Overcoming challenges to protect children against measles and rubella.

Measles-rubella catch-up campaign succeeds in overcoming logistical and religious barriers.

John Mokwetsi
A nurse at Mutambara hospital administers vitamin A supplementation following a catch-up campaign that has succeeded in overcoming logistical and religious barriers following the devastating Cyclone Idai.
UNICEF Zimbabwe/2019/Shepherd Tozvireva

02 July 2019

CHIMANIMANI, Zimbabwe – As Tapiwa Madanhi waited with other young mothers at Mutambara Hospital for her daughter,4, to be vaccinated against measles and rubella, she reflected on the anguish and anxiety she experienced in the aftermath of Cyclone Idai.

“It was distressing to look at,” she said between heavy sighs of exasperation. “My family was vulnerable. We were left with nothing after the cyclone. We were stranded and did not know what to do. I needed to take my daughter for that critical immunisation (against measles) and the vitamin A supplementation that our village health worker said was important.”

“My family was vulnerable. We were left with nothing after the cyclone."

The bridge that connects Mutambara hospital to the rest of the district, stands like a crashed colossus. In March, the powerful Cyclone dumped vast amounts of rainwater that washed away everything in its path and destroyed this essential transport link. Government has since established makeshift bridges made of wooden planks while work takes place to restore the destroyed infrastructure. Where possible side roads have been created to allow vehicles to pass through.

“It took some time for the water to subside for residents and helpers from various organisations to come up with makeshift bridges along main roads. The biggest challenge for some were rivers that had become too full to even allow us to use timber as bridge infrastructure. We have since managed and this is why I am here,” Tapiwa said.

School children cross a makeshift bridge along Chimanimani road. The bridge was washed away during a devastating Cyclone Idai that affected the region.
UNICEF Zimbabwe/2019/Shepherd Tozvireva
School children cross a makeshift bridge along Chimanimani road. The bridge was washed away during a devastating Cyclone Idai that affected the region.

Following the cyclone, the Ministry of Health and Child Care (MoHCC) with support from UNICEF and WHO, ran a vaccination catch-up campaign from 12 - 23 May in Chipinge and Chimanimani districts to reach children who were unable to access health facilities and missed their routine immunisation.

Children aged 6-59 months were vaccinated against measles and rubella. Some 100,500 doses of measles-rubella vaccine plus injection devices and safety boxes were procured by UNICEF with funding from the UN Central Emergency Relief Fund (CERF) and UK aid from the UK government.

The campaign also included screening for nutrition status for children under five and Vitamin A supplementation for children 6-50 months.

Speaking of her daughter’s immunisation, Tapiwa explained that information from village health workers reminded her to visit the hospital as soon she could. “I was due to be here last month, and I could not. I have always adhered to the timetables. I am elated that I managed to have the immunisation done as many others who are my neighbours who were here last week. The village health workers tell us about securing the future of our children and I am happy that I can do that,” she said

Breaking down barriers

While some parents were initially reluctant to immunise their children, claiming that it went against their religious beliefs, at Biriiri Rural Hospital in Chimanimani, 66 kilometres from Mutambara, Anesu*, mother of seven, was nevertheless persuaded to protect her youngest children against the vaccine-preventable diseases.

Tapiwa join others at Mutambara hospital in Chimanimani for the critical immunisation (against measles) and the vitamin A supplementation for her four-year-old daughter.
UNICEF Zimbabwe/2019/Shepherd Tozvireva
Tapiwa join others at Mutambara hospital in Chimanimani for the critical immunisation (against measles) and the vitamin A supplementation for her four-year-old daughter.

“The reason I am here is that I learnt from a health worker from our church that this vaccine was important for my two children who are three and four years old."

“The reason I am here is that I learnt from a health worker from our church that this vaccine was important for my two children who are three and four years old. However, it is still hard to do this openly although some of our leaders who attended trainings are softening on their stance,” said Anesu.

Sister-in-charge at Biriiri Hospital, Elizabeth Tinofa, said the government outreach programme supported by UNICEF had helped to educate communities, including religious sects to participate in the campaign.

“We visited them, especially the young generation. We have said to them that we want you to be the village health workers. We told them that while we acknowledged that they use holy water for healing purposes, our message was that they should use the vaccines as well. I have two village workers, one female and another male who are from [that] church and they have helped a lot,” Tinofa said.

Impact of outreach

The catch-up campaign strategy included mobilising religious leaders in Biriiri to encourage caretakers in their communities to take children to vaccination sites. In addition, authorities responsible for 302 schools in Chimanimani and Chipinge were briefed on how to use their schools to engage communities in the campaign.

As a result, over 61,000 children were vaccinated during the campaign.  Parents and caregivers also received child health cards to replace those lost in the cyclone.

Sister-in-charge of Biriiri Hospital in Chimanimani, Elizabeth Tinofa shows the map of areas that have received awareness campaigns on the importance of immunising against Measles.
UNICEF Zimbabwe/2019/Shepherd Tozvireva
Sister-in-charge of Biriiri Hospital in Chimanimani, Elizabeth Tinofa shows the map of areas that have received awareness campaigns on the importance of immunising against Measles.

Provincial Maternal Officer, Admire Maravanyika described the impact of the campaign’s outreach. “Access to cyclone-affected areas was a challenge and…many children who were due for vaccination were not able to do so because of the dire situation. This catch-up campaign therefore has been able to reach out to these communities who were cut off by the flooding. We thank the UN agencies for being helpful with their provision of technical support and all the other support the Ministry of Heath needed.”

*Not her real name