Expanding vaccination reach through integrated services in Eswatini

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It was an enormous relief to mother Jabumkhaliphi Sifundza when her ten-year-old daughter, Nozweno, was vaccinated against human papillomavirus (HPV). She’d heard about the vaccine on social media and wanted to do everything possible to protect Nozweno from cervical cancer.

Alongside Eswatini’s efforts to vaccinate girls like Nozweno during immunization drives in schools, the government is leveraging the opportunity to simultaneously vaccinate the boys against COVID-19 in an innovative advance towards integrating these vaccines into routine immunization.

High HPV rates in the country are fuelled by high HIV rates, driving up cervical cancer case numbers and deaths. As of 18 April, Eswatini has, with the support of partners including World Health Organization (WHO), vaccinated over 50 000 girls in schools, with a national coverage of 64.3%.

Meanwhile, although the emergency phase of COVID-19 is over, the virus continues to spread and endanger people’s lives. In Eswatini, integration of COVID-19 vaccination into other health programmes, including HPV immunization, chronic diseases and HIV, is high on its health agenda after the recent release of the country’s COVID-19 Vaccine Post-Introduction Evaluation by the Ministry of Health.

“Expanding access to preventative vaccines is vital to improve health and survival, as well as to lay the foundation for countries to reach every person with the basic health services they need to thrive. This dual immunization effort in our schools is an excellent example of optimizing our resources to boost overall vaccine coverage,” says Hon Mduduzi Matsebula, Eswatini’s Minister of Health.

The report says that while Eswatini did well to achieve COVID-19 vaccine coverage of above 70% among people 40 years and older, overall coverage as a proportion of the general population remained low, at 36.9%, at the end of June 2023. For younger people, aged between 12 and 39, coverage remained low at below 50%, negatively impacting the country’s efforts to meet WHO’s global 70% target.

Going forward, integration of vaccines is key to sustainable delivery, the report adds, explaining that the “one-stop-shop” approach to delivering a package of vaccines has the capacity to make the best use of health system interventions.

“In resource-poor settings such as Eswatini, it makes sense to optimize delivery of vaccines in every way possible. If teams are visiting schools to administer HPV vaccines to the schoolgirls, the idea of simultaneously vaccinating the boys against COVID-19 is a perfect example of doing just that,” says Dr Lonkululeko Khumalo, an immunization and surveillance officer in WHO’s Eswatini country office.

WHO supported the Ministry of Health to ensure that WHO guidelines were used to develop national guidelines. The Organization also supported the development of a health workers field guide, training of health workers on HPV introduction and conducting a readiness assessment, including providing supportive supervision during vaccine roll out nationwide. To increase awareness of the vaccine rollout to the population, WHO supported Eswatini in the development of key messages and also sensitized the media to ensure accurate reporting. 

“As WHO, we are proud to be supporting these innovative efforts by the government of Eswatini towards integrated vaccine programmes which, together with strengthening primary health care, is fundamental to our mutual goal of universal health coverage for all,” says Dr Susan Tembo Zimba, WHO Representative in Eswatini.

Distributed by APO Group on behalf of World Health Organization (WHO) – Eswatini.

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