Mozambique’s grand plan to reach more than 750,000 unimmunised children in 2024

A cocktail of disasters, from COVID-19 to Cyclone Freddy, has led to a precipitous increase in unimmunised children in Mozambique. This month they launched a new plan to turn things around.

20 December 2023
4 min read
by Collins Mwai
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<article> <h1> <span>Mozambique’s grand plan to reach more than 750,000 unimmunised children in 2024</span> </h1> <div><p>A cocktail of disasters, from COVID-19 to Cyclone Freddy, has led to a precipitous increase in unimmunised children in Mozambique. This month they launched a new plan to turn things around. </p></div> <ul> <li> <b>20 December 2023</b> </li> <li> <b class="me-2">by</b> <span> <a href="https://www.gavi.org/vaccineswork/authors/collins-mwai" hreflang="en">Collins Mwai</a> </span> </li> </ul> <figure> <img src="https://www.gavi.org/sites/default/files/vaccineswork/2023/Header/RS32436_PIC00230_h1.jpg" width="1080" height="720" alt="A mother and her child at a community health outreach session in a rural area north-west of Maputo. Credit: Gavi/2020/Svetlomir Slavchev" loading="lazy"> <figcaption>A mother and her child at a community health outreach session in a rural area north-west of Maputo. Credit: Gavi/2020/Svetlomir Slavchev</figcaption> </figure> <div> <div> <div> <div> <div> <p> </p><p>Mozambique's tally of unimmunised children has risen to 750,000 from about 97,000 in 2019 – a consequence of a cocktail of disasters, including COVID-19, Cyclone Freddy, and outbreaks of cholera, polio and measles. But earlier this month the country's Ministry of Health unveiled a grand plan to reach them all with lifesaving vaccines.</p><p>Speaking at a press conference following December's Gavi Alliance High Level Visit to Mozambique, Minister of Health Dr Armindo Daniel Tiago detailed a comprehensive new roadmap resulting from the extensive discussions and technical sessions of the preceding days.</p><blockquote><h2>“The commitments cannot be realised without everyone’s commitment. We therefore call on Gavi to guarantee to help the country to access new vaccines, including the malaria vaccine, the cholera vaccine, the hepatitis B vaccine at birth, the hexavalent vaccine, the typhoid vaccine, among others that justify their introduction in the country, taking into account our epidemiological profile.”</h2><h6>– Dr Armindo Daniel Tiago, Minister of Health</h6></blockquote><p>Central to the strategy is the execution of three rounds of Periodic Intensification of Routine Immunization (PIRI) campaigns – comprising time-limited, specially targeted activities – to reach the 750,000 so-called <a href="https://www.gavi.org/vaccineswork/zero-dose-child-explained">"zero-dose" children</a>.</p><p>"We recognise the importance of our partnership with Gavi and remain committed to swiftly implementing the recovery plan for zero-dose children," emphasised the minister. The plan aims not only to expedite immunisation but also to serve as an exemplary model for other nations facing similar challenges," he said.</p><p>Since 2022, Mozambique has found itself on an unenviable roster: the ten countries worldwide that are home to the highest numbers of unimmunised children. The aim of the current plan, in part, is to change that.</p><p>Initial doses for the recovery plan are set to arrive in the country before the end of 2023, with the roll-out expected to kick off in January 2024, targeting children 0–59 months.</p><div><h4>Have you read?</h4><ul><li><a href="https://www.gavi.org/vaccineswork/how-major-typhoid-vaccine-campaign-helped-nepal-find-missed-out-zero-dose-kids" data-entity-type="node" data-entity-uuid="276c0bb1-b945-4228-9b45-6b07bd7c9bff" data-entity-substitution="canonical" title="How a major typhoid vaccine campaign helped Nepal find missed-out “zero-dose” kids">How a major typhoid vaccine campaign helped Nepal find missed-out “zero-dose” kids</a></li><li><a href="https://www.gavi.org/vaccineswork/tracking-zero-dose-children-slums-cameroon" data-entity-type="node" data-entity-uuid="95fd05f5-5d53-4053-9bf4-73a087493668" data-entity-substitution="canonical" title="Tracking zero-dose children in the slums of Cameroon">Tracking zero-dose children in the slums of Cameroon</a></li><li><a href="https://www.gavi.org/vaccineswork/routine-immunisation-guinea-mountain-climb-find-zero-dose-children" data-entity-type="node" data-entity-uuid="0c9eed59-9480-495f-8460-42e7a0221a01" data-entity-substitution="canonical" title="Routine immunisation in Guinea: A mountain to climb to find zero-dose children">Routine immunisation in Guinea: A mountain to climb to find zero-dose children</a></li></ul></div><p>The new roadmap also stipulates the introduction of a suite of operational adjustments, including weekly monitoring of progress by the Ministry of Health leadership and updates to the ministry on the intensified efforts as well as measures to reduce the customs clearance time for vaccines entering the country.</p><p>"We would like to inform you that the challenge [of vaccine clearances at customs] was already identified and measures have been taken to overcome this delay from January onwards. We have taken steps to reduce the green light time from 15 to 3 days," he noted.</p><p>Further adjustments, the minister said, will be made in data management. The ministry is piloting a digital children's register to improve data quality and ensure accurate immunisation records.</p><p>The plan also calls for support by Gavi and Alliance partners, with the minister urging partners to take up a role in ensuring allocation of and access to vaccines, especially for routine immunisation.</p><p>"The commitments cannot be realised without everyone's commitment. We therefore call on Gavi to guarantee to help the country to access new vaccines, including the malaria vaccine, the cholera vaccine, the hepatitis B vaccine at birth, the hexavalent vaccine, the typhoid vaccine, among others that justify their introduction in the country, taking into account our epidemiological profile," he said.</p><p>Beyond just catching up those 750,000 most at-risk children, the country is also planning to build long-term resilience in health with investments in the cold chain, modern logistics systems, expanded vaccination infrastructure as well as by strengthening community health sub-systems for immunisation services in remote communities.</p><p>Speaking at the same briefing, Gavi CEO David Marlow committed on behalf of partners to support Mozambique's 2024 catch-up sprint.</p><p>"It is in the spirit of listening and really hearing what the country [has] planned," he said. "I am confident that the cooperation that we have had since 2001 – with a total investment of over US$ 600 million – can continue to flourish with the immunisation of the children of Mozambique."</p><p>Despite constraints and competing priorities, in recent years, Mozambique has achieved several milestones. The current plan, which makes Mozambique one of the first countries to develop a recovery plan to catch up children who missed vaccinations during the COVID-19 pandemic period and to strengthen health systems, ranks among them.</p><p>Mozambique has also successfully responded to polio and cholera outbreaks, rolled out measles-rubella vaccination campaigns; and has made important steps towards shifting from cholera outbreak response to longer-sighted preventive efforts.</p> </div> </div> </div> </div> </div> <p> <a target="_blank" rel="noopener noreferrer" href="https://www.gavi.org/vaccineswork/mozambiques-grand-plan-reach-over-750000-unimmunised-children-2024">Original article</a> </p><p>This article was originally published on <a target="_blank" rel="noopener noreferrer" href="https://www.gavi.org/vaccineswork">VaccinesWork</a> </p><script>(function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start': new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0], j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src= 'https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f); })(window,document,'script','dataLayer','GTM-M7H54VD');</script><noscript><iframe src="https://www.googletagmanager.com/ns.html?id=GTM-M7H54VD" height="0" width="0" style="display:none;visibility:hidden"></iframe></noscript></article>

