Why Polio Cases Persist in Nigeria

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Vaccination team members administering vaccine to children

Ignorance of parents, culture, Islamic fundamentalism and insecurity among others work against governments’ efforts to rid the country of polio and other killer childhood diseases

By Chinwe Okafor  |  Sep. 2, 2013 @ 01:00 GMT

EZE Nduka, a three-year old boy, played happily in front of his parents’ house. The peal of his laughter and the gaiety with which he threw the ball around, left no one in doubt that he was a child contented with his world. His grandmother almost a yard apart sat on a bench under a mango tree and watched him in silence as he played. Suddenly, the boy looked up and saw the vaccination team coming, he took to his heels and on reaching where his grandmother sat, he hurled himself around her.

The old woman held him firmly and very tight and with the weird look on her face, shouted a resounding no to the vaccination team that were already close to her. She wouldn’t even listen to the vaccination team that tried to educate her on the benefits of the vaccine. As two women who lived in the same compound saw the situation of things, they quickly rushed to her, spoke to her in a native dialect and the situation changed immediately. The old woman released her grandson and he was vaccinated.

The situation is not so with Amara Ofoegbu, a school teacher and mother of four, who said that she enjoys immunising her children because she knows the benefit of such vaccines. “I have always given my children oral polio vaccine because I know it is good and healthy to their body. I even take it upon myself to educate and enlighten young mothers who are still new into the system,” she said.

Mother shows off baby to be vaccinated
Mother shows off baby to be vaccinated

Unfortunately, Nigeria is still among the polio-endemic nations of the world simply because of new polio cases arising from the Northern parts of the country. Without vaccination, it is obvious that there could be more new polio cases because the nation presently has over 100 cases of polio. Even one case of polio is a threat to the entire nation. For instance, 11-month old Zarau Audu, may not be able to walk well when she grows up because she already faces the daunting prospect of being physically challenged throughout life.

Aishetu Audu, her mother, is obviously unaware of the predicament she has placed her daughter in. “I allowed my two other children to be immunised twice during the immunisation campaigns but I never bothered to give that privilege to Zarau because I wanted the will of Allah to be done in her life but I didn’t know it would result to a situation like this. I have learnt my lessons though but it came in a hard way,” she said.

The manner in which some parents shun the immunisation of their babies is not a welcome idea to eradicating the killer diseases amongst children. Abdullahi Bala Magaiba, north west coordinator, National Primary Health Care Development Agency, NPHCDA, who over sees all the immunisation activities in the states of Zamfara, Sokoto, Jigawa, Kebbi, Katsina, Kano, Jigawa and Kaduna, said that many parents give reasons why their children have not been vaccinated earlier. “These excuses are giving us headaches because the government is investing so much to see that these killer diseases are wiped out in the country but what is the need if the people do not value it? We must not waste public funds procuring vaccines and then people don’t go to receive them,” Magaiba said.

Rotimi Adesanya, child and public health specialist, said that vaccinations prevent childhood killer diseases, namely pneumonia, diphtheria, polio, tetanus, tuberculosis, measles and whooping cough. He also noted that babies must be vaccinated against rotavirus, hepatitis B and influenza.

Polio affected children
Polio affected children

President Goodluck Jonathan, has given an assurance that his administration is committed to eradicating polio from Nigeria by 2015. He expressed appreciation for Australia’s pledge of 50 million dollars to support Nigeria’s polio eradication programme.

The country is still faced with so many other challenges militating against polio eradication. Nigeria witnessed the worst threat to its campaign on polio eradication during its last national immunisation campaign in February when seven polio vaccinators were brutally murdered in Kano State. In spite of previous enlightenment programmes on the benefits of polio vaccination, Islamic fundamentalists still succeeded in confusing people and inciting them to kill the vaccinators. There is still the problem of shortage of vaccines and cases of missed children and resistance.

During the last immunisation exercise, some states also ran out of polio vaccines. For instance, in Osun State, what was available could only meet 85 per cent of the quantity required. The state vaccinated only 98,000 children out of its target audience of 104,000. Adebola Adeosun, state immunisation officer, said that the state government tried its best to fully support the immunisation campaign by funding it and mounting enlightenment campaigns towards its success but inadequate vaccine was a challenge as the vaccinators had to stop when there were no longer vaccines.

Tommi Laulajainen, chief of communication, UNICEF Nigeria Country Office, said that children who are absent when vaccination teams visit are usually at playgrounds, which are usually not far from their homes, or they may be at social events, which often take place in or near the household. He, however, said that non-compliance was the reason missed children remained high during IPDs in some parts of Nigeria. “Nationally, caregivers’ refusal to vaccinate their children account for 24 per cent of the total number of missed children during campaigns. States like Borno, 41 percent, Yobe, 38 per cent and Katsina, 24 per cent still have a high proportion of unresolved non-compliance even after revisit teams have gone back to the households refusing vaccination in the first place,” he said.

Vaccination in progress
Vaccination in progress

While the proportion of missed children has shown a slightly decreasing trend in the last three rounds of immunisation plus days with 8.0 percent in December, 2012, 7.8 percent in February and 7.8 percent in March, the data analysis shows that Kano has the highest percentage of missed children 9.8 percent followed by Kebbi 9.7 percent and Jigawa 8.5 percent. The world body explained that child absence remained the main reason for missed children, accounting for more than 66 percent of the total number of missed children.

Meanwhile, the European Union, EU, has signed an N11.75billion memorandum of understanding, MOU, with the National Health Care Development Agency, the National Planning Commission and the 24 implementing states for routine and polio immunisation in Nigeria. Anthony Ayeke, the health programme manager, EU delegation to Nigeria, said the project was part of EU’s support for immunisation and good governance in Nigeria.

He said that the participating states were selected on the basis of their successful implementation of the past EU projects in their domains. Ayeke disclosed that a higher part of the money which was mapped out was for routine immunisation, while the other part was for polio immunisation. He added that all the legal requirements for smooth implementation had been taken into consideration. “The EU is out to assist the FG to reduce child morbidity/mortality, as well as the wild polio virus that is still ravaging the country. The EU would launch one technical assistance in each of the implementing states to assist in the smooth implementation of the project,” he said.

Bassey Akpanyung, director of the international cooperation, National Planning Commission, said the commission was involved because the EU-SIGN programme had the capacity to improve the health status of Nigerians. “The Federal Government has always found a good partner in the European Union, particularly in health-related issues such as immunisation and polio eradication. Government shall give the programme all the necessary support it deserves,” he said.

The 23 implementing states and the Federal Capital Territory were chosen from the six geo-political zones of the country. The states include Abia, Ebonyi, Osun, Anambra, Kogi, Gombe and Cross River.

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