10 Apr 2024

A milestone in the achievement of accelerated Integration of Community Child Health Services (in child health routine immunisation), particularly in the Kweneng region, heralds a promising future for all and most importantly for the children of Botswana. 

Minister of Health, Dr Edwin Dikoloti, who also called on the community to embrace community-oriented revitalised heath care, shared the sentiments at a ceremony to appreciate Integration of Community Child Health Services project in Motokwe on Tuesday. 

The child health routine immunisation, which has been hailed as a success, made possible through the support from development partners being UNICEF, Botswana Red Cross Society (BRCS) and the United States Agency for International Development (USAID), Dr Dikoloti said would help to achieve one of the UN Sustainable Development Goals, specifically goal number 3.1, which speaks to reducing under five mortalities to 25 per 1 000 live births by 2030. 

This is indeed a sign of a promising future for all of us and most importantly for our children, he stated. “We are, therefore, delighted for these rare achievements that would not have come, had it not been the support of our valuable partners,” he said. 

In November 2020, he said the Ministry of Health launched the Integrated Based Community Health Services (ICHBS) guidelines towards the fulfilment of the 'one health approach,' for coordinated and standardised health provision in communities. 

“Since children are one of the most vulnerable groups in our society, my ministry has adopted the Child Health Days initiative in order to deliver a package of high impact and cost-effective interventions. As a result, child health days are observed annually in May and November to ensure that we keep the momentum throughout the year,” Minister Dikoloti said. These interventions, he said, were meant to help us reduce under-five morbidity and mortality, thus increasing child survival rate. 

The implementation of these high impact interventions will definitely ensure that primary healthcare is redefined and revitalised in the health sector. As a ministry, we prioritise primary health because of its preventative nature. 

The State of the World Children's report of 2023, he said, has revealed that globally, a total of 67 million children missed out on vaccinations between 2019 and 2021. This indicates that children born just before or during the advent of the COVID-19 pandemic, who would normally have been vaccinated, may actually have missed crucial lifesaving vaccinations. This, therefore, calls for urgent action to catch up for those who missed immunisations during that 'dark period'.

He said Botswana, like the rest of the world, was not spared the challenges and hindrances emanating from COVID-19, which affected all sectors of the economy, including access to healthcare services. 

During that time, essential services were redirected towards those with co-morbidities and other emergency cases. In the end, the decline in routine immunisation coverage also affected the country. Through the support of UNICEF and BRCS, he said the ministry had been able to mobilise and implement child health services for hard-to-reach communities in some parts of the country, including the Kweneng District. 

These efforts were achieved through house-to-house visits, community engagements, mobile stops, mobile outreach and community dialogue, the minister said. Through these mobilisation activities, he said the Ministry of Health had been able to gather information that would inform decision-making and strengthen 'our primary health system'. 

As a result, community health workers managed to identify children who missed on routine vaccination. 

He highlighted that under the leadership of President Dr Mokgweetsi Masisi, the government prioritised health, not just as a key service, but also as a human right. “It is against this background that I implore all of you to take responsibility in caring for our children who are the leaders of tomorrow,” he made the appeal. 

For his part, UNICEF representative, Dr Joan Matji, said UNICEF as a child-centered UN Agency, was extremely alarmed by the fact that in 2022, 20.5 million children across the world missed out on one or more vaccines while 24.4 million children missed their vaccines in 2021. This, Dr Matji said, was mostly attributed to disruptions escalated by the COVID-19 pandemic. 

However, we are also aware that there are other factors contributing to low vaccination of children. He said implementation research undertaken through a similar programme in five districts, including Kweneng in 2021, showed that 49 per cent of children were not vaccinated due to lack of sense of agency on the part of caregivers or child negligence, while 25 per cent cited unavailability of vaccines during the scheduled time. 

Furthermore, 24 per cent of caregivers had missed children's appointments with child welfare clinics. To address these challenges, community engagement and behaviour change approaches are essential to raise awareness of caregivers and urge them to take up immunisation and wider child welfare services for the survival and thriving of children, she stated. 

Secretary General and CEO of Botswana Red Cross Society, Mr Kutlwano Mukokomani said the society engaged in a partnership with UNICEF and USAID to help strengthen primary healthcare as implemented in the Kweneng East and Kweneng West districts. 

“Through this project, we have provided 58 human resource support that includes 40 mobilisers, eight data clerks, eight vaccinators and two supervisors who are placed in 17 villages across the two districts. 

In addition, we have supported the delivery of services through the deployment of vehicles. These vehicles also supported the distribution of vaccines and other commodities to hard-to-reach areas” Mr Mukokomani said. 

Since the project inception, he said they had managed to reach over 259 000 people with health messages through various customised formats. Looking at the statistics, he said tailor-made community messaging proved effective. 

He said to date, the project had administered 10 532 doses of vaccinations to children under five years. In line with the reset agenda, and President Masisi's call for mindset change, he said BRCS had adopted the use of technology in health promotion. 

“We are engaging with communities through the use of social media chatbot and mass messaging amongst others. 

Despite the efficiencies of digitalisation and technology, there are also challenges of misinformation and harmful rumours adding a layer of complexity to community engagement,” he said. However, we believe the digitalisation of health information management is an area of improvement, he said. 

US Embassy deputy chief of mission, Ms Amanda Jacobsen hailed the initiative, saying it was aligned with the World Health Organization (WHO)'s global guidelines and recommendations. 

“Botswana, as usual, is at the forefront of following WHO recommendations. We look forward to continuing the partnership that we have built over many decades,” she said. In his welcome remarks, Kgosi Batho Tshoso of Motokwe hailed the Integration of Community Child Health Services (in Child health routine immunisation) initiative, saying the right to good health was of utmost importance. 

He however, regretted that the village clinic was not in good condition, which was compounded by shortage of transport and drugs, adding that such challenges were affecting healthcare service delivery. 

He appealed to the US Embassy to construct a modern clinic in Motokwe. 

For his part, area MP, Mr Tshoganetso Leuwe expressed gratitude for the community participation, adding that the health of the children were in their hands. ends