Preparations begin early in Tanzania for the introduction of rotavirus vaccines

With GAVI support, Tanzania plans to introduce the rotavirus vaccine into its immunisation programme by 2013

Sister Moshi Athumani at Mnazi Mmoja Child Health Clinic in Dar-es-Salaam holds a baby who has been brought for routine vaccination.

Text and photos: Doune Porter
Health workers and Ministry of Health officials in Tanzania are gearing up for the huge task of preparing to introduce a new vaccine against rotavirus, the leading cause of severe infant diarrhoea.
Thrilled to be among the 12 African countries that have just been approved for GAVI support to introduce rotavirus vaccines, they are undaunted by the work ahead of them.
Dr. Dafrossa Lymio, manager of Tanzania’s Expanded Programme on Immunisation (EPI) team, brims with enthusiasm for the task, as she knows introducing this vaccine will lead to a reduction in child deaths and illness in her country.
“I am very happy and very excited about the introduction of this new vaccine,” she says, “My colleagues who are working in hospitals are happy and excited about it; and as a mother, with a child under five myself, I think this is the solution for Tanzania in reducing the number of our children who are frequently suffering with diarrhoea.”

Cold chain

As soon as officials from the Tanzanian Ministry of Health applied to the GAVI Alliance for support to introduce rotavirus vaccines they started preparing for introduction and aim to launch the vaccine in 2013.
“First we started to expand our cold chain capacity for vaccine storage,” explains Dr. Lymio from the EPI. “We are expanding national storage capacity, as well as regional and district level capacity,” she adds.

Dr. Dafrossa Lymio, Expanded Programme on Immunisation manager, in front of the central vaccine room in Dar-es-Salaam, one of Tanzania’s storage facilities undergoing major expansion to accommodate new vaccines.
Source: Doune Porter/GAVI/2011

Expanding the cold chain is a major undertaking and involves the construction of new buildings as well as the addition of new walk-in refrigerators at the existing central medical stores in Dar-es-Salaam. Dr. Lymio explains that the expansion strategy is designed also to include other new vaccines that will come in the future.

Health workers

When the time approaches for the vaccines to be delivered to a country, says Dr. Lymio, “Another important preparation will be training for health workers who will be providing this vaccine for children. We also have to develop information and education materials for health care providers and all of those who will be involved in delivering the vaccines to children.”
A further crucial element in vaccine introduction is advocacy and communication to other stakeholders, including other government officials in order to mobilise necessary resources, and community leaders so they understand why the vaccine is important and will support its successful introduction into the routine immunisation programme for children.

Spreading the word

A little girl recovering from severe diarrhoea at Tanzania’s Muhimbili National Referral Hospital in Dar-es-Salaam.
Source: Doune Porter/GAVI/2011

A major communication effort aimed at parents will also be launched, much of it through the mass media as well as local health centres, so parents will understand the benefits of vaccination and bring their babies in at the correct ages.
The wider impact of this vaccine introduction is not lost on health workers on the ground, as nurse Moshi Athumani at the Mnazi Mmoja Child Health Clinic in Dar-es-Salaam is quick to point out, “These vaccinations will help to prevent illness and death of under fives from diarrhoea,” she says, “But it will also help us to develop our country economically, because parents with sick children have to stay home to take care of them; like me, if I have a child with diarrhoea at home, I cannot come to work. If we prevent death and illness, parents will be able to spend more time in business and in the work place. Introducing this vaccine in my country makes me very happy.”

Georgia, one of the 16 countries graduating from GAVI support, plans to use information campaigns to further boost its immunisation coverage. Based on revised eligibility criteria, the former Soviet republic will start to phase out GAVI support from 2012.
Georgia’s routine immunisation coverage is 91%, up from 80% in 2000, but public attitudes and lack of information remain the biggest obstacles to increasing immunisation, says Givi Azaurashvili, Georgia’s manager for the Expanded Programme on Immunization.
“Based on the information campaigns that we are planning to run, we expect that demand for vaccines will increase. Georgia stands firm on its commitment to increase coverage, to increase the budget for immunisation,” he says.
Georgia has already introduced the pentavalent vaccine, is rolling out the rotavirus vaccine in 2012 and aims to introduce the pneumococcal vaccine in the near future.