How community’s involvement in policy changes its health fortunes

Routine immunisation, especially polio, was a very controversial issue for decades in many parts of Nigeria, especially in the North. Many people believed polio vaccination was a sinister motive to reduce their population. The reason was however not farfetched because there are common diseases like malaria that needed to be tackled rather than focusing on […]

Routine immunisation, especially polio, was a very controversial issue for decades in many parts of Nigeria, especially in the North.

Many people believed polio vaccination was a sinister motive to reduce their population. The reason was however not farfetched because there are common diseases like malaria that needed to be tackled rather than focusing on what they see as a lesser threat – polio which affects only a few people.

Clad in her blue hijab, Zainab Hassan – a Volunteer Community Mobiliser (VCM) – felt accomplished as she watched four-month-old Bilkisu Mu’azu smile in her mother’s arms.

Zainab is one of the about 180 VCMs deployed to various communities in Toro Local Government Area of Bauchi State through a programme introduced by the United Nations Children’s Fund (UNICEF) in 2014.

The programme was to mobilise and create awareness for parents and caregivers on Routine Immunisations (RIs), antenatal and post-natal activities, hygiene and other health practices in the targeted communities.

Little Bilkisu is one of her success stories in her four years of work as a VCM because the child had her full vaccination routines as reflected on her vaccination card.

Maryam Mu’azu, the 30-year-old mother, has five other children -Usman, Sumayya, Aisha, Amina and Halima, whose vaccination cards reveal a change in the way Routine Immunisation has been accepted.

All the other children have also been immunised with only one or two breaks as shown on their cards.

“All our children have been immunised. We have been encouraged to accept routine immunisation in order to save our children from diseases,” she said.

The community leader Mu’azu Hassan, Mai Unguwar Baba Gombe, is the father of little Bilkisu and one of the active mobilisers for the community with over 700 residents.

“We have seen the results of the VCMs efforts because our perception of routine immunisation has changed and visits to health clinic and hygiene practices have also greatly improved,” he said.

The community leader, who has two wives and 17 children, said that he is fully engaged in all awareness and enforcement activities alongside the VCMs and other community leaders which helped a lot in the success recorded.

He commended UNICEF for its effort through community engagement, which gave an opportunity for communities to be carried along in matters that affect them.

“Communities were left out in the past and that was what brought the suspicion and resentment, but now people are being carried along. That was what brought the change we have seen,” he added.

On her part, Zainab said they deployed all the persuasion skills to convince households about their activities.

“Despite being from the community, people were initially suspicious about the whole thing but thank God we endured and built trust and confidence which paid off, and the communities are enjoying the benefits,” she said.

The stories are also the same in other communities like Sabon Garin Narabi, Rinjin Gani community of Ribina East Ward all in Toro Local Government Area.

Sabon Garin Narabi Community leader, Haruna Adamu, described the UNICEF community engagement programme as a turning point which helped the community change its perception of routine immunisation, ante-natal attendance and personal hygiene.

The community leader whose wife, Maryam Adamu, is also a VCM has a community engagement register to keep records of births in the community.

The registers are routinely checked and harmonised with the records at the community’s health centre to monitor all births and immunisation activities.

Alhaji Adamu Sarkin Baka Narabi, a ward head at Sabon Garin Narabi, would do everything to stop members of his household from being immunised in the past.

According to him, he had a strong resentment towards anything that has to do with polio immunisation or any other routine immunisation.

This has however changed as a result of the community engagement programme which he said had changed his once defiant mind.

The community leader and his likes have become active community mobilisers, creating awareness for people to embrace health programmes brought to the community.

“Nobody dares to go to my house for immunisation in the past because I didn’t believe in the whole issue. But after being educated about the benefits and protection it guarantees our children, I became encouraged and I advise or sometimes force others to immunise their children and send their pregnant wives to ante-natal clinic holding at our health centre,” he said.

One of the challenges facing the community, according to the community leader, is that the community with almost 5000 inhabitants has only one health facility which he said cannot cater for everyone.

“Our health facility cannot serve and provide all the needed services. You need to see the crowd whenever antenatal clinic is holding at the health centre. 

“The place needs to be expanded because we have enough space for expansion and the government needs to provide us with another health centre to ease our sufferings,” he said.

Yusuf Umar, the officer in charge of routine immunisation at the Sabon Garin Narabi Health Center said the VCMs help in routine immunisations monitoring and compliance, adding that they are recording tremendous success.

At Rinjin Gani, another community on the outskirts of Toro, the efforts of another VCM Rashida Saminu is paying off.

The small community located in Ribina East ward has seen a transformation in its healthcare as the VCM sensitises households on the need to accept routine immunisation, antenatal and hygienic practices.

When our reporter visited the community’s health centre, Fatima Adamu, the person in charge of the centre, explained that the maternity has over 90 percent immunisation coverage and compliance.

She added that the maternity records more than 20 deliveries in a month, as more women prefer delivering at the health centre due to increased awareness.

“There is a great improvement because of increased awareness by the VCMs operating in the communities. This is the only maternity in Ribina East and it serves many communities around this area and beyond,” she said.

Giving an overview of the programme, the Bauchi State UNICEF Cluster Consultant, Mr Samuel Sule Ajanson, disclosed that there are 403 Volunteer Community Mobilisers (VCMs) in nine local government areas of the state. 

According to him, the local governments include Bauchi, Toro, Ningi, Darazo, Ganjuwa, Misau, Katagum, Kirfi and Tafawa Balewa.

He said the community engagement initiative works through connected committees and individuals which include community leaders, religious leaders, prominent individuals and active community mobilisers.

“We have Ward Development Committees (WDCs) which comprises of ward heads, imams, pastors, health workers and has the Routine Immunisation In Charge as the secretary.

“We also have Village Development Committees (VDCs) which also comprises of village heads, health workers and others. These committees meet once in a month to review activities and harmonise registers of births among other things,” he said.