COMMUNITY INVOLVEMENT IN VACCINATION : PRACTICAL EXPERIENCE BY H.N. YAHAYA, R. SAIDU- YAHAYA

COMMUNITY INVOLVEMENT IN VACCINATION : PRACTICAL EXPERIENCEBY H.N. YAHAYA, R. SAIDU- YAHAYA PRESENTED BY HRH DR HALIRU YAHAYA EMIR OF SHONGA, ( CHAIRMAN BOT HERFON ) NIGERIA

OUTLINE • INTRODUCTION • CONTEXT • NIGERIA • THE HEALTH SYTEM • COMMUNITY LEADERSHIP • COMMUNITY INVOLVEMENT • HEALTH AND DEVELOPMENT • VACCINATION • LESSONS • CHALLENGES • OPPORTUNITIES • WAY FORWARD

INTRODUCTION

THE CONTEXT NIGERIA THE HEALTH SYSTEM

PHC IN NIGERIA • Primary Health Care (PHC) constitutes the core of the Nigeria’s Health Policy. • Over the years through PHC strategy, the Nigerian Government has strived for the achievement of the lofty goal of building a responsive and effective health system. • .Progress has been rather slow

COMMUNITY LEADERSHIP STRUCTURE • TRADITIONAL/RELIGIOUS • POLITICIANS • BUREAUCRATS • THE WEALTHY

TRADIONAL LEADERSHIP • COMMUNITY CHOSEN RESPECTED • TRUSTED AND BELIEVED • OCCASSIONALLY REVERED BY POLICAL & OTHER COMMUNITY LEADERS • OPINIONS OFTEN SOUGHT AND RESPECTED • INVOLVEMENT TENDS CONFERS CREDIBILITY ON HEALTH PROGRAMMES • COULD THEREFORE BE THE FOCAL POINT FOR HEALTH ACTION AND DEVELOPMENT

COMMUNITY PARTICIPATION • A major principle of the PHC is community involvement and participation which is seen and recognized as a critical and an essential ingredient to achieving ‘Health For All’. • The National Health Policy states that, ‘the people of this nation have the right to participate individually and collectively in the planning and implementation of their health care. However, this is not only their right but also their fundamental duty’

Cont.. • Community participation has been defined as ‘ an educational and empowering process in which people, in partnership with those able to assist them, identify problems and needs and increasingly assume responsibility themselves to plan, manage, control and asses the collective actions that are proved necessary’. • Active participation is what was recommended by the Alma Ata Declaration.

The rationale The rationale for community involvement and participation • The community has felt needs; and it alone can best express such needs • The community can be assisted to develop capacity to solve their problems and meet felt needs • The community has resources, and can be guided to harness such resources, thus promoting self reliance, self determination and sustainability.

The benefits • The benefits of community participation are numerous. They include: • Development of appropriate, relevant and effective PHC which meets the specific needs of the community. • Ensures wide acceptance and proper utilization of health services ( because the people identify with them)

Cont… • Guarantees universal coverage of health care ( because of cost sharing possibilities and empowering of people) • Has been used to prevent and control epidemics.

Mechanism/Platforms for promoting community participation in PHC • Community Leaders. • Committee system, membership to be drawn from all interest groups • Social Organizations such as the religious groups – church or mosque, professional/trade groups, age groups etc

- EXPERIENCE FROM EDU LOCAL GOVT. AREA OF KWARA STATE NIGERIA

SOME ON-GOING KEY HEALTH PROGRAMS • POLIO ERADICATION INITIATIVE (PEI) • ROUTINE IMMUNIZATION • INTEGRATED MATERNAL, CHILD & NEW BORN HEALTH (IMNCH STRATEGY) • COMMUNITY BASED HEALTH INSURANCE SCHEME

KEY CHALLENGES KEY CHALLENGES KEY CHALLENGES KEY CHALLENGES

PHC OVER THE YEARS

LESSONS LEARNT • THE NEED FOR IMPROVED COMMUNICATION AND EMPOWERMENT OF THE TRADITIONAL LEADERSHIP • COMPENSATION MAY NOT REACH THE INTENDED BENEFICIARIES • INCENTIVES NEED TO BE PROVIDED TO VOLUNTEERS TO ENGENDER COMMITMENT • NEED FOR FEEDBACK TO THE COMMUNITY • NEED FOR EFFECTIVE MONITORING AND SUPERVISION BY EMPOWERED LEADERS

CHALLENGES • INADEQUATE POLITICAL WILL PARTICULARLY AT THE OPERATIONAL LEVEL, THE LGAs • IGNORANCE - ALL LEVELS • POOR COMMUNICATION ESP WITH COMMUNITY LEADERS • LOW IMMUNIZATION COVERAGE • PRESENCE OF WILD POLIO VIRUS ( WPV) • VESTED INTEREST IN PEI -”CATCH 22” • FELT NEEDS NOT ADDRESSED -- MEASLES, DIARRHOEA, WATER SUPPLY ETC • FATIGUE DUE TO TOO FREQUENT POLIO CAMPAIGNS ( SURVEYS??) • EXCESSIVE MONETIZATION OF (DONOR) PROGRAMMES DISCOURINGING VOLUNTARISM

- • HIGH MATERNAL AND CHILD MORTALITY ESPECIALLY IN NORTHERN NIGERIA • INADEQUACY OF HUMAN RESOURCE FOR HEALTH • NEED FOR SUSTAINABLE PHC FINANCING MECHANISM • ILLITERACY • POVERTY • ATTITUDES VALUES

OPPORTUNITIES • A NEW LEADER IN THE NORTH IS ABLE TO GALVANIZE ALL THE CHIEFS IN NORTHERN NIGERIA TO MOBILIZE: • FOR PEI AND RI PARTICULARLY IN HIGH AREAS • MATERNAL MORTALITY REDUCTION PROGRAMMES • GIRL CHILD EDUCATION

COMMUNITY INVOLVEMENT IN VACCINATION : PRACTICAL EXPERIENCE BY H.N. YAHAYA, R. SAIDU- YAHAYA