From the cold chain to children in hard-to-reach areas
Following a presidential declaration of a national public health emergency, after Malawi confirmed a case of wild poliovirus in February, UNICEF Malawi supported the Ministry of Health to immediately procure and distribute 6.9 million polio vaccine doses for approximately 2.9 million children under the age of five in Malawi.
To ensure that vaccines are safe and accessed by all under-five children regardless of their geographical location, UNICEF assisted the Ministry of Health to install 223 new vaccine refrigerators, repair 51 vaccine refrigerators and distribute 200 vaccine carriers and 38 cold boxes to health centres across the country in preparation for the mass vaccination exercise.
“For the success of this programme, the use of potent and safe vaccines is of utmost importance. To ensure all health centres have the vaccines and that Health Surveillance Assistants carry the doses deep into hard-to-reach areas, it is recommended that ice-lined refrigerators, deep freezers, and refrigerators maintain a temperature of ≥2° to ≤8° centigrade for Oral Polio Vaccines, hence the significance of ensuring a smooth cold chain linkage from the central source to the last beneficiary," said Ghanashyam Sethy, UNICEF Malawi Health Specialist.
Malfunctioning compressors and gas leakages have been key issues that made some refrigerators cease to operate, as reported at the Lilongwe District Health Office.
Repairs of the refrigerators have helped us to have adequate ice banks to help transfer the vaccines to remote areas without compromising on the recommended low temperatures at health facilities," explained Boston Gwaluka, Cold Chain Technician for the Lilongwe District Health Office at Bwaila.
The Lilongwe District Health Office has a catchment area of 60 health facilities catering for both urban and rural parameters of the district.
UNICEF supported the repair of three refrigerators, each of which keeps up to 50,000 doses of the polio vaccine.
"We keep monitoring temperatures of the refrigerators manually every morning and evening using the fridge tag. This helps us keep in check the performance and condition of the refrigerators," Gwaluda said.
Mitundu Community Hospital, located on the outskirts of Lilongwe District, is one of the facilities that got polio vaccines from the District Health Office. It caters for 13 clinics in the polio vaccination national campaign.
Agnes Mzazila, one of the 47 Health Surveillance Assistants at Mitundu, highlights how they beat the odds of poor transportation and compromised road network to ensure that vaccines reach communities in the villages.
"Equipped with portable cold boxes, we mostly use private push bikes, motorcycles and sometimes minibuses as means of transport to reach out to the 22 sites we have on target. Despite the nature of the roads, and distances within our catchment areas, we ably administer the vaccine preserved at the recommended temperature. The cold boxes perfectly maintain the temperatures of the vaccine from our health centre," she elaborated.
Adds Mceston Kachipapa, a Senior Health Surveillance Assistant, "Despite challenges, in terms of mobility, the vaccine is well preserved and taken to under five children in hard-to-reach areas. The effectiveness of an uninterrupted cold chain is key to making the oral polio vaccination campaign a success."
Lilongwe District Health Office targets to vaccinate 407, 000 under-fives against polio. Malawi just finished its second phase of the polio vaccination campaign in April. Meanwhile, all unused vaccines are collected and kept safely at the central district point of collection.
Round three of the polio vaccination campaign commences in June.
Polio is a highly infectious viral disease, which mainly affects young children under the age of five. The poliovirus enters the body through the mouth when eating food or drinking water that is contaminated with faecal matter from a person who carries the poliovirus.
Initial symptoms of polio include fever, fatigue, headache, vomiting, stiffness in the neck, and pain in the limbs. In a small proportion of cases, the disease causes paralysis, which is often permanent. A polio outbreak can spread rapidly.
There is no cure for polio. Vaccination is the only way to stay protected against this deadly disease.
UNICEF, WHO and other partners of the Global Polio Eradication Initiative - Gavi, Bill and Melinda Gates Foundation, Rotary and Centers for Disease Control and Prevention are supporting the Ministry of Health to vaccinate all children under the age of five in four mass vaccination campaigns.