Simple Interventions Keep our Children Healthy
By Mali Kambandu, Communications Officer, BID Initiative Zambia
Jul 6, 2016
Sitting in his office in Lusaka, Dr. Francis Mwansa smiles. “I decided early in my career that I wanted to give back to the community as soon as possible because I might not have the chance later in life.” The desire to give back to his community changed the trajectory of this young doctor’s career, but brought something special to Zambia’s health service.
Dr. Mwansa heads the Child Health Unit at the Zambia Ministry of Health. He has been in this role for two years and regards it as an important position in securing and protecting the health of children in Zambia. Dr. Mwansa understands the value of simple interventions to achieve better health outcomes, something that was reinforced during his time in rural Zambia. “With children, it’s best to prevent the disease, as treatment might be complicated or begin too late. I practice this at work and in my family with my 11-month old son.”
Before leading the Child Health Unit, Dr. Mwansa spent three years in Kaputa, a town in rural Northern Province with very unique health challenges, such as high maternal mortality (5 deaths per month), high newborn mortality, and high rates of malaria and diarrhea. Kaputa is a rural district with a population of 87,233 where many people depend on agriculture and fishing for their livelihoods.
When he arrived in Kaputa, Zambia was in the middle of a devastating measles outbreak. There were numerous cases presenting at health centres, and Dr. Mwansa saw how hard-hit children aged six-months to two-years were by the disease. “I didn’t know measles could kill like that. We saw many deaths. Measles is an immune-compromising disease, so it aggravates respiratory diseases such as tuberculosis and pneumonia and conditions such as malnutrition.”
Dr. Mwansa explains that children would be brought to the health facility with a measles rash and other complications. Treating them would be very difficult. Eventually, the medical team lead by Dr. Mwansa decided to look at their data and examine the coverage of simple interventions such as immunizations, which would provide children with protection against pneumonia, measles, and other vaccine-preventable diseases.
“Our DPT3 coverage (the most common measurement of basic immunization services) was at about 30 percent, and we realized that if we could get it up to at least 60 percent, we would make a big impact in reducing pneumonia, diarrhea, and even measles.” This is because by the time DPT3 is administered at 3 months, children have already received many other life-protecting vaccinations. Additionally, the longer that mothers keep their children enrolled in the under-five clinic, the more they are exposed to the benefits of health education. For such mothers, the uptake of measles vaccine, which is administered at nine months, is higher compared to those who drop out early. So we knew that if we could raise DPT3 uptake, measles coverage would also increase.
Another area where Dr. Mwansa saw a significant change due to simple interventions such as vaccines was with rotavirus. In Zambia, each year 3,600 children die due to severe and fatal diarrhea caused by rotavirus, making it the third-leading cause of death of children under five. The rotavirus vaccine was introduced in Zambia in 2012, and Dr. Mwansa speaks of the results. “The introduction of the rotavirus vaccine amazed me. The change was so dramatic and I thought, maybe [the health workers] are not reporting all the incidents of diarrhea. But later, I saw that the vaccine’s introduction was the only change. The rotavirus rate dropped to 24.7 percent in 2014, from 40 percent in 2012 before the vaccine was introduced. This is what drove my interest in vaccinology and its critical role in keeping children healthy.”
Dr. Mwansa is a brilliant clinician who has successfully treated patients in rural and urban settings. While he is now in a more programmatic position, he maintains the same passion for simple interventions such as vaccinations, and work related to improving the immunization coverage and access for children, such as the BID Initiative. “Early interventions prevent complications later, and in Zambia we must concentrate on preventing disease in young ones.”