promotion of immunisation in uganda - republic of uganda

B o o k l e t f o r L e a d e r s

June 2 0 0 2

Promotion of

in UgandaImmunisation

Promotion of I m m u n i s a t i o n i n U g a n d a

“A healthy community is a

result of good leadership”

Immunisation promotes

the health status of the

community.

“As a responsible leader

ensure that all children

in your community

are fully immunised

on time.”

Promotion of I m m u n i s a t i o n i n U g a n d a 3

INTRODUCTION

The Immunisation Programme in Uganda has been in existencesince 1983 and was re-launched in 1987 by his Excellencythe President of Uganda. Leaders played a big role in mobilisingtheir communities for immunisation services.

This resulted in the achievement of high immunisation coverage,which was maintained until mid-1990s. However, a stagnationin the immunisation coverage was observed followed by adownward trend since 1995.

In 2001, 63% of children under the age of 1 year had notcompleted the immunisation schedule while others had not hadany immunisation at all.

This exposes our children to great risk of illness, disability anddeath due to eight childhood immunisable diseases (i.e. Polio,Measles, Tuberculosis, Diphtheria, Tetanus, Hepatitis B,Haemophilus influenzae type b and Whooping Cough).

In an effort to reverse the situation, the Ministry of Health hasembarked on intensive community mobilisation to promoteutilisation of immunisation services.

The success of immunisation services in this country greatlydepends on the participation of leaders in mobilising theircommunities for these services. We ask you for your supportin this effort.

Immunisation is a right of every child.

Promotion of I m m u n i s a t i o n i n U g a n d a

A C K N O W L E D G E M E N T S

The Ministry of Health - UNEPI wishes to acknowledgewith appreciation the immense contribution from communityleaders and partners in health for successful production ofthis booklet.

Special thanks go to UNICEF, WHO and DISH for thecontinued financial and material support that made this taska reality.

Technical contribution by the various non governmentorganisations, line Ministries, and Ministry of Healthdepartments deserve special mention and recognition.

2

P R E F A C E

This booklet has been developed to provide basic informationon immunisation for leaders to enable them mobilise theircommunities to promote and utilise immunisation services.

The booklet explains the importance of immunisation, thechildhood immunisable diseases and the roles of communityleaders in promoting immunisation services.

These community leaders include political, civic, traditional,religious, cultural and other opinion leaders.


IMMUNISATION COVERAGE IN UGANDA, 2001

KayungaWakiso

SsembabuleKanungu

PaderKampalaMayuge

BugiriMasaka

AruaGuluApac

NakapiripitRakai

KamwengeMubende

IgangaKaberamaido

BushenyiMbarara

KotidoKibogaLuweroKabaleYumbeKisoroTororo

KapchorwaNtungamo

LiraJinja

KitgumMpigi

MukonoKyenjojo

PallisaRukungiri

NebbiBundibugyo

MasindiKamuli

NakasongolaHoima

KibaaleMoyo

AdjumaniKabarole

KaseseBusia

MbaleKalangala

SironkoKatakwi

SorotiKumi

% COVERAGE120100806040200 140 160

PERCENTAGE OF CHILDREN UNDER ONE WHO HAVE HAD 3 DOSES OF DPT BY DISTRICT

SOURCE: MINISTRY OF HEALTH

Promotion of I m m u n i s a t i o n i n U g a n d a4

THE STATUS OFIMMUNISATION IN UGANDA

AAAAA The proportion of children who are fully immunisedhas been dropping since 1995, from 47% in 1995to only 37% in 2001.

BBBBB Most children (84%) receive one round ofimmunisations, but only 37% receive all five rounds.

CCCCC As many as 63% of mothers do not know whentheir child needs his or her next immunisations.

DDDDD Because of good commitment by leaders and healthworkers, some districts have maintained high levelsof immunisation, as shown by the graph on the nextpage.


II) IMMUNISATION SCHEDULE FOR WOMEN FOR TETANUS TOXOID (TT)

I) IMMUNISATION SCHEDULE FOR CHILDREN IN UGANDA

3. When should immunisation be carried out?

DISEASEPREVENTED

Girls and women 15-45 years oldGirls and women 15-45 years oldGirls and women 15-45 years oldGirls and women 15-45 years oldGirls and women 15-45 years oldand pregnant womenand pregnant womenand pregnant womenand pregnant womenand pregnant women VACCINE

At least 4 weeks after TT1

TT1

TT2

TT3

TT4

TT5

Tetanus

At least 6 months after TT2

At least 1 year after TT3

At least 1 year after TT4

Tetanus

Tetanus

Tetanus

Tetanus

First visit

AGE OF CHILD

At birth or soon after birth

6 weeks oldPolio,,,,, Diphtheria, Whooping Cough,Tetanus, Hepatitis B & Haemophilusinfluenzae type b illnesses

