Cotonou ‒ Throughout her ten years as a midwife, Françoise Kouveglo, who works at Houenoussou Health Centre in Cotonou, Benin, has witnessed some highly emotional moments in the delivery room. “Giving birth is a deeply powerful moment with lots of strong sensations, but what stands out for me is to make sure that the baby is born safely and that both mother and baby are in good health,” she says.

To ensure newborn and child health, one of the key measures Benin is undertaking is to increase access to essential vaccines. Benin is one of the 14 countries in the African region that have mainstreamed the hepatitis B vaccine into their Expanded Programme on Immunization (EPI) and is progressing steadily towards the target of eliminating priority diseases by 2030, including hepatitis B.

“Since 2020, every newborn has received a free first dose of hepatitis B vaccine either in the delivery room or within 24 hours of birth, which is supplemented by two or three additional doses administered at intervals of at least four weeks,” says Professor Sossa Edmond Gbedo, Coordinator of the National Hepatitis Control Programme in the Ministry of Health.

Hepatitis B is a liver infection caused by a virus bearing the same name. The infection can be short- or long-term, with a high risk of death. Childhood vaccination is a vital weapon in fighting against hepatitis B. According to World Health Organization (WHO), it is the most effective means of halting transmission of the virus, given that 95% of the chronic disease burden stems from infections contracted in children before their fifth birthday.

In Benin, prevalence of the disease is 4.49% among the general population and 4.32% in children under 5 years, below WHO’s endemic threshold of 8%. Overall, the indicators are promising, with an almost 85% of babies immunized at birth in 2023, versus 9.2% in 2020.

Systematic vaccination from birth is a core component of the WHO-supported training programme for frontline health workers. “Training health professionals is one of the primary preventive measures against hepatitis B for breaking the chain of transmission and protecting future generations,” says Dr Jean Kouamé Konan, WHO Representative in Benin.

With WHO support, 84 doctors and 97 nurses and other health workers have undergone training between 2020 and 2023. Similarly, 87 statisticians and epidemiological surveillance managers have been trained to develop data collection tools and mechanisms, as well as national surveillance guidelines.

Françoise is one of 64 midwives trained in preventing and managing the disease. She has honed her skills in monitoring vaccination registers and raising awareness among pregnant women. As early as the antenatal consultation, she screens women to find out their status and raises awareness of the benefits of immunization, ensuring that they understand the need to administer the first dose of hepatitis B vaccine to their babies once they are born. “This is how we ensure good health for babies born under our care,” she says.

This approach makes it easy for women to accept screening and immunization for their babies. This was the case for Victoire , 28, who was attended to by Françoise during her pregnancy. “Once my baby arrived, my midwife reminded me that the baby should be vaccinated against hepatitis B. I’ve seen the effects of this disease on those around me, so I'm happy that my baby will be protected from the very first hours of life. The treatment is costly, so I liked the fact that the vaccine offered for the baby was free of charge,” she confided.

With the free vaccine, newborn babies are no longer vulnerable to hepatitis B infection in Benin as long as mothers give birth in a health facility. The promising strides made in immunizing newborns against hepatitis B have a lot to do with births taking place in health facilities under the care of qualified health workers.

Following joint efforts to raise awareness of the issue and establish appropriate facilities, an estimated 77.2% of childbirths in Benin were attended to by qualified health workers in 2022, according to WHO data, compared with the African region average of 71%.

“Benin is indeed on track to meet the 2030 target for hepatitis B. Our vision is to eliminate vaccine-preventable diseases as a public health challenge for our people,” says Dr Konan.