Tuesday, July 5, 2011

Polio eradication: From NID to IPD and the way forward

June 23, 2006

By Sani Garba Mohammed

The struggle to eradicate polio started in 1988 wit the aim to eradicate it out of the world. Since then, various steps were [and still being] taken, but still it is not yet eradicated.

Recently 2003-04 precisely, polio eradication programme or better known as National Immunization Days [NIDs] suffered a major setback of rejection based on cultural, religious and other factors, including a position my state governor took to stop it pending the outcome of the team he instituted to verify the claim of whether or not it is safe.

Many things happen then, which at last the programme to eradicate polio was continued. Since then polio vaccination is being conducted at not less than six times a year, yet the number of polio cases is increasing in Nigeria, and Kano precisely leads in having the highest number of cases.

Having seen the lapses of NIDs, a new name was created to replace the former, that is Immunization Plus Days. The difference is that the latter included not only polio vaccines, but also Diphtheria, Pertussis, Tetanus and Measles injectable vaccines plus 'pluses' like insecticide treated nets, soaps, paracetamol syrup etc that will be given to every mother that brings her child for vaccination. This serves as a booster and encouragement to parents and others to be prompt in making sure their children are protected against these deadly and dangerous diseases.

The change from NID to IPD really brings a positive change, for parents who were hitherto uncompromising and are rejecting the polio vaccines, now brings their children for it, due to the pluses being given. For instance, in my last two days at the last exercise at the ward I Serve, our vaccines finish soon because of the pluses being given.

To those who know me knows that, I am against polio vaccine [despite being a preventive health practitioner] because of the complaint of my people which are why polio only, and yet still it is not eradicated etc, which I even join hand with the like of Dr Aminu Magashi, Supreme council of Shariah in Nigeria etc to call on our governor to do some thing about the polio vaccines as people are scared, hence the institution of committee of expert to determine whether or not it is safe. After the committee's findings shows that it is safe, I decided to join hands with those who matter to fight the deadly disease.

My being in the programme at my LGA level proves to me that the number of polio cases is increasing daily despite the polio vaccine programme. As such, my little experience tells me that all the previous setback and rejection based on some factors not withstanding, health workers, health education unit and LGA authorities must also be blame. There are many health workers that engage in polio vaccination programme, yet they are preventing their children and those they are close to not allow their children be vaccinated with oral polio vaccine, they are still much around, as such their posture further re-embolden many not to accept it, based on the fact that even 'health worker[s] did not believe in it, why should I'?

The health education unit of majority of our local government authorities are moribund, no money for them, no working equipment, in fact no any logistical support to carry out their duty of educating the public to know the importance of immunization in relation to the health status of their children. The local authorities [in collaboration with some medical staffs] have hijacked and politicize the recruitment of polio administrators by engaging those they like [with inclusion of few health practitioners], some of which are even illiterate and ignoramus about vaccine safety, administration, who were given the job to do just to get the money. This does not mean I am against them to get something, but let them be recorder or ay other things necessary but not polio or any other vaccine administrator[s].

But now with the introduction of IPD, the situation is changing, as each team of vaccinators must have 1 supervisor, 2 vaccinators [all of which must be health practitioners], plus 2 recorders and crowd controllers who can be others.



The way forward



Since now the challenge to eradicate polio has shifted to the end of 2007, and the highest cases is in Nigeria, Kano to be specific, I am advising WHO, UNICEF, COMPASS etc to ensure that these pluses being given are maintain, in fact let some expensive goods be given to mothers so as to encourage them the more, for no large amount of money donated in health services is too much or a waste. If this kind of programme was initiated since, by now large numbers of areas could have been covered, though it is not late.

District ward head [precisely mai unguwa] should be included fully in this activities, because the work will not succeed without their co-operation, for they know their people better than anybody, as such funds and other logistical support should be given to them so as to get maximum result. Mai unguwa has more roles to play more than district head, he should be the man to be help more than district head. I emphasized on him because in most cases they are being sideline by their [some of them] district head, even if they got something from authorities to share with them.

The current exercise need not only a health worker, but competent one, excellent in inter personal communication, advocacy etc, hence COMPASS, must ensure all its consultants makes only a capable ones are recruited to be supervisors and vaccinators.

The local authorities should consider health as a wealth, gives all the necessary logistical support to the programme without sacrificing and compromising competency and standard to their political leaning/selfish interest. Their co-operation will help a lot to make sure we reach the target.

Lastly, all hand must be on deck to make sure polio is not only eradicated n Nigeria but Africa and the world at large.



Sani Garba Mohammed, PHC department, Karaye LGA, Kano state.