Routine immunisation credited for drop in infant deaths in Zimbabwe

Zimbabwe has made strides in reducing neonatal and childhood mortality over the past decade and a half, a result attributed by health leaders to the country’s extensive vaccination programme, among other public health interventions.

At a public address to mark the Expanded Programme on Immunization’s (EPI’s) golden jubilee in Harare late in 2024, Health and Child Care Minister Dr Douglas Mombeshora said vaccines are saving six lives each minute.

“The EPI is still aiming to prevent more preventable diseases where vaccines are available. Vaccines have life, vaccines are saving six lives every minute. As a result, we have benefitted from vaccines that are available in the region, in the country.

“We started with six antigens and now we have 13, and that’s a huge milestone,” Dr Mombeshora said. “We use neonatal mortality, infant mortality, as a measure to say where we are going.

“We have positive results. We have been reducing infant mortality partly due to vaccination, partly due to proper management of the mother as well during her pregnancy. So, vaccines really are a saviour.”

Neonatal mortality refers to deaths of newborns within the first 28 days of life, often caused by infections, such as tetanus, which is preventable with a vaccine administered routinely to pregnant women in Zimbabwe, complications during childbirth or related to preterm birth, and a lack of adequate healthcare.

Like many other sub-Saharan African countries, Zimbabwe has recorded strikingly high neonatal mortality rates in years past. According to the UN Inter-agency Group for Child Mortality Estimation (UN IGME), neonatal mortality rates stood at almost 33 per 1,000 live births in 2008, almost twice the current global rate of 17 per 1,000 live births. But by 2022 IGME estimated that newborn fatalities in Zimbabwe had declined to 24.26 per 1,000 live births.

Under-five mortality rates are tracking a similarly hopeful trajectory. In 2008, 93.33 children out of every 1,000 died before their fifth birthday; by 2022, that fatality rate was down to 47.73, according to UN IGME estimates.

A fair shot

Dr Aspect Maunganidze, Health and Child Care Secretary, says that the national immunisation programme, backed by international partners such as Gavi (since 2000), UNICEF, and the World Health Organization, has been a keystone contributor to the turnaround, and continues to be central to Zimbabwe’s health strategy.

“Improved access to healthcare by communities through investments in health infrastructure, investments in human resources – skilled healthcare workers – to provide immunisation and other integrated services,” have been crucial to the decline in infant deaths, Dr Maunganidze told VaccinesWork in an interview.

“There have been significant investments in the Expanded Programme on Immunization. The government will continue to aim to reach out to everyone everywhere with life-saving vaccines in the spirit of leaving no-one behind. The Ministry is also expanding the reach of vaccination through capacitating all health facilities.”

The skilled health workers trained by the government don’t only administer vaccines, Dr Maunganidze underscored, but also play a pivotal role in educating communities about the importance of immunisation.

Outreach vaccination

According to village health worker (VHW) Tariro Makahamadze, community outreach has made all the difference.

“The success story in neonatal mortality can be attributed mainly to outreach programmes that we have been carrying out over the past two years. We have been educating expectant mothers on the importance of prenatal clinic visits,” said Makahamadze of rural Buhera in Manicaland Province.

Miriam Munyikwa, 26, explained how postnatal visits saved her one-year-old daughter’s life. “To be honest, during the birth of my first child I never bothered visiting the clinic for check-ups. However, education on the importance of postnatal clinic visits from local health professionals impacted greatly on my child.

“When I visited the clinic three days after birth, I was told that the child had pneumonia, which put the life of the child at risk.” Munyikwa explained that her daughter was subsequently immunised, adding, “I can safely say it saved my child had and had I not received the education, it would have been à different story.”

In Buhera’s Nyanzira village, parents expressed gratitude over the health interventions that they said saved their children’s lives.

“I lost my first child at two weeks old because we could not access the clinic. Today we are happy because mobile clinics visit us and our children are up to date in terms of vaccination,” said Charity Chiga, a mother of three.

A local health worker, Sithabile Maswa, said: “We have seen an increase in the number of children receiving vaccines during our visits to villages. With support from the Ministry and local village leaders, we have been able to carry awareness programmes and the results are there for us to show.”

Dr Maunganidze said the government would continue its efforts to expand vaccination coverage and ensure that every child, no matter where they live, is vaccinated.

“We will continue to conduct outreach visits to hard-to-reach areas, as well as provide adequately trained and skilled human resources to promote vaccination services. The goal is to ensure that Zimbabwe’s children grow up in a healthy environment, free from the burden of vaccine-preventable diseases,” he said.