Improving prospects for young children in Botswana through immunisation

According to The United Nations Children’s Fund (UNICEF), acute respiratory infections and diarrhoea remain the major causes of morbidity and mortality among children under five years old in Botswana.

After the 2011 diarrhoea outbreak in Botswana claimed the lives of over 120 children, the Botswana Ministry of Health introduced pneumococcal (PCV 13) and the rotavirus (Rotarix) vaccines, which were rolled out nationally in July 2012.

The vaccines were introduced as part of routine immunisation on the National Immunisation Schedule in an effort to reduce the Infant Mortality Rate (IMR) and Under 5 Mortality Rate (U5MR), strengthen disease prevention and control, and eradicate vaccine-preventable diseases in Botswana.

At the helm of the National Immunisation Schedule is Australia Awards Alumna, Ndibo Joyce Monyatsi. Ndibo completed a Masters of Public Health from Deakin University, Victoria, in 2010. On return home, she was appointed as Manager of the Botswana Expanded Program on Immunisation (EPI) with the Child Health Division of Botswana’s Ministry of Public Health.

Ndibo led the introduction of the two new vaccines within a 12-month period, a rare feat considering that the average is one new vaccine per year. The introduction of these vaccines called for advanced planning and coordination. Using award-gained advocacy skills, Ndibo successfully influenced decision-makers by presenting evidence-based cases for the new vaccines, and positioning them as a step towards reducing the disease burden in the country.

Next, she organised social mobilisation activities and the training of health workers on the administration of the new vaccines, and developed a comprehensive vaccine introduction plan, which comprised district-level micro planning for the roll-out of the vaccines.

Where Ndibo and her team lacked technical expertise, they collaborated with external partners and sought technical support from organisations such as UNICEF and the World Health Organisation (WHO), thus ensuring that the new vaccines were introduced and administered according to WHO guidelines.

Under Ndibo’s leadership, routine immunisation has steadily gained wider coverage. Some 97% of children under one in Botswana have been immunised since Ndibo’s return, exceeding the minimum target of 90% set by the WHO.

Ndibo is grateful for the skills, knowledge and experience she gained in her Australian studies, which have enabled her to successfully drive Botswana’s far-reaching national immunisation program, although she admits facing challenges.

“I face a lot of challenges, such as having to deal with outbreaks, but I feel I have developed and gained so much experience during my award studies that have enabled me to work well with other team members and guide them,” says Ndibo.

“My managerial and leadership skills have improved, as reflected by my advocacy, negotiation and guiding skills during the process of introducing the new vaccines into the Botswana National Immunisation Schedule. I am now a more focused and results-orientated leader,” she adds.

In recognition of Ndibo’s outstanding leadership and her success as the Botswana Expanded Program on Immunisation Manager, Ndibo was promoted to Head of the Child Health Division in 2013 where she leads a team of 12 officers.

Next on Ndibo’s agenda is the introduction of two other new vaccines – polio vaccine and human papilloma virus (HPV) vaccine. According to the Botswana Ministry of Health, the HPV virus is the major cause of cervical cancer in women in Botswana, a leading cause of cancer deaths among women. The HPV vaccine will target both schoolgoing and out-of-school girls aged 9 to 13 years. Trials started in 2013 with a roll-out expected in 2015.

Nbido is an outstanding example of where the knowledge and skills gained through the Australia Award have been put to good use on return, and have had a direct, positive impact on the lives of many people, children in particular.