Community Health Workers increase Vitamin A Supplementation (VAS) and Immunization coverage

Kenema, Sierra Leone – Morie Momoh is a Community Health Worker (CHW) who lives in the Kpetewuma Community in Kenema District, Eastern Sierra Leone. As a CHW attached to the Blama Community Health Center (CHC), Morie says he has been supporting the Blama CHC in reaching out to the Kpetewuma community on health and nutrition interventions.

With a total population of 665 of which 150 are children under the age of five years old, Kpetewuma Community is a hard-to-reach community where mothers and caregivers travel long distances to access the health facility for immunization and other routine services. Reflecting on the roles and responsibilities entrusted to him by his community members, Morie confidently stated, “I remain committed to the delivery of services that will improve the lives and wellbeing of my community despite the challenge they are faced with.” 

According to the Sierra Leone Micronutrient Survey (SLMS 2013) report, vitamin A deficiency (VAD) among children 6 – 59 months in Sierra Leone at 17 per cent is a public health problem of moderate public health significance. WHO strongly recommends high-dose VAS in children 6-59 months of age in a setting where VAD is a public health problem. In Sierra Leone, VAS is a component of the primary health care service of the Basic Package of Essential Health Services. With support from the Government of Canada-funded Vitamin A in a New Age (VINA) project, UNICEF in close collaboration with the Ministry of Health (MoH) is working to improve the coverage of VAS with more focus on children 12-59 months in hard-to-reach areas. One of the strategies to enhance coverage is working with CHWs in hard-to-reach communities and giving them the prerequisite support to administer VAS, conduct Integrated Community Case Management (ICCM), nutrition screening for under-five children with Mid Upper Arm Circumference (MUAC), health promotion alongside other health and nutrition interventions. The CHWs are linked to health facilities to facilitate defaulter tracing and referrals to the health facilities where needed. The Facility In-Charges on need basis carry out capacity building, monitoring, reporting and ensure their participation in campaigns.

Briefly giving an overview of his functions as a CHW in Kpetewuma Community, Morie noted that the administration of VAS was not part of their work but was later integrated in the routine services they were providing following a training that was conducted in 2023 on the revised scope of work for CHW.

“I have the profile of my community which gives a clear picture of the total number of pregnant and lactating women, under-five children, and other categories of people. This profile is updated on a quarterly basis which helps me to plan and carry out routine household visits, disease control and prevention, health promotion, community screening, immunization and other integrated community Case Management (ICCM) and Reproductive Maternal Newborn Child and Adolescent Health (RMNCAH) services. I support the health facility with defaulter tracing, participate in community sensitization and awareness raising during periodic campaigns and routine interventions,” Morie Momoh added.

In addition to improving the health status of community members, the CHW programme offers meaningful work and an opportunity for CHWs to receive some income in the form of stipends (incentives). They also commands respect within their communities.

Holding her son in her arms and with a deep smile on her face, Hawanatu Karimu, a teenage mother of Lansana Karimu expresses her appreciation for the work of CHWs like Morie Momoh. “Giving birth to my son at the age of 15 years, I had little knowledge on how to care for him and enhance his wellbeing. But with the support from our CHW and the health care workers at the Blama facility, I now have more insights to even support my peers and other mothers. I cannot overemphasize the importance of the Red Capsule (Vitamin A Supplement) in protecting my son against illness and helping him with a perfect eyesight,” Hawanatu stated. Going through her son’s under-five card, Lansana Karimu has an updated immunization record for all the antigens. She ended up by saying “mi pikin dↄn take ↄl i marklate” which means Lansana has completed all his vaccines and added that she will continue to ensure that he takes the six-monthly routine VAS and deworming until he reaches age five.

It is evident that mothers and caregivers in Kpetewuma Community are highly appreciative of the work and services delivered by the CHWs. There is a high rate of VAS acceptance due to the outreach of CHWs, educating mothers and caregivers on its importance. All the mothers and caregivers are happy to see their children growing well and healthy.