Ghana has taken a major step toward reducing its under under-five mortality rate with the introduction of two new vaccines for rotavirus and pneumococcal disease, but a UNICEF official in the West-African country says it won’t be enough to meet the fourth Millennium Development Goal (MDG).
That goal is to reduce the under-five mortality rate by 75 per cent between 1990 and 2015. Currently, 80 children out of 1,000 do not make it past the age of five in Ghana. The country would have to cut that number down to 40 deaths per 1,000 to achieve the fourth MDG.
“Ghana is doing a lot but I don’t think it’s enough,” said Dr. Anirban Chatterjee, UNICEF’s chief of health and nutrition in Ghana. “I think there is definitely scope and need for more improvement.”
Rotavirus and pneumococcal disease are the leading causes of diarrhea and pneumonia in young Ghanaian children. Together they account for close to 25 per cent of under-five mortality and are behind only malaria as the leading causes of child deaths in Ghana.
Ghana has become the first African country to introduce both vaccines at the same time. Both are given to young children before they reach four months of age. The GAVI Alliance, a public-private global health partnership, has helped fund the vaccines, which will be available for free to all Ghanaian children. More than 400,000 Ghanaian children are expected to be immunized against both diseases.
The two new vaccines are expected to prevent 12,000 pneumonia-related deaths and another 10,000 deaths from diarrhea, said Dr. Antwi Adjei, program manager of the expanded program on immunization with the Ghana Health Service.
On April 26, Ghana’s health minister, Alban S. K. Bagbin, said in a press statement that the new vaccines will give Ghana the extra push it needs to meet the fourth MDG by 2015.
But for UNICEF, efforts to improve the nutritional health of children need to happen in concert with vaccinations to reduce the under-five mortality rate. Chatterjee said malnourishment can sometimes double or triple the chances of dying from a condition like diarrhea or pneumonia. “[Malnourished children] are more susceptible to contracting the disease, having the sever forms of the disease and also to dying of the disease,” he said.
Exclusive breastfeeding for the first six months of a child’s life is one way to prevent malnourishment in that crucial period. UNICEF has promoted the practice because it also helps create immunity to early childhood killers like pneumonia and diarrhea.
In Ghana, 63 per cent of children are exclusively breastfed during that period. Many women do not breastfeed their children because they are not aware of the benefits or work in an environment—such as the informal sector—where it is difficult to do so.
Adjei said the Ghana Health Service has regular cooperation between departments such as vaccinations and nutrition. In the second week of May, the Ghana Health Service’s various departments meet for Child Health Promotion Week to develop new strategies and programs related to child health.
One big challenge for the Ghana Health Service will be to reach all children with the rotavirus and pneumococcal disease vaccines. About 87 per cent of children under one in Ghana have been immunized for tuberculosis, poliomyelitis, tetanus, hepatitis B, measles and several other childhood diseases. Reaching the last 13 per cent has proven difficult.
“Wherever a person is, we have a responsibility to reach them and vaccinate them,” said Adjei. “Against rising costs it makes it more and more difficult.”
Some isolated communities around Ghana’s Lake Volta, for instance, can only be reached by boat. The Ghana Health Service reaches these small communities at a much greater cost than urban populations.
A small number of Ghanaians also do not take vaccinations due to religious or traditional beliefs. Adjei said the local Twi dialect has only one word for ‘medicine’ that does not differentiate between preventative vaccines and drugs used to treat diseases. He said it is difficult to overcome such beliefs. “Fortunately for us they are isolated cases.”
The new vaccines have just started to roll out across Ghana. La General Hospital, in Accra, was one of the first institutions to offer the vaccines in the capital on Friday, May 4. About 40 mothers were gathered at the hospital with their crying infants in tow, as they waited for their turn for inoculation.
Cynthia Noonu, a nurse at the hospital, said the mothers have been very cooperative. La General Hospital is ready to receive a different group of mothers each week. The vaccines will be rolled out to different hospitals in Accra, and across Ghana, in the coming weeks.
Gladys Otabil was at La General Hospital with her two-month old son Gabriel. “All I understand by the addition of the two vaccines is that they will protect my child from any disease and sicknesses,” she said. Otabil added that she was also advised to breastfeed her son for his first six months of life.