Childhood vaccinations in South Africa faced immense challenges prior to Covid-19.

In fact, South Africa was already listed as one of the top 10 countries worldwide battling to increase the number of children with access to routine vaccinations.

Since the start of the pandemic, the sharp drop in SA national immunisation coverage (from 82% in April 2019 to 61% for April 2020) has sparked concerns of a resurgence of vaccine-preventable diseases for children under five years of age.

Despite the catch-up programme set in motion by the Department of Health in November last year, there is still an immunisation backlog, and urgent intervention is needed to support the success of catch-up efforts.

The reality is that accessing hard-to-reach rural areas is a problem for vaccine distribution.

Add to this the issue of myths surrounding vaccines which disproportionally affects rural communities where there is limited access to information.

A partnership to address missed childhood vaccinations

World Vision South Africa in partnership with AMREF Germany – GESUNDES AFRIKA, supported by World Mercy Fund-Barmherzigkeit, has launched the ‘Increasing the uptake of routine vaccinations for vulnerable children in rural areas of South Africa’ (IUVSA) project to assist the Department of Health’s Expanded Programme on Immunisation.

The intervention aims to increase the uptake of neglected childhood vaccinations amongst the target population through key messaging and efficient delivery of routine immunisations to children in rural areas.

South Africa is experiencing COVID-19 hesitancy, with many refraining from visiting health facilities due to fear of transmission. By bringing healthcare to the patients, parents, and caregivers, they do not have to travel long distances and risk being exposed to COVID-19.

Redirection of medical resources due to COVID

Under normal circumstances, childhood vaccinations in rural areas depend on DoH school visitations for vaccine administration, but resources, including medical personnel, have been redirected to COVID-19 response.

Schools have also turned their efforts to education-related learning catch-up programmes, leaving a service delivery vacuum of vaccinations in the process.

What is worrying is that the vaccination of girls who turn nine years of age should be receiving immunisation against cervical cancer as part of the school health programme.

Another major concern is the sharp decrease in the coverage rate of the second dose of the measles vaccine from 77% in April 2019 to 55% in April 2020. Protecting communities and health workers in high-risk Covid areas should not mean that children are permanently affected.

Launched in June 2021, implementation of the IUVSA project has begun in Limpopo (Ga-Sekororo and Sekgosese) and Eastern Cape (Nelson Mandela Bay), targeting 9000 children between 0-12 years old over a period of five months. The programme will address routine vaccinations such as BCG, measles, mumps, rubella, and polio.

Closing the communication gap

Areas being targeted have been chosen based on lack of service delivery, hard-to-reach health care facilities, outdated information, and widespread myths about COVID-19 within the community.

There is a communication gap in these areas, which are the main areas to target to significantly increase access to childhood vaccination.

Government campaigns are usually television focussed, so they are not reaching the people who really need to be reached. Our job now involves a rigorous communication effort with communities at grass root level.

The IUVSA project will involve leveraging established World Vision South Africa platforms and models already in place and apply them to childhood vaccination campaigns in local languages (Sepedi, Sotho, Zulu, and Xhosa).

A key differentiator of this project is that information is not pre-packaged, but rather derived through assessment and area analysis to determine the level of consistency and compliance with vaccine uptake within communities.

Information is then adapted to suit the demographic, and language and cultural sensitivities so that we can have a higher success rate of behaviour change.

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