A mother and her child at a community health outreach session in a rural area north-west of Maputo. Credit: Gavi/2020/Svetlomir Slavchev

Mozambique's tally of unimmunised children has risen to 750,000 from about 97,000 in 2019 – a consequence of a cocktail of disasters, including COVID-19, Cyclone Freddy, and outbreaks of cholera, polio and measles. But earlier this month the country's Ministry of Health unveiled a grand plan to reach them all with lifesaving vaccines.

Speaking at a press conference following December's Gavi Alliance High Level Visit to Mozambique, Minister of Health Dr Armindo Daniel Tiago detailed a comprehensive new roadmap resulting from the extensive discussions and technical sessions of the preceding days.

“The commitments cannot be realised without everyone’s commitment. We therefore call on Gavi to guarantee to help the country to access new vaccines, including the malaria vaccine, the cholera vaccine, the hepatitis B vaccine at birth, the hexavalent vaccine, the typhoid vaccine, among others that justify their introduction in the country, taking into account our epidemiological profile.”
– Dr Armindo Daniel Tiago, Minister of Health

Central to the strategy is the execution of three rounds of Periodic Intensification of Routine Immunization (PIRI) campaigns – comprising time-limited, specially targeted activities – to reach the 750,000 so-called "zero-dose" children.

"We recognise the importance of our partnership with Gavi and remain committed to swiftly implementing the recovery plan for zero-dose children," emphasised the minister. The plan aims not only to expedite immunisation but also to serve as an exemplary model for other nations facing similar challenges," he said.

Since 2022, Mozambique has found itself on an unenviable roster: the ten countries worldwide that are home to the highest numbers of unimmunised children. The aim of the current plan, in part, is to change that.

Initial doses for the recovery plan are set to arrive in the country before the end of 2023, with the roll-out expected to kick off in January 2024, targeting children 0–59 months.

Have you read?

The new roadmap also stipulates the introduction of a suite of operational adjustments, including weekly monitoring of progress by the Ministry of Health leadership and updates to the ministry on the intensified efforts as well as measures to reduce the customs clearance time for vaccines entering the country.

"We would like to inform you that the challenge [of vaccine clearances at customs] was already identified and measures have been taken to overcome this delay from January onwards. We have taken steps to reduce the green light time from 15 to 3 days," he noted.

Further adjustments, the minister said, will be made in data management. The ministry is piloting a digital children's register to improve data quality and ensure accurate immunisation records.

The plan also calls for support by Gavi and Alliance partners, with the minister urging partners to take up a role in ensuring allocation of and access to vaccines, especially for routine immunisation.

"The commitments cannot be realised without everyone's commitment. We therefore call on Gavi to guarantee to help the country to access new vaccines, including the malaria vaccine, the cholera vaccine, the hepatitis B vaccine at birth, the hexavalent vaccine, the typhoid vaccine, among others that justify their introduction in the country, taking into account our epidemiological profile," he said.

Beyond just catching up those 750,000 most at-risk children, the country is also planning to build long-term resilience in health with investments in the cold chain, modern logistics systems, expanded vaccination infrastructure as well as by strengthening community health sub-systems for immunisation services in remote communities.

Speaking at the same briefing, Gavi CEO David Marlow committed on behalf of partners to support Mozambique's 2024 catch-up sprint.

"It is in the spirit of listening and really hearing what the country [has] planned," he said. "I am confident that the cooperation that we have had since 2001 – with a total investment of over US$ 600 million – can continue to flourish with the immunisation of the children of Mozambique."

Despite constraints and competing priorities, in recent years, Mozambique has achieved several milestones. The current plan, which makes Mozambique one of the first countries to develop a recovery plan to catch up children who missed vaccinations during the COVID-19 pandemic period and to strengthen health systems, ranks among them.

Mozambique has also successfully responded to polio and cholera outbreaks, rolled out measles-rubella vaccination campaigns; and has made important steps towards shifting from cholera outbreak response to longer-sighted preventive efforts.