10 weeks old

14 weeks old

9 months old Measles

VACCINE

Polio and Tuberculosis

Vitamin A dropsin the mouth

VITAMIN A SUPPLEMENTATION

Polio,,,,, Diphtheria, Whooping Cough,Tetanus, Hepatitis B & Haemophilusinfluenzae type b illnessesPolio,,,,, Diphtheria, Whooping Cough,Tetanus, Hepatitis B & Haemophilusinfluenzae type b illnesses

Oral Polio, BCG

Oral Polio,DPT-HepB+Hib

Prevents blindness and strengthensresistance against other diseases

DISEASES PREVENTED



Measles

6 months old and every6 months until 5 years


1. What is immunisation?

Immunisation is a means ofprotectingthe human body against specificdiseases by building up the body’sdefense system. This is done by givingvaccines either through injection or by mouth.

(i) Reduces suffering to child andfamilymembers due to ill health.

(ii) Reduces disability and death to the childand burden to the parents, the community and thenation.

(iii) Contributes tochild’s proper growth anddevelopment.

(iv) Reduces costs in terms of time and money spenton treatment. This will contribute tosocio-economic development.

(v) Protects the entire community from thesediseases.

2. Benefits of immunisation.


� � Polio vaccine is administered by putting drops inthe mouth of the baby while all other vaccines are

given by injections.

5. How is immunisation carried out?

6. Why is it important to immunise?

When most children are fully immunised, the entirecommunity is protected from these 8diseases, because the germs cannot easily find anyoneto infect.

Many of these 8 diseases are deadly and cannotbe treated easily. Neonatal Tetanus, for example, isalmost always fatal. Yet immunisation canprevent it.

Once a child is fully immunised, he or she is protectedagainst these 8 diseases.


Baby boys and girlsGirls and women15 - 45 years old Pregnant Women

4. Who should be immunised?

� All children below 1 year.

� � All women of child-bearing ageincluding pregnant women.

Immunisation is given to all girls andwomen 15-45 years old andpregnant women to protect them andtheir new born babies against Tetanus.


What is Polio?

Polio is a disease which is characterised by weakness ofthe limbs especially of the legs. It is caused by a virus.Children get it by taking in water and food contaminated byfaecal matter, containing the Polio virus.

How can one tell a child has Polio?

� Polio is a sickness that begins with a mild cold.

� Some children may develop weakness in one or morelimbs which progresses to lameness and thinness of theaffected limbs.

� Sometimes Polio can affect the lungs and the child willstop breathing and die.

How can Polio beprevented?

� Polio can be prevented byimmunising the child withPolio vaccine 4 times. (seepage 7)

� Additional doses of Poliovaccine to all children below5 years during NationalImmunisation Days (NIDs)will eradicate Polio diseasefrom your community.

� Use of safe water, washinghands before handling foodand after using the toilet orlatrine.

Poliomyelitis(Polio)


� Children are immunised against eight childhood killerdiseases which include:

� In addition,girls and women 15-45 yearsold and pregnant women are immunisedagainst Tetanus.

Poliomyelitis (Polio)

Tuberculosis (TB)

Diphtheria

Measles

Tetanus

Whooping Cough

Hepatitis B (liver disease)

Haemophilus influenzaetype b illnesses (Meningitisand Pneumonia)

7. What diseases are immunised against?


What is Tuberculosis (TB)?

This is a disease caused by a bacteria, characterised byfever, cough and weight loss. Most children get theinfection from infected adults. It is spread through airespecially where one is near an infected person.

How can one tell a child has TB?

� A child has prolonged cough of more than 2 weeks� A child has no appetite and loses weight

How can TB be prevented?

� TB can be prevented byimmunising a child withBCG vaccine at birth.

� Proper feeding (balanceddiet).

� Children should not mixwith infected people.

� Live in well ventilated houses.

� Cover your mouth whencoughing to avoid spread-ing the disease.

Tuberculosis


What is Whooping Cough?

This is a disease characterised by long coughing spellssometimes followed by a whoop and sometimes followed byvomiting. Whooping Cough is caused by a bacteria. It isspread through air by other infected children.

How can one tell a child has Whooping Cough?

A child with Whooping Cough has a long lasting cough witha whooping sound, running nose, fever, and vomiting.

How can Whooping Coughbe prevented?

� This disease is preventedby immunising a child withcombined DPT-HepB+Hibvaccine three times beforethe age of one year. Thisprevents Whooping Coughas well as 4 other dis-eases.

� By living in a wellventilated house.

� Covering one’s mouthwhen coughing to avoidspreading the disease.

WhoopingCough


What is Diphtheria?

This is a disease of the throat characterised by sore throat,swelling of the neck, mild fever, hoarseness, difficulty inswallowing and breathing.

