23 July 2018

Kenya: Alarm As Children Miss Vaccines Due to Health Workers' Strikes

A prolonged health workers strike last year has cost the country its gains in immunisation coverage, exposing children under one year to polio, pneumonia and tuberculosis.

Statistics from the Ministry of Health show that the gains made in improving immunisation uptake have sharply declined in many counties in the past three years.

The ministry said that by last year, out of 864,619 recorded births countrywide, only 65 per cent of the children underwent full immunisation, with 76 per cent recorded for a vaccine primarily used against tuberculosis, BCG (Bacillus Calmette-Guérin).


According to the Economic Survey 2018, the coverage dropped from 1,101,279 (69 per cent) immunised children in 2016 to 1,014,894 (63 per cent) in 2017.

The 2017 figure is the lowest coverage since 2005, when it stood at the same level.

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According to the Nyandarua Director of Health Services, Kariuki Gichuki, the number of unimmunised children in the county and the country as a whole had continued to increase every year.

"This predisposes the county and country to outbreaks of vaccine-preventable diseases. It's easier and cheaper to immunise children than to treat them of the diseases," Dr Kariuki said.

He gave the example of measles treatment, saying the budget was enough to vaccinate about 100 children.

According to the data, the worst immunisation rate was recorded in June last year, when the nurses' strike began, recording a 46 per cent coverage. This forced the ministry to offer crash vaccine services after the four-month strike.

Healthcare services in all the public facilities ground to a halt last year when nurses went on strike between June and November for 152 days. The industrial action came hot on the heels of the doctors' strike, which began on December 5, 2016, and ended on March 14, 2017.

Consequently, nearly 500,000 children were not vaccinated against some of the world's most debilitating diseases such as polio, pneumonia, meningitis, measles, influenza and hepatitis.


In an overall analysis, 21 counties registered above the projected 10 per cent dropout rate in the immunisation coverage last year.

Data from the Division of Vaccines and Immunisation and The District Health Information System indicate that by last year, a majority of counties did not meet their target coverage in the provision of the Penta 1 and Penta 3 (Pentavalent) immunisations, which are given to children to protect them against multiple diseases.

Pentavalent is a mandatory vaccine introduced in 2002 for all children. It is given in three doses to protect a child from five life-threatening diseases: Diphtheria, pertussis, tetanus, hepatitis B and haemophilus influenzae type b. Mandera County trailed at 30 and 35 per cent coverage in Penta 1 and Penta 3 coverage, respectively. Kiambu led in Penta-3 at 100 per cent.


Other routine vaccines introduced afterwards include PCV 10 in 2011, measles second dose in 2013, Rota Virus in 2014, Immunised Polio Vaccine in 2015, while in 2016, the ministry switched from measles only to measles-rubella, which are all performing dismally.

In Nyandarua County, the measles vaccine coverage reduced from 15, 429 in 2014 to 12, 248 in 2017.

According to Dr Kariuki, the statistics are a wakeup call to all to vigorously create awareness and reach out to immunisable children.

"The body has its own immune system; the importance of routine immunisation is that it helps the body to produce antibodies, which prepare it to fight preventable diseases," he said.

To mitigate the challenge in the county, the Department of Health is using mobile phone alerts sent to mothers a day before the immunisation date.


"What we are doing is to document the mothers' mobile phone numbers at delivery then computerise the due dates for an automatically generated alert," said Dr Kariuki.

Ms Jane Njeri, a community health educator, says some of the immunisable diseases have no cure while others cause permanent disabilities, or studded growth.

"Some of the preventable diseases such as tuberculosis are expensive and time consuming to treat. Diarrhoea is also a big challenge for our children, yet it is also immunisable," said the health educator. She advised parents to adhere to the Mother-Child booklet, which contains information on pregnancy, delivery and post-partum course, immunisation, nutrition and other data to monitor the child.


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