Tag Archives: featured

India Launches Massive Scale-Up of Pentavalent Vaccine

This month begins a massive scale-up of Pentavalent vaccine for India’s children. With the largest rate of child mortality in the world, this new, national immunization effort will help reduce the number of child deaths in India. The Pentavalent vaccine combines diphtheria-tetanus-pertussis (DTP) with hepatitis B (hepB) and Haemophilus influenzae type b (Hib). Haemophilus influenzae type b kills 72,000 Indian children each year. Currently there are 6.8 million unimmunized children in India.

With the help of GAVI, the Vaccine Alliance, India will roll out free Pentavalent shots in 12 states during its first phase. 8 states already have free Pentavalent immunizations. By the end of phase one 2/3 of all India’s children will have access to the Pentavalent shot, according to GAVI. Phase two will cover the remaining 16 states with the Pentavalent shot. Phase two begins in 2015.

India Pentavalent Vaccine Rollout

“India’s decision to expand access to Pentavalent vaccines through the Universal Immunization Programme will have a major long-term positive health impact by averting the deaths associated with Hib pneumonia, meningitis and hepB liver cancer,” said Dr Seth Berkley CEO of Gavi.

India has already shown that massive immunization roll-outs are in its citizens’ best interest in order to have a healthier populace. India was recently declared polio free because of its willingness to scale-up its polio vaccination programs.

Read more at GAVI.org.

Looking at Voluntary Medical Male Circumcision in the Field

Amos Emmanuel Kakere really wanted to undergo voluntary medical male circumcision (VMMC).

A slight young man who looked far younger than his mere 24 years, Kakere, who is married and lives in Mhango village in Tanzania’s Shinyanga region, opted to undergo the procedure after seeing a large VMMC mobile field clinic near his village.

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The clinic, housed in a large, deployable tent and powered by a massive generator, with a waiting area and operating tables inside, was erected and run by IntraHealth International-trained health workers. The mobile clinic reaches 25,000 local men and young boys over the age of 10 from three villages who want to undergo VMMC but do not have access to nearby health facilities.

“I was passing nearby and heard there was a tent and asked what was being done,” Kakere said through translation. “I was anxious to get the service.”

Voluntary medical male circumcision is a common, 15- to 20-minute procedure that reduces HIV acquisition by 60 percent during heterosexual sex. VMMC is considered to be one of the easiest and most effective methods to reduce HIV transmission.

When I asked him how he felt about the procedure, Constantine gave a thumbs-up and simply said, “Poa,” which means “cool” in Swahili.

It’s been found, surprisingly, that women in sub-Saharan Africa tend to be excellent targets of VMMC messaging, as they encourage their partners to get circumcised and they understand that while not foolproof, a circumcised partner poses a lesser HIV threat than one who isn’t.

Village announcement campaigns also educate and bring in potential VMMC clients. Constantine Michael, 10, heard the announcement in his village and asked his older sister, Rosalea Michael, 19, to take him to IntraHealth’s mobile clinic.

“I heard from the announcement in the village,” Constantine said in a low, shy voice. “I asked my sister to bring me.”

Rosalea agreed to take Constantine to get the procedure, but only after explaining VMMC to him. When I met them, Constantine was waiting in line with other young boys to get tested for HIV and be counseled afterward before undergoing the procedure.

When I asked him how he felt about getting the procedure done, Constantine gave a thumbs-up and simply said, “Poa,” which means “cool” in Swahili.

IntraHealth, a global NGO that works in 90 countries and trains health workers to serve public health, works in Shinyanga, Simiyu, and Mara regions in northeast Tanzania to help the Ministry of Health reach the voluntary male circumcision targets set in 2009.

The main challenges are supply-chain management, governance, continuing education, and low pay for health workers.

The expectation is to successfully perform 200,098 voluntary male circumcision procedures by 2017 in these regions.

Located two hours outside Mwanza, Tanzania’s second-largest city, along dusty, bumpy, unpaved roads, IntraHealth’s mobile clinic in Shinyanga region has a daily capacity of 40 to 60 procedures.

Armed with CDC funding, IntraHealth works to effectively reduce the 7.4-percent HIV-prevalence rate in the three regions in which they work on VMMC. The HIV rate in these areas is higher than the nationwide average, making the scale-up and outreach of VMMC critical.