It is caused by a bacteria. The child gets it by breathing indroplets from an infected child.

How can one tell a child has Diphtheria?

A child with Diptheria has a sore throat, mild fever, swellingof the neck, and difficulty in breathing.

How can Diphtheria beprevented?

� Diphtheria can beprevented by immunisinga child with combinedDPT-HepB+Hib vaccinethree times before the ageof 1 year. This preventsDiptheria as well as 4other diseases.

� Living in a well ventilatedhouse.

� Covering mouth whencoughing to avoid spread-ing the disease.

Diphtheria


How can one tell a child has Measles?

A child with measles has a generalised body rash, highbody temperature, red watery eyes, running nose, sores inthe mouth and a dry cough.

What is Measles?

Measles is a disease characterised by a generalised bodyrash, high fever, running nose, and red and watery eyeslasting at least 3 days.

Measles is caused by a virus. It is spread by breathing indroplets from an infected child.

How can Measles beprevented?

� Measles can be preventedby immunising all childrenwith measles vaccine at 9months of age.

� Additional doses ofMeasles vaccine to allchildren younger than 15years during massMeasles campaigns willeliminate Measles fromyour community.

Measles


What is Neonatal Tetanus?

Neonatal Tetanus is a disease seen as muscle spasms (musclecontractions) and failure to breastfeed by a baby who was bornhealthy. It is caused by a bacteria. Tetanus can also affect adults.

How can one tell a child has Neonatal Tetanus?

A child with Neonatal Tetanus is born normally, but after a fewdays stops breastfeeding and gets a locked jaw and stiff musclesall over the body especially when touched.

How does a child get Neonatal Tetanus?

A new born child gets Tetanus through the umbilical cord. Thisoccurs when the cord is cut with contaminated instruments, tiedwith a contaminated string, rubbed with contaminated soil, ashes, oranimal dung or delivered in a dirty environment.

Older children and adults can get Tetanus from deep cuts orwounds that get dirt in them.

How can Neonatal Tetanus be prevented?

� Neonatal Tetanus can be prevented by immunising all womenof child bearing age and pregnant mothers with TT vaccine,and using a sterile instrument to cut the umbilical cord.

NeonatalTetanus

� Delivering a child in clean environ-ment (Tetanus germ free environ-ment) — at a health facility with atrained health worker.

� Immunising all children under oneyear three times with combinedDPT-HepB+Hib vaccine protectsthem from Tetanus later in life. Italso protects against 4 otherdiseases.


What is Hepatitis B (Hep B)?

Hepatitis B is a serious disease of the liver and is caused bythe Hepatitis B virus (HBV) which usually exists in theblood and bodily fluids of the infected person.

Hepatitis B virus causes chronic infections that lead to liverdamage (cirrhosis), liver cancer and death. There is no curefor Hepatitis B Virus illnesses.

Children get it through cuts, casual contact and from theirmothers at birth. Hepatitis B is also spread through bloodtransfusions, unsafe injections, and sexual contact (adults)with an infected person.

Hepatitis B

How can one tell a child has Hepatitis B (Hep B)?

� In children, no signs or symptoms are usually seen,but infected children remain infected for many years andcan spread the infection to others.

� Usually, the effects of Hepatitis B appear duringadulthood as yellow skin and eyes, weight loss, vomitingand weakness. Over time, Hepatitis causes coma anddeath. Many people become infected with Hepatitis Bduring childhood, and carry the disease into adulthood.

How can Hepatitis B (Hep B) beprevented?

� Through immunising all childrenbelow one year3 times with combined DPT-HepB+Hib vaccine. Threeinjections prevent Hepatitis B and4 other diseases.

� Immunisation in childhoodprotects the child from HepatitisB for at least 10 years.


PRIME MESSAGES

� Immunisation protects children against 8 killervaccine-preventable diseases.

� Immunisation should be completed in the 1st year ofa child’s life with 5 rounds of immunisation.

� The vaccines are safe, effective and free; and they areavailable at government and non-government healthfacilities.

� It is safe to immunise a sick child.

� Child Health Cards should be kept and taken to thehealth unit every time the child visits, even if he or sheis sick.

� Additional doses of vaccines during specialimmunisation campaigns strengthen children’simmunity against diseases. Support specialimmunisation campaigns in your area.

� Remember to take the child for Vitamin A when he is 6months old and then after every 6 months until he is 5years old. Vitamin A helps children fight diseases andprevents blindness.

� Leaders should keep updated records on children whohave been immunised in their area.

For further information contact the nearest Health Centre

This booklet provides basic information

on immunisation for leaders to enable

them to mobilise their communities

to utilise immunisation services.

Produced by the Ministry of Health, UNICEF, WHO andDelivery of Improved Services for Health (DISH), with funding fromthe United States Agency for International Development (USAID)

promotion of immunisation in uganda - republic of uganda

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