Nearly half of under-fives in Uganda are going un-immunised or under-immunised against serious childhood diseases such as measles, tuberculosis and diphtheria. The Ministry of Health says its aim is for every child to be “fully vaccinated...against the vaccine-preventable diseases”. To this end, the Ugandan government has already announced plans to introduce new vaccines for rotavirus, pneumonia and the human papillomavirus (which causes cervical cancer).
But at the recent launch of the government’s 2013 measles and polio campaign (which will also involve protecting children against onchocerciasis or river blindness), Uganda’s Minister of State for Health admitted that cases of common childhood diseases such as measles are “increasing” in Uganda.
World Health Organization (WHO) data reveals that over 70% of Ugandan children were immunised against measles in 2006, but this coverage had dropped to 55% in 2010 and was running at a similar level in 2011, according to estimates from the UN’s child agency (UNICEF). Speaking to the news agency IRIN, a UNICEF technical officer in Uganda explained that the decline in immunisation was due to “health system issues that are affecting the entire health [service] delivery”.
A reduction in health spending is seen by many as the main cause for the reduced coverage of children. However, the country also faces other challenges. In rural areas, health centres can be a long trek for parents to bring their children. And while infants may be brought at the start, parents may not be able to afford the time or travel costs to complete the scheduled number of vaccinations. Cultural or religious issues can also be a factor. The leaders of some religious sects now encourage people to believe that healing comes only from God. And in some regions, baseless rumours about the nature of vaccines further discourage parents.
The Ministry of Health blames the re-emergence of diseases like measles on the “accumulation of non-immunised children because parents and caretakers have not been taking [their] children for immunisation”. To tackle this problem, a government bill was put forward at the end of 2012 which would impose fines on those who fail to have their children immunised.
But health experts believe that more needs to be done at a local level. As well as working to change attitudes, they suggest that health centres need more staff and equipment. Extra funding would also allow for incentives to be given to health workers in rural regions and for immunisation capabilities to be strengthened among rural health teams. Such measures would, they believe, lead to Uganda’s immunisation rates rising once again, helping to protect the country’s children.