Measles, malaria and motorbikes: Immunisation in Ghana
Edmund Atweri Duodo:
I was born in a village called Teacher Mante in the Eastern Region of Ghana. In 1988, measles, known in my local language as ‘Ntobro’, was a household name and believed to be a routine infection every child should have.
In my village, there wasn’t much known about immunization. We lacked a strong health system and the small amount of health workers we had needed more training. As a result I lost friends from measles and other, I now know, vaccine preventable diseases. I remember seeing people with paralysis of the leg as children and I did not even know it was polio.
Things have really changed since the 1980s.
Ghana has one of the highest essential immunisation rates in the world, and is one of the few countries in Sub-Saharan Africa with over 90% coverage with the measles vaccine. In the 1980s, measles used to be the second highest cause of death after malaria of children under 5. Now, across the whole country, only 19 measles cases were reported in 2017. A drop from over 23,0000 less than 20 years ago. Further, Ghana has not recorded any polio cases since 2013.
Vaccinations have proven to be one of the most important ways to protect and save lives in Ghana. Under five mortality has declined by more than two thirds since 1988, and this remarkable achievement would not be possible without dedication to reach every child with all their essential vaccines.
The Government of Ghana is a world leader on Immunisation. They have introduced all the WHO recommended vaccines (all with impressive coverage rates), and are currently one of the first countries to trial the malaria vaccine in six selected regions.
"Immunisation is the surest bet in preventing diseases in children. I reach out to hard to reach island communities in making sure no child is left behind."
One of the ways the Government of Ghana ensures every child is reached with vaccination is through their Community Based Health Planning Services (CHPS); this is where health services are provided in communities by trained Community Health Nurses. I became a Registered Community Health Nurse because I wanted to reach communities and prevent problems before they are started, instead of waiting to work with people once they were already sick. This passion grew due to the experience I had growing up. As a trained registered community nurse and a district CHPS Coordinator, I provide and support immunisation activities in over 200 communities (a population area of around 140,000 people) including hard to reach communities where accessibility is a major problem. The Kwahu Afram Plains South, one of the communities I am responsible for, is located at the basin of the Volta Lake, and there are island communities which can only be reached by boats. Further, some communities can only be reached by motorbikes because there are no proper roads. As community health nurses are based in the communities, we use all means of transport to trace unimmunized children through home visits to ensure all children are reached and vaccinated.
Support from Gavi, the Vaccine Alliance (Gavi) helps me in my role as a Community Health Nurse to ensure all children get all their vaccines. Not only has Gavi support allowed Ghana to introduce new vaccines, such as those which protect against pneumonia and rotavirus, at the same time as they were rolled out in higher income countries like the UK, Gavi support has ensured I have a motorbike to reach my hard to reach communities. The motorbike can move through bush roads, and can be loaded onto a boat, ensuring I can reach communities after crossing the river.
As a result of the Government prioritizing immunisation, and with support from Gavi, I no longer see cases of measles in my village. Children no longer die from diseases we can protect them from, and that is because vaccines work.
Edmund Atweri Duodu is a trained Registered Community Nurse in Ghana, a World Health Organization Primary Health Care Young Leader, a District Community Based Health Planning Services Coordinator at Kwahu Afram Plains South of the Ghana Health Service, and the Executive Director of Divine Mother and Child Foundation. He is an active member of the GAVI CSO immunisation platform Ghana. You can follow Edmund on Twitter: @edmundduodu