Manyara - A big gray cloud dims the sun for a small crowd seated on chairs arranged on a grass clearing beside a hospital ward and long, roofed corridor. Officials from the district, Ward and village seat on row of chairs on the corridor, facing the crowd of mothers who nurse infants and children on their laps.

A few men dot the mainly ladies gathering. Behind the small crowd an earth-colored tent is pitched. On its gable a handwritten sign announces the occasion: Vaccination week, Ayalagaya Ward.

World Health Organization (WHO) immunization officials joins the district medical officer, immunization officer, and the in-charge of the hospital and the guest of honor-the Ward Councilor, Ms. Selina Ammi.

This is one of local African Vaccination Week (AVW) events, snowballing after the national launch on 24th April in Babati Town.

“The national launch usually sparks awareness. In smaller, gatherings like these, we set off the messages through word of mouth deeper into the communities. In this week, defaulters and those who missed are identified and vaccinated,” says the Babati District Immunization Officer, Mr. Mleli David.

With financial support from Canada, WHO supports Manyara region to carry out outreach vaccination. During the AVW 2023, implementation of this support began. Additionally, WHO supports review of guidelines for integration of COVID-19 vaccination into routine immunization.

Serving a highly populated Ward, Ayalagaya health facilities vaccinate up to 200 eligible population on each of the three days set for vaccination on routine days.

“We usually have many clients on routine vaccination days because generally the community trusts vaccination, especially for children,” says

Selina Sule, a Nursing Officer at Ayalagaya health facility.

The global ‘Big Catch up’ theme—cannot be overemphasized in Tanzania, and Manyara in particular.

Despite a generally high coverage on routine immunization Tanzania experienced sporadic outbreaks of Measles in 2022 with unvaccinated children aged five years and above hospitalized. A few deaths were reported. At five years children must have completed scheduled childhood vaccination.  

According to Mleli, Babati has 90 percent coverage for most of the vaccines. The routine vaccination program in Tanzania provides 13 antigens. However, like the rest of Tanzania there are pockets of communities, where children missed doses of Measles and Rubella vaccine and, HPV vaccination coverage is below acceptable rates.

The message of the Guest of honour, a respected popular Councilor, to the gathering addressed this issue. Speaking up—there are no mega speakers or fanciness of big events—her word permeated.

“Remember, in our region a child aged above five died from measles last year. This should remind us that missing vaccines is serious. Please invite everyone to ensure their children are vaccinated,” she says.

A couple of journalists scribbled on their notebooks and recorded in their cameras, later to amplify in locally popular media outlets.

Similar community level events take place on AVW in other wards in Manyara and other regions.

In the context of equity and leaving no one behind, Manyara is one of regions with mobile nomadic population where WHO Tanzania zoomed its efforts since last year, in addition to its role of supporting policy and planning at national level. At the beginning of 2022, Manyara region was trailing last with COVID-19 vaccination. The WHO and partners’ effort contributed to raising coverage of COVID-19 vaccination from 4 percent to more than 90 within six months. Thanks to the involvement of CHAI, JHPIEGO and Save the Children, Manyara sustained an upward trajectory uplifted the region to the top tier.

“We tried to integrate outreach for child vaccination on the momentum of COVID-19 vaccination,” said Mleli. It raised doubts initially. Eventually the community understood and accepted the approach.

The African Vaccination Week was flagged nationally in Tanzania with a call to ensure that all children that missed their doses are reached. Officiating the launch in Manyara, Northern Tanzania, the Permanent Secretary of the Ministry of Health Professor, Tumaini Nagu emphasized the importance of vaccination.

“I call upon parents and community members who know children that have missed their vaccine doses to note that missing vaccination puts children and the community at risk of contracting diseases,” said Prof. Nagu. She noted that many children missed their doses of Measles and HPV vaccines.  

At Ayalagaya health centre the sun peers from behind the cloud. A speech has ended, and mothers are queued at the vaccination tent.

Occasionally, a child shrieking cry breaks above the din. With an assured face a mother walks away down the corridor, comforting her baby after a painful, but important lifesaving encounter with a nurse. Many more children got vaccinated.