The Tanzanian government takes part in the human-resource side of regional VMMC projects and also pays health workers, explained Dr. Gissenge Liga, the head of the Clinical STI Unit and a national VMMC focal person. Yet there are still challenges that health workers who work on VMMC face.

Dr. Ntuli Kapologwe, a regional medical officer in Shinyanga, says the main challenges are supply-chain management, governance, continuing education, and low pay for health workers. “On the regional level people are competent,” Kapologwe said. “We are doing our best.”

Paying nothing for his circumcision because voluntary medical male circumcision is an HIV-prevention procedure, Amos Kakere underwent the relatively quick procedure inside the air-conditioned field clinic. Aside from the initial pain of the anesthesia shot, Kakere lay still on the operating table during the relatively painless procedure. He was given painkillers, instructed to return after three days for follow-up, and told to abstain from sex for six weeks in order for the circumcision to fully heal.

Voluntary medical male circumcision has made definite inroads in Tanzania through years of initial pilot projects, awareness and education campaigns, and a scale-up of VMMC services provided in health facilities and in mobile units. The approach seems to be working.

Before undergoing the procedure Kakere said, “I will encourage my friends. They shouldn’t be scared.”

Disclosure: I traveled to Tanzania as a guest of PSI to see their lifesaving work on the ground with health workers, as well as to see IntraHealth’s VMMC mobile clinic in Shinyanga region.

Photos courtesy of Jennifer James.

– See more at: http://www.intrahealth.org/blog/looking-voluntary-medical-male-circumcision-field#.VEZEDPnF8t4

Why Global Handwashing Day Matters

One of the top three killers of children under the age of five globally is diarrhea. Human feces carries diarrhea pathogens and  “a single gram of human feces can contain 10 million viruses and one million bacteria“. An easy way to curb deaths of children under five is to simply wash one’s hands. This goes for pneumonia as well, another global killer of children in low- and middle-income countries.

Handwashing is an intervention that works, but one that proves hard to catch on in some parts of the world due to a lack of knowledge, behavioral norms, and a lack of soap! Studies show most homes worldwide have soap, but it is typically used to wash clothes and not hands. If one simply washes their hands it breaks the cycle of a disease. That is how powerful, effective, and inexpensive handwashing is, but unfortunately isn’t used nearly enough to curb some of the most deadly infectious diseases that take the lives of millions of children every year.

October 15 is the annual Global Handwashing Day where over 200 million people celebrate handwashing around the world to reinforce the importance of washing hands to stay healthy and ultimately save lives.  Simply washing one’s hands with soap significantly reduces the spread of disease. And yet, given that, data shows that health workers only wash their hands 40% of the time when they are in a health care setting. That is certainly unacceptable and one of the primary reasons Global Handwashing Day exists. Studies also show that children who live in homes where handwashing is a part of the regular routine are more healthy than those who do not.

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A Day in the Life of a Family Planning Health Worker

Salasala, Tanzania — It took over an hour in notoriously congested Dar es Salaam traffic and gingerly moving through winding, narrow, dirt roads to visit Blandina Mpacha. Mama Blandina, as her community affectionately calls her, is a PSI health worker who teaches women, men, and whole families about the importance of family planning. This isn’t something new to her. Mama Blandina has been a family planning health worker for over twenty years and has seen the slow-going, but eventual change in attitudes toward spacing births. In a country where women give birth to 5.29 babies on average, Mama Blandina is saving lives and giving women a chance to raise their families instead of living in a perpetual cycle of pregnancy.

Greeting us on her front porch where adult shoes and sandals laid strewn about, Mama Blandina first wanted to show us her chickens. It wasn’t just a few adult hens milling about and pecking around; no, it was a coop full of at least seventy growing chickens being raised for sale, for as much as Mama Blandina is a family planning health worker, she is also an entrepreneur and has been for much of her adult life.  This is yet another sign of Mama Blandina’s resourcefulness, standing, and importance in a relatively poor community on the immediate outskirts of Dar es Salaam.

Blandina Mpacha first learned about being a family planning health worker on the only radio station in Tanzania at the time. Back then, she recalled between sips of coffee, only women who worked in offices used family planning methods. Now, for the most part, the stigma has fallen away.

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