, delivery and distribution of vaccines, cold chain equipment and training and supervision of health personnel and other service providers have been critical to ensuring success.

11 March 2019

Northern Red Sea Region, Eritrea – Amid the melee of screaming toddlers and concerned mothers at the Amatere Health Centre in Massawa, 10-year-old Abdulrashid Shahid calmly consoles his seven-year-old sister, Shayeda.

“Don’t worry, it does not hurt if you are not scared. Just close your eyes when the needle comes close and you will be OK,” says Abdulrashid, gently draping his arm over his younger sister’s shoulder. Shayeda glances nervously at the younger children squirming and screaming while getting vaccinated.

When it is her turn, little Shayeda does exactly as instructed and keeps her eyes tight shut as she gets her dose of the combined measles and rubella injectable vaccine. After it’s over she smiles while her brother keeps his reassuring hand on her shoulder. The oral dose of Vitamin A supplement is almost like a treat after that.

On another bench, a mother named Anna winces as her 18-month-old daughter Senait gets vaccinated and receives Vitamin A supplements.

“I have been waiting in line for two hours now, but I know that this is worth it because it will keep my daughter safe from infectious diseases.”

– Anna

Around them, hundreds of children with their mothers and/or fathers and caregivers wait in turn to get vaccinated and receive their Vitamin A supplements, as part of the national measles and rubella campaign in November 2018.

Sister and brother
UNICEF Eritrea
Abdulrashid comforts his sister Shayeda after she received the measles vaccine.
A girl receives an injection
UNICEF Eritrea
A young schoolgirl gets vaccinated during the national measles rubella campaign.
National Measles Rubella and Vitamin A supplementation campaign launched

The Ministry of Health launched the national measles and rubella and Vitamin A supplementation campaign in Eritrea, targeting more than 1.5 million children nationwide aged between 6 months and 15 years, as one of the largest immunization campaigns undertaken recently.

“Childhood immunization campaigns provide a high return on investment and Eritrea has been working hard to ensure high immunization coverage to prevent vaccine preventable diseases like measles, rubella etc.,” said Ms. Amina Nurhussein, the Minister for Health during the launch of the campaign in Eritrea’s capital Asmara.

The campaign, largely funded by GAVI – the vaccine alliance – was supported by UNICEF Eritrea in collaboration with WHO right from the planning, procurement, delivery and distribution of vaccines, technical support and provision of supplies for cold chain systems, the training and supervision during implementation of health workers.

The launch of the campaign was initiated after almost two years of thorough preparations and after accomplishment of many important pre-requisite steps, which allowed Eritrea to access GAVI funding for this new combined vaccine.

UNICEF supported the Ministry of Health to conduct the Immunization Equity Assessment and bottleneck analysis, which guided the microplanning for the MR campaign. The programme also implemented recommendations of the 2016 Effective Vaccine Management Assessment related to the overall management of vaccines and the cold chain system.

UNICEF procured vaccines with support from GAVI and other donors, and conducted air charters in April 2018 and in October of 2018, where doses of measles-rubella vaccine were airlifted for 1.5 million children for the routine MR campaign.

The MR campaign was concluded in December 2018 and Eritrea again managed to achieve a 97.5 per cent immunization rate nationally as per the post-immunization coverage survey, with over 1.2 million children getting vaccinated.

“This is a commendable achievement for the children of Eritrea. These efforts must be sustained, and a system set up to ensure that all children who miss out on routine campaigns are followed up if Eritrea is to achieve its goal of measles elimination by 2020,” said Dr. Pierre Ngom, UNICEF Representative in Eritrea.

Funding from Government of Japan for cold chain systems will strengthen immunization services
Representatives from UNICEF and JICA
UNICEF Eritrea
Dr. Pierre Ngom, UNICEF Representative and Mr. Shinjiro Amameishi, Senior Representative, JICA Kenya Office sign the Grant Agreement.

In 2018, Japan International Cooperation Agency (JICA) supported the Ministry of Health to seek funding from the Government of Japan for the EPI programme that will be used for bolstering the vaccine cold chain systems and storage equipment. In March 2019, the Japanese Government provided a grant of USD 2.4 million to UNICEF through JICA to procure 195 Solar Direct Driven (SDD) refrigerators to replace obsolete battery type solar refrigerators, 30 units of electrical coolers, 1 large electric stabilizer (40 KVA), 4 medium sized electrical stabilizers (15KVA), and 30 tool kits for maintenance and repairs of the solar refrigerators.

Building on the efforts made by JICA in the past, the funding will support Eritrea’s EPI programme by expanding its cold chain capacity and strengthening and improving the overall efficiency of the immunization process by 2021, to benefit 850,000 people. This includes an estimated population of 850,000 people (including 25,000 children below one year of age, 127,000 children below five years and 37,000 pregnant women) accessing immunization services.