Laurinda Pandasala was excited when she gave birth to her daughter, Ana, in July 2023. While the event was joyful, she also experienced underlying anxiety. She wanted the best for her child, especially regarding health care. However, accessing routine childhood vaccinations for Ana in Canduvene, a small city in Angola’s Bié Province community, proved daunting. The journey to the nearest health facility was difficult, particularly with a newborn child and due to other family priorities. Ana missed essential vaccinations, leaving her among the country’s zero-dose children who failed to receive routine immunisation. 

Routine vaccination is at the heart of health security, representing an essential component of primary health care. Disruptions associated with COVID-19 vaccination efforts overwhelmed health systems in 2020 and 2021, resulting in dramatic setbacks and many children like Ana being left out of vaccination coverage. 

Therefore, in 2023, the Angola Ministry of Health launched the Middle-Income Countries (MICS) Zero-Dose project, funded by Gavi, the Vaccine Alliance, with support from World Health Organization (WHO), UNICEF and World Vision International, to boost routine vaccination coverage and integrate zero dose children into vaccination programmes. The project was implemented in September 2023 and targeted the provinces of Luanda, Huambo, Bié, Cunene, and Cuanza Sul. It has changed the lives of thousands of families in the 22 most affected municipalities with low indicators. These provinces have 41% of the total national population under one year and accumulate about 60% of children with zero dose status. 

The project includes a series of activities, including providing technical support during vaccination campaigns, supervision of health facilities, preparation of cold chain inventory and micro plans for intensifying vaccination, participation in social mobilisation activities and exchange of lessons learned and good practices among all stakeholders. 

“WHO has provided technical support in training health facilities technicians in good routine vaccination practices and in strengthening the cold chain, at the national system level, both at the municipal and provincial level, to guarantee good quality vaccination at all levels,” says Camilo Tomé, Provincial Consultant for the MICS project in Bié. 

As a result, Ana was one of the 471 122 children under 1, representing 41% of this age group, who were reached by the MICS Zero-Dose project. Since its implementation, there has been a positive impact on national immunisation indicators, with an increase in vaccination coverage of over 60% for all ten antigens due to enhanced community social mobilisation activities through local media, engagement of traditional and community leadership, use of community health leaders who are involved in the mapping of all local organisations supporting health activities, clear identification of zero dose children and implementing targeted intensification with mobile/outreach vaccination activities. Comparative national vaccination data from October to December 2022 / 2023 shows an improvement in both access and utilisation rates, having raised the first pentavalent (DPT1) dose from 75.8% to 90.2% in 2023, while the third dose (DPT3) coverage increased from 67% to 84% in 2023 respectively. 

According to Dr Zabulon Yoti, WHO Representative in Angola, the increase in vaccination coverage reflected the Ministry of Health’s commitment to overcoming challenges and creating a healthier future for future generations. “WHO thanks GAVI for the valuable funding and all the partners involved in this important initiative that has brought not only vaccines but also hope to Angolan families,” says Dr Yoti.

Through the collaborative efforts of the MICS Zero-Dose Project, vaccination teams, social mobilisers, community, and religious leaders came together to ensure that no child was left behind in the fight against vaccine-preventable diseases. Ana and countless children received their first dose of vaccination and continue to comply with the vaccination schedule to enable them to live a healthy life in fullness.

“Now, I am happy because my child is protected against diseases, and she is healthy. All children in our community are now healthier because of vaccines. We are very grateful,” says Laurinda Pandasala.