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Set in a remote rural region of Tanzania dominated by mountains and precarious pot-holed roads, Mpwapawa's 32 health centres represent a vital lifeline for delivering basic vaccines to the district's 280,000 inhabitants. Yet, until recently, immunisation rates here were worringly low.
Health worker weighs a new born child at a clinic in Mpwapawa district, Tanzania.
Source: Dr Elizabeth Guinness
Remote villages
Health workers lacked both training and the means to reach Mpwapawa's remote rural villages to check on mother and child health.
Refrigerators for storing vaccines frequently broke down and vaccination cards to monitor immunisation rates were in short supply.
When Tanzania applied for GAVI's immunisation services support (ISS), Mpwapawa was an obvious place to invest the funding.
ISS encourages developing countries to expand their immunisation coverage by offering a US$ 20 reward for every additional child injected with three doses of the diphtheria-pertussis-tetanus vaccine (DPT3) compared with the previous year.
Making the most of ISS
Mpwapawa received US$ 13,000 of Tanzania's first ISS award in 2002. There was no shortage of ways to strengthen the district's immunisation platform:
- health workers were trained and given bicycles to reach even the most distant patients;
- refrigerators were fixed;
- calculators were provided to help improve data collection;
- vaccination cards were purchased to keep track of each dose of DPT3.
Grassroot support
At the same time, district authorities worked with partners such as St.Luke's dispensary, Care International and Simavi to reach out to all communities throughout Mpwapawa. By tapping into the district's strong community structures and holding meetings with local leaders, grassroot support for immunisation increased.
Within a year, Mpwapawa's DTP3 rates - the recognised benchmark for national immunisation coverage because only robust health platforms can deliver three doses in 14 weeks - started to rise.
They have not fallen since.