“Equity is a key concern. Covid-19 is having the greatest impact on communities that are already vulnerable and marginalized, especially those with high levels of disease and less access to essential health services. The principles of universal health coverage (UHC) are still valid in the event of a pandemic; we must meet the health needs of the most vulnerable at all times.
The above words of Dr Alex Gasasira, World Health Organization (WHO) Representative in Zimbabwe, are in line with the efforts of Village Health Workers (VHWs) to tackle the resurgence of killer childhood diseases in order to meet the full scale of herd immunity.
The primary role of these village health workers is to advocate for underserved individuals or communities to receive services and resources to meet health needs.
Village health workers collect data and relay information to stakeholders to inform programs and policies. They also provide informal counseling, health screenings and referrals and build community capacity to address health issues.
ASVs are essential because they help alleviate the enormous burden of epidemics and pandemics on health systems around the world.
A recent visit to Mahusekwa District Hospital and Chihota Rural District Hospital in Mashonaland East revealed that these workers have a bigger role to play in complementing the efforts of the Ministry of Health and Care. of children with respect to health care delivery systems.
The Chief Medical Officer of Marondera District, Dr Delight Madoro, said there were positive achievements thanks to the support of VHWs. “We are quite happy with the number of children who are vaccinated against measles, the parents are now open and they no longer hide their children in houses because the majority now understand the negative consequences of avoiding vaccinations. They have seen death in their communities.
“We commend the VHWs for making them aware of the importance of vaccination. They go door-to-door to encourage communities to adopt health-promoting behavior.
“More so, they reach hard-to-reach areas using their bikes. They were trained in good communication skills, which enabled them to be accepted by some members of the apostolic sects who were unwilling to participate in the vaccination campaign, which saw 86% of children in Mashonaland East get vaccinated during the Expanded Program on Immunization (IEP),” he said.
Dr Madoro said that in the first days of the first measles and rubella vaccination campaign, they managed to vaccinate 25,984 children against a target of 30,376, which translates to a percentage of 86%. and that it has not been an easy journey to get there. due to some communities being hesitant to get vaccinated.
“We managed to collect samples from all 80 suspected cases and have so far received 27 results pending the remaining difference,” he said. “Of the 27 results, six of them were positive for measles, which is why we comment on the remarkable efforts of the VHWs.”
Dr Madoro said 80 suspected measles cases were reported by VHWs and they managed to quarantine the suspects to minimize the spread of the disease.
“With trainings on prevention and appropriate infection control measures, the ASVs are also good examples of how to prevent measles and polio in the communities they serve,” he said.
“In Marondera district, we have a robust immunization program where we see children vaccinated in all our health facilities.
“However, we have heard of about 12 unreported cases of children suspected of having died from measles, mainly due to some religious groups who are still reluctant to seek treatment at health facilities.
“Therefore, it is the duty of the media and CWHs to educate communities about the importance of vaccinations so that they save lives and do not affect their religious and traditional beliefs in any way. These cases have not been confirmed; therefore, they remain speculation,” he said.
Dr Madoro said measles can be prevented and treated if people get to health facilities in time. “Measles is a serious disease caused by a virus and is normally transmitted through direct contact with an infected person and through infected air. Anyone who has never had measles before and has not been vaccinated can get it. Unvaccinated children under five are at greater risk of measles and its complications, including death. Unvaccinated pregnant women are also at risk,” he said.
Marondera district nurse, Mrs. Marian Fadzi, said people were still coming for vaccinations and most of them belonged to apostolic sects. The Acting Sister in Charge of Chihota Rural District Hospital, Mrs. Evelyn Zvomuya, said that they are targeting influential people in the apostolic sects for their sensitization campaigns.
“We have taken the participatory approach in disseminating information, through the identification of one or two members of an apostolic church who will then go and encourage others to have their children vaccinated,” she said. declared.
“Thanks to the intervention of the CHWs, we exceeded our target of 85% vaccination and we are now at 124%.”
Community health worker Mrs Easter Bonda said they were working with local leaders to mobilize people to get their children vaccinated. “We work as community advocates, conducting outreach and community engagement activities for public health programs and providing health education and services,” she said.
“During this measles outbreak, we championed the vaccination campaign while working closely with chiefs, village leaders and nurses in our area.
“We even accompany some members of the community to the nearest health facilities, which is why we have ‘baptized and converted many’.”
Chihota community health worker Mrs Beaullah Chipeni (62) said she was trained by the Ministry of Health and Child Welfare and other partners to generate and use data to take informed decisions and improve access to essential health services.
“During our community information dissemination programs, we educate people on how measles is spread through coughing and sneezing or direct contact, which is why we encourage the quarantine of sick people and the importance of seeking emergency care in health facilities so that we don’t end up having everyone in the community infected,” she said.
“Signs of measles include a hot body, a rash that starts on the forehead, neck then covers the whole body and runs from the nose and eyes, red eyes, diarrhea and white patches in the mouth . If not treated early, the child can develop a severe cough, pneumonia, blindness, deafness and malnutrition and this can lead to death.
Ms Naomi Mangwanya, who had gone to Mahusekwa hospital to have her twin children vaccinated against measles and polio, said she was motivated by village health workers.
“The CHWs in our communities are the ones who told us that the vaccination program is still going on at the hospital and in the local clinics,” she said. “Some assumed the program was over, therefore, we thank them for bringing the messages right to our doorstep.
“Due to the escalation in the use of social media, people are sending out false information, but VWHs are trusted because we know they work closely with nurses and stay in our communities. We have seen deaths in our communities and it also pushes so many parents to adhere to the primary vaccination course for children which should be completed before their first birthday,” she said.
The Executive Director of the Community Health Task Force, Mr Itai Rusike, said the principles of universal health coverage are based on equitable and resilient health systems.
“The empowerment of ASVs is crucial to maintaining availability and access to essential health services. When people have the right information at the right time, it makes all the difference in saving lives, providing treatment and preventing disease,” he said.
“Health systems monitoring and analysis, followed by practical support, is essential to the decision-making process throughout the health system. It cultivates good health-seeking behavior and saves lives. A good example is what was happening in the province of Manicaland where some members of the apostolic sect were reluctant to have their children vaccinated. Several tactics have been employed including the use of VHW and we are now seeing a positive reduction in cases and deaths,” he said.
Members of the Apostolic sect, who previously opposed vaccination, are now bracing for the ongoing measles vaccination blitz after the disease killed more than 500 people and affected more than 2,000 others.
The measles outbreak was first recorded in Manicaland province on April 10, 2022 and has since spread across the country and is contained through various government interventions.
The government launched a nationwide polio immunization blitz targeting under-fives from October 27-30 in the first phase of the campaign, with the second phase starting from December 1-4.
Zimbabwe has successfully eliminated polio, with the last case detected in 1989, while the World Health Organization certified the country polio-free in 2005.
The World Health Organization (WHO) Zimbabwe, with support from the Universal Health Coverage Partnership, worked closely with the Ministry of Health and Child Welfare and provided technical assistance to strengthen delivery of essential health services in rural, district and provincial health facilities — before and during the Covid-19 pandemic and outbreaks such as measles, cholera, poliomyelitis, among others.