Eritrea continues to maintain the highest immunization coverage. According to a report by the UNICEF, Eritrea registered significant increase in vaccine intake in 2020 as compared to 2019, which is an increase of 14% immunization coverage. The success is the result of the proactive efforts of Eritrea’s Ministry of Health (MoH) which is seen in its commitment to intensify community mobilization as well as enhance access to rural communities through its integrated mobile outreach services all over the country.
WHO report shows that Eritrea is one of the countries in Africa that has attained MDG 4 and one of the few countries on track for MDG 5. The reports by far indicate that the country is working in collaboration with partners to attain SDG related goals and targets. The reports by UNICIEF and WHO corroborate the country’s all-time commitment to ensure societal wellbeing despite challenges of any kind.
Before 1991, all social services, and particularly healthcare services, in the country were confined to narrow urban areas with below 10% of immunization coverage, where children under one year of age received lower vaccination shots that were limited to only 6 vaccine types.
Eritrea’s commitment to ensure the prevalence of social justice has been clear from the onset. In the immediate aftermath of the country’s independence, social services were evenly and strategically developed across the country. Hence, ensuring the wellbeing and health of women and children has been commendable with an ever-increasing immunization coverage as a driving force in guaranteeing healthy lifestyle.
According to Mr. Tedros Yehdego, Manager of Expanded Program on Immunization (EPI) at the MoH, all 349 healthcare facilities across the county have developed the capacity to deliver efficient immunization service while 301 are actively engaged in providing routine vaccination services six days a week.
Mobile clinics have been offering immunization services in around 450 outreach sites along with prenatal and postnatal as well as other healthcare services to mothers and children every two months. What is more, additional nutritional packages have been offered to children below five years of age while anti-mosquito nets have been distributed in all high-risk areas. Mr. Tedros further indicated that the vaccination teams have been visiting outreach areas not only to offer immunization service but also to mitigate health related problems in all distant areas. Thus, immunization service has been an entry to the outreach areas to deliver other healthcare services in the less inhabited and highly scattered populations at remote locations.
The six traditional vaccines that have been given in Eritrea since the 1980s include BCG, Diphtheria, Pertussis, Tetanus, Polio and Measles. In 2002, the Government introduced new vaccines in a bid to curve any outbreak of contagious diseases that are well researched and confirmed to be societal health problems that should be prevented with an increase in immunization coverage.
Hepatitis B vaccine was introduced in 2002, while Haemophilus Influenza type B vaccine was introduced in 2008. Haemophilus Influenza type B was identified as a high-risk disease in infants under 5 years and for becoming a healthcare burden in increasing pneumonia cases in children and creating other respiratory problems along with other health challenges.
All the newly introduced vaccines are aimed at ensuring the health of the Eritrean society. Eritrea takes a mitigating action as soon as a disease is potentially identified as a healthcare risk to the Eritrean society. Eritrea introduced Pneumococcal Conjugate Vaccine (PCV) in 2015 to mitigate the health burden in infants and in 2018 Rubella vaccine was introduced to get rid of congenital Rubella syndrome and related complications. Rubella vaccine has been delivered along with measles vaccine altogether as Measels-Rubella vaccine.
Mr. Tedros clarified the reason for the introduction of Meningococcal Vaccine in 2019 saying that Eritrea is in a region known as meningitis belt — a geographical location comprising 26 countries. Adi-Quala, Tserona, Senafe, Tesenai and Lalay-Gash areas are susceptible to the risk. A national immunization campaign was carried out on around 2.8 million young adults and children (1-30 years of age) in a bid to rid of the potential burden.
Eritrea continues to make huge immunization strides as part of the collective effort required to eradicate vaccine preventable diseases, and routine immunization service for women and children has never been delayed or postponed. Regular Meningococcal Vaccine has now been given for 18 months infants in all healthcare service providing facilities.
Mr. Tedros affirms that Measles is no more a healthcare problem in Eritrea. A national Measles-Rubella vaccination campaign was carried out in 2018 for children 1-14 years of age. Since measles vaccination has been given for infants when they are 9 months and 18 months in a series of two doses, higher immunization is ensured.
The MoH has made all necessary preparations to introduce Human Papillomavirus (HPV) vaccine in 2022, targeting female children who are 9-14 years of age. Mr. Tedros said that almost 75% of the target groups are reachable in schools and, thus, the MoH is working in collaboration with the Ministry of Education to achieve the intended goal. While the rest 25% will receive the HPV vaccine through joint efforts of the MoH and administrative bodies. Once the national campaign on HPV is carried out, a routine vaccination service will be given to female children of 9 years of age. HPV vaccine is being introduced as a coordinated strategy to prevent cervical cancer and to mitigate reproductive health problems before the female children reach 15 and become sexually active.
Measles, polio and other respiratory diseases are no more healthcare problems in Eritrea owing to the intensive immunization campaigns carried out in the country. This success is not, however, a contribution of immunization services alone but the collective result of healthcare services such as those given to prevent malaria, HIV and malnutrition. Currently, death and disability due to measles and polio is no more a burden in Eritrea.
Eritrea also stays committed to prevent cross virus importation through regular vaccination services by deploying mobile teams four times a year in all sub-zones that are very close to neighboring countries. All in all, 14 vaccine types have been included in the national immunization coverage. Mr. Tedros emphasizes that Eritrea is a country with the highest and most sustainable immunization coverage of 95% on average, which is confirmed by WHO and UNICEF.
The huge strides Eritrea has made enabled the country to achieve four awards mainly for sustainable and highest immunization coverage and other achievements it registered in the healthcare sector. Eritrea was awarded in 2009 in Hanoi, Vietnam, in recognition of its highest immunization coverage; in 2016, in Uganda, in appreciation of Vaccine Stock Management and Equitable Distribution; and in 2017, in Rwanda, in recognition of Effective Vaccine Management. Eritrea has also been awarded for its Exceptional Achievement in Vaccine Stock Management in an event held in June 2022 in Nairobi, Kenya.
The extensive vaccination campaigns carried out in Eritrea over the years have increased people’s awareness which resulted in higher immunization demand in Eritrea. Aware of the benefits of vaccines in building a healthy society, communities and administrative bodies have been actively engaged for the success of all vaccination programs. It is clear that investing in mothers and children is investing in the country’s better tomorrow. Eritrea has been a Tetanus free country since 2002.
Mr. Tedros said preparation is being made to introduce new vaccines such as Hepatitis B birth dose in 2023 and Malaria vaccine in 2024. The commitment of the Government and the engagement of the Eritrean people will continue to make a difference in sustaining the high immunization coverage in the country.