A Visible Difference: Immunizations in Ethiopia

Caption: Haymanot Aimro prepares to feed supper to her nine-month-old son Bokallu Mosfon in Guraghe zone, Sodoo district, Kela kabele, Ethiopia. Earlier in the day, Bokallu received his last of nine mandatory childhood vaccinations, an event memorialized with a certificate from the local health center.

Nine month old Bokallu Mofson scoots a toy car across his family’s brown laminate floor, pushing it through a shaft of evening sunlight. Finally, he throws it near a shelf that holds one of his mother’s newest prized possessions: a piece of yellow paper.

The neatly-folded sheet is a health record showing that, earlier in the day, Bokallu received the last of nine immunizations required by the Ethiopian government for children under one. For Bokallu’s mother, Haymanot Aimro, the paper proves that her son is healthy – and will continue to be.

Bokallu is one of a slowly growing number of immunized Ethiopian children. Just 51 percent have been inoculated against DPT (diphtheria, pertussis, tetanus) and 62 percent against polio, according to the United Nations Children’s Fund and World Health Organization estimates from 2011. A measles outbreak in 2011 underscored just how vulnerable the country’s young are to disease: about 2 million children were at risk of contracting measles, the WHO said at the time.

Increasing the country’s child immunization rates is vital to the health of millions of Ethiopian children. But doing this requires not only improving the ability to distribute immunizations – lack of refrigerators and deep freezers for storing vaccines is a problem, for example – but advocating the government for a stronger national immunization system overall.

Ensuring strong immunization policies

About 120 km away from Aimro’s rural home, Semu Teffera looks like any other office worker in the world. He types at his computer, talks on the phone and sits under dim fluorescent lights as the bustling sounds of Addis Ababa drift in through a window. With each keystroke, Semu ensures coordinated CSO efforts for health and immunization services in Ethiopia.

Semu’s latest accomplishment is a just-published directory listing all the country’s civil society organizations (CSOs) working on immunizations and other health issues. The directory, nearly 200 pages thick, helps organizations see where they might partner on related programs and geographic areas. It also allows for more collaboration in organizing health advocacy activities, thus improving health services overall.

“Before, there was no well-coordinated effort to bring together the voice of civil societies and to strengthen the health sector for immunizations,” said Semu, the forum coordinator for Ethiopia’s CSO platform led by the Consortium of Christian Relief and Development Associations. “But nowadays, we know which organizations are working on which specific interventions.”

The directory is among several projects funded by a grant administered by Catholic Relief Services to increase advocacy for immunizations and to strengthen CSOs working on those systems in Ethiopia. Among other projects the grant has funded in Ethiopia is the creation of a national health forum that brings government and CSO officials together to discuss immunization issues, and CSO participation in government meetings about health policies. Semu said the CSO network will be a success when it consistently coordinates its work on a national level. He figures the network is about 75 percent there.

“Our [CSO platform] work in the office and [our] representation of CSOs to government, policy makers and other partners is very important,” he said. “We represent the grassroots level CSOs working in health, advocating on their behalf for an enabling policy environment.”

An astute observation and a small regret

Back at Aimro’s home, abstract policies are not part of daily life. Like many Ethiopian mothers in rural areas, where people are often illiterate and can’t easily access radio or television, she personally witnessed the benefits of immunizations in other children. “I have been observing that vaccinated and unvaccinated children have quite a difference,” said Aimro. “Those unvaccinated children are suffering from measles and polio and I see various other health problems.”

Aimro wavered only once in her decision to immunize Bokallu. It was his 45th day of life and he had just received his second immunization. Afterward, Bokallu had trouble sleeping that night and Aimro regretted taking him for his vaccination. That feeling soon dissipated, though, when she focused on the positive impact the immunization would have on her son.

“I normally tell mothers that they should vaccinate their children to protect them from tuberculosis, to protect their eyes, their ears and to protect them from other health complications, and to bring health and strength to their future,” she said. “I love my child and I will do whatever I’m told to do for him.”

— By Laura Elizabeth Pohl for Catholic Relief Services and the GAVI CSO Constituency