Members of Parliament on the Health Committee on Wednesday quizzed state minister for primary health care Sarah Opendi on why Uganda is lagging behind on immunization.
Florence Mutyabule, the Woman MP for Namutumba district, in her presentation cited the National Development Plan which shows inadequate funding for immunisation programmes to support the provision of supplies, equipment and transport. These are the major constraints to the delivery of the minimum heath care package.
Although the Global Alliance for Vaccines and Immunisations (GAVI) and other development partners provide all the capital equipment such as vehicles, cold chain and most of the funding for vaccines, the government is responsible for the operational costs of the immunization programmes.
Mutyabule however, notes that the allocation to the Uganda National Expanded Programme on Immunisation (UNEPI) for the operations of the immunization programme remains the same at one billion shillings over the years. The Uganda Parliamentary Children’s Forum chairperson is asking for an additional funding of 3 billion shillings.
Even though part of primary health care funding to health centres is supposed to be ring-fenced for immunization outreach, current allocation is not sufficient. Only 3 billion shillings would be needed to ensure one outreach per month per parish according to standards or 1.3 billion would be needed to ensure one outreach per quarter per parish for the financial year 2013/14.
Kinkiizi East MP Dr Chris Baryomunsi adds that even though the Ministry of Health has continuously stated that funding is an issue, there are other factors such as complacency, programme fatigue, motivation of health workers to carry out outreach programmes and transport among others.
According to the Uganda demographic health survey 2011 only 52 percent of children under five in Uganda are fully immunized. This coverage does not compare favorably to the neighbouring countries in the region.
Rwanda has 90 percent coverage, Kenya stands at 77 percent and Tanzania is at 75 percent. Uganda is only better than Somalia which has 45 percent immunisation coverage in the East and South Africa.
Minister Opendi responded that while it is the ministry’s mandate to provide services, the population should also take responsibility for the children they produce.
She however, blames the lack of facilitation to health workers especially in Health Centre Twos and transport challenges after GAVI suspended funding to the health ministry. In 2006, GAVI halted its funding to Uganda after a financial scandal involving three and staff at the ministry of health. GAVI had in 2004 rewarded Uganda with 7.6 billion shillings for surpassing the targeted national immunisation coverage in 2002.
The money at the time was also being used to support village health teams (VHTs) to mobilise mothers and run messages on radio and support supervision for immunization.
The Director General Health Services Dr Jane Ruth Aceng recalls that Uganda had over 90 percent immunization coverage in 2006. Dr Aceng cites other challenges such as resistant religious sects, and lack of cold chain technicians to man refrigerators that are used to store vaccines.
The Ministry of Health is also embarking on a campaign dubbed reach every child, reach every district. Also to boost the immunization coverage, all refugees from DRC and populations around border areas are to be immunized to avoid a polio outbreak.
However, Dr Aceng maintains that the only way for Uganda to improve immunization in the country is to strengthen routine immunization and increase human resource in order to meet the 2015 Millennium Development Goals (MDGs). The sixth MDG talks about combating HIV/Aids, malaria and other diseases by the year 2015.
Uganda has the biggest number of unimmunized children in the region. Over 652,000 children have not been immunized against measles and over 590,000 others are yet to be immunized against Diphtheria.