It was a calm sunny afternoon, and Mrs Faith Umbagadu could be seen nursing and breastfeeding her baby in Angwan Maikai, Keffi, Nasarawa State. The baby, who is just a month old, was sucking her mother’s breast, oblivious of the environment.
Mrs Umbagadu, a young mother of one, experienced difficulty getting her baby immunised within the stipulated time. The baby, who was supposed to receive the Bacille Calmette-Guerin (BCG) immunisation at birth, was given it almost two weeks after.
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“Wen I born my baby, I no fit get her the medicine (referring to the vaccine) as the hospital for here no get am, they say make I wait small, them go call me if them get the medicine,’” she responded in pidgin.
The baby was yet to receive oral polio vaccine (OPV) and Hep B vaccine stipulated to be given at birth.
This was the fate of Mrs Umbagadu’s child and other children in Angwan Maikai and its environs at Keffi, Nasarawa State community. The Primary Health Center (PHC) in Angwan Maikai has difficulties accessing the critical vaccines for newborns after the flood that took place in 2022.
Mrs Joy Abumiku, whose baby was born in early November 2022 (about nine weeks old), noted her baby had received just one vaccine (BCG) and was yet to be administered any other one.
For Hajia Halima Gambo, her son, born in October 2022, received his first vaccine after four weeks of birth. She said there was no vaccine at the time of birth at the health center, and the floods worsened the possibility of accessing it. So she had to wait to be informed when the vaccine was available.
It was discovered that most of the children born in Angwan Maikai and the surrounding communities needed to receive their vaccines on time. This could be attributed to the poor state of the health centre, aggravated by the floods.
Poor immunisation history
Nasarawa State has a poor vaccination record. According to the National Housing Demographic Survey (NDHS) of 2018, the state vaccination record is below 40 percent across all ages for infants and children.
The survey states that for the age range of 0 to 15 months, only 39.1 percent of the infants have received all basic vaccines. About 60.9 percent of the infants born in the state have yet to receive any form of vaccination.
For those from 15 to 23 months, only 6.4 percent have received the basic vaccinations for their age.
Overall, only 29.5 percent of them have received the vaccines appropriate for their ages.
While this is a case in Nasarawa, it is reported that at least 25 million children were unvaccinted or under-vaccinated in 2021 globally. Vaccine coverage fell from 86 percent in 2019 to 81 percent in 2021. Eighteen million of this number didn’t receive any form of vaccination. Nigeria is one of the 10 identified countries that accounted for over 60 percent of these 25 million infants/children.
The state’s vaccination statistics is lower than the regional average.
One-room health centre
Officer in charge of the PHC, Hajiya Rakiya Tanemu, noted that the health centre had never had a structure of its own. When the floods worsened, she and her team had to move few pieces of equipment to a safer place, she said.
The community chief provided the place and donated a room in his house for this purpose.
Thus, PHC Angwan Maikai can best be described as a ‘one-room health centre’ where all the activities occur.
The health centre contains a bed that also serves as a table, two plastic chairs, a weighing scale for babies and adults, a cupboard where drugs and other consumables are kept, as well as a stretcher placed against the wall.
Hajiya Tanemu noted that before the floods, she and her team were getting some supplies once in a while from Anguwan Waje PHC, but there were no more supplies now. “Most of the time, I have to go to nearby health centers to collect unsealed vaccines so they don’t get wasted. The floods have made the situation go from bad to worse.”
At the health centre, demonstration, immunisation, antenatal, and other activities occur under a tree.
The size of the centre has limited the services it renders to fever/malaria, child immunisation, and antenatal care.
Poor access to health
Immunisation is a major problem at PHC Angwan Maikai.
It is the only health centre that serves three communities – Dokari, Angwan Malamgambo (Fulani settlement), and Angwan Maikai. Members of these communities depend on this centre for their health challenges.
Angwan’s Chairman, Mr Jacob Kasu, said the community was at a great risk as the facility was unable to handle medical emergencies. “The worst is immunisation, which is a vital medical intervention in babies’ lives,” he said.
He narrated how community members often had substantial challenges conveying mothers to the health centre for childbirth. “You know the expected delivery date is monitored and analysed at the antenatal stage. The state of the facility here makes antenatal difficult, and most of the mothers give birth at home,’” he lamented.
A community chief, Mr James Kuje, said the area was in dire need of a befitting facility. He noted government officials had always visited the health centre with a promise of a reform, but they never returned.
He said the community needed a proper facility for effective service delivery as the people had to travel for over 7 km to access health services. This made it difficult for the centre to attend to emergencies, especially at night, he said.
The Youth Leader of the community and Secretary to the former Chairman of Angwan Maikai, John Ekon, said the health centre reflected the issues the community was facing. “We are practically at the mercy of God in the event of a medical emergency, childbirth inclusive,” he said.
He noted that the nearest health facility was at Gauta, which was at least 7km from the community. “How do you expect a heavily pregnant woman to walk that distance?” he asked. “This tree where I am sitting is where most of the activities in this centre occur,” he added.
Newly borns facing danger
The CEO and National Coordinator of Ask the Pediatrician Foundation, Dr Gbemisola Boyede, said immunisation was about protecting children from vaccine-preventable killer diseases.
“Immunisation is one of the child survival strategies that reduce deaths of children below the age of five years,” she said. In 2021 alone, data show that about 5 million children died from vaccine-preventable diseases before reaching their fifth birthday.
The CEO of Ask the Pediatrician Foundation emphasised that unimmunised children were at risk of death from vaccine-preventable diseases. According to her, ‘”They are also at risk of disability like paralysis from poliomyelitis, which can lead to the inability to walk. Poliomyelitis is one of the vaccine-preventable diseases.”
She further said the children were also at risk of certain long-term chronic illnesses, including chronic liver disease caused by Hepatitis B.
Dr Boyede added that there was no alternative to vaccines when it came to living, noting that it was about choosing between life and death/disability.
Thus, vaccines had the power to save and transform lives, she added.
Nasarawa State Ministry of Health responds
Monitoring and Evaluation (M&E) Officer at the Nasarawa State Ministry of Health, Mrs Ann Joshua, in her response, said the PHC Angwan Maikai was facing the challenge of vaccine supply because it might not have aligned itself with the right distribution matrix.
She said the health structure was designed to have a PHC in each ward serving as a focal health centre.
The focal PHC would handle the supply of medical consumables within its ward, she said. Though she acknowledged that there were seven wards in the state without focal PHCs, she said the state government was attempting to provide such at the moment.
The M&E officer said the PHC would receive its supply from Sabon Gari Health Clinic, which served as a focal PHC for the ward. The delay in accessing vaccines could be attributed to the fact that PHC Angwan Maikai got its supply from PHC Angwan Waje, she noted.
She further said that the health centre lacked an adequate befitting structure. However, it was one of the out-post facilities in the state, and the government was looking towards providing a befitting structures for it and others.
This story was supported by the Africa Data Hub Community Journalism Fellowship.
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