Model immunisation system sets standard for Mozambique

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As Mozambique makes preparations to introduce pneumococcal vaccine with GAVI support, the Manhica district’s immunisation system is setting an example that the Ministry of Health wants the nation’s other 127 districts to follow.

14 March 2012

00 Mozambique health workers
Eva-Lotta Jansson/GAVI/2012

Manhica's local health workers register and track each child vaccinated at the mobile session. A mother and her child talk with a male health worker in the cool of the shade in their makeshift clinic.

01 People at Manhica district hospital
Eva-Lotta Jansson/GAVI/2012

It’s the rainy season and one in five children brought to the Manhica district hospital, 70km north of Maputo, have severe pneumonia. Like the rest of Mozambique’s 23 million population, Manhica bears the burden of a series of deadly diseases: pneumonia, diarrhoea, malaria, TB and HIV.

02 mums wait for babies to receive a 1st dose of pentavalent
Eva-Lotta Jansson/GAVI/2012

The local immunisation system is the first line of defence. Four mums wait for their three-month-old babies to receive a 1st dose of pentavalent; the multivalent vaccine, funded by GAVI, stops haemophilus influenzae type b, the 2nd most common cause of pneumonia deaths in Under-5’s.

03 Mobile clinics in Manhica province
Eva-Lotta Jansson/GAVI/2012

In Manhica district, the local health system runs mobile clinics to ensure life-saving vaccines reach even the remotest village. Today, NGO Village Reach has brought vaccines from Maputo to the Maragra health centre, ready for distribution at Bairro Macendzele, 10 km away.

04 Checking vaccines
Eva-Lotta Jansson/GAVI/2012

Cecilia Salina Vasco Saudoso Mandlate, a field coordinator at the provincial health ministry, double-checks that the right vaccines, which include measles, polio and pentavalent, have been delivered for the right place.

05 Loading vaccines into a health ministry vehicle
Eva-Lotta Jansson/GAVI/2012

The vaccines are then loaded into a health ministry Land Rover. With temperatures in excess of 30 degrees, the precious cargo is stored in a large cold box packed with ice.

06 Road to Bairro Macendzele
Eva-Lotta Jansson/GAVI/2012

At midday, the Land Rover sets-off along the bumpy road to Bairro Macendzele. In January, at the height of Mozambique’s rainy season, these sandy tracks flood and are almost impassable.

07 Bairro Macendzele local school playground
Eva-Lotta Jansson/GAVI/2012

At Bairro Macendzele, the local school’s playground and the shade of a baobab tree form the backdrop for a monthly mobile clinic.

08 Health workers attend a flow of patients
Eva-Lotta Jansson/GAVI/2012

Health workers, seated at chairs and tables borrowed from the school, attend a flow of patients. Most are mothers and babies waiting for immunisation but today 82-year-old village elder Albertina Macic gets a dose of paracetamol from nurse Lidia Domingos Cossa to soothe a flu attack.

09 Rapid malaria test on Abilio Elias Macie
Eva-Lotta Jansson/GAVI/2012

With a high fever, six month-old Abilio Elias Macie cannot receive his second dose of pentavalent. Jose Joaquim Freita Nhavotho performs a rapid malaria test for which Abilio tests positive and is put on a course of anti-malaria medicine.

Mothers head back to their villages
Eva-Lotta Jansson/GAVI/2012

After three hours, the mobile clinic is finished and mothers head back through the banana trees and coconut palms to their villages.

10 Loria Albino has her weight checked
Eva-Lotta Jansson/GAVI/2012

Loria Albino, aged two-and-a-half, has her weight checked. Like their counterparts in developed countries, Manhica’s local health workers take advantage of vaccination clinics to check-up child and maternal health.

11 Immunisation cards keep track of vaccinations
Eva-Lotta Jansson/GAVI/2012

Whether attending the Manhica District Hospital, Maragra health centre or a mobile clinic, immunisation cards help keep track of children’s vaccinations throughout the district – as well as the efficacy of each vaccine.

14 Local support
Eva-Lotta Jansson/GAVI/2012

When Madino Simao Mazie, pictured with his nine-year-old daughter Fausia, lost his first child to malaria in 2004, he volunteered to help the mobile clinic. Now, like the Manhica district immunisation system, he represents an inspiring example to Mozambique’s other 127 districts.

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