Cross border collaboration and multi country approach in the fight against polio in Malawi

Health authorities have therefore put in place common strategies not only at national level in Malawi, but also in all districts bordering other countries involved in the response: Zambia, Tanzania and Mozambique. This entails putting in place micro plans: mapping the cross-border communities, migratory routes, cross-border entry/exit points, and transit routes for each of the cross-border facilities. Synchronization of vaccination plans across neighboring countries is key when it comes to identifying and reaching all households where eligible children live in the cross-border areas, so that the risk of paralysis due to the virus can be avoided.

As part of that joint multi country response aimed at vaccinating 23 million children, Douglas Alimoyo (Health Surveillance Assistant) participated in the vaccinators trainings undertaken with technical support from WHO. He stayed full-time last week in the Muloza border post (image above), in between Malawi and Mozambique, surrounded by trucks and people following their regular trade route.

Douglas therefore met both Mozambicans and Malawians crossing daily with their babies, informing them about the need to get the vaccine, and vaccinating those who agreed. “Sometimes is hard to stay in the middle because people are not aware of the ongoing campaign, and some other times I do not see many families crossing the border, so I go around bordering districts with my speaker to call families” - he adds.

This was the case of Florence and her 8-Month-old daughter, Magret, who were crossing between the trucks from one country to another to get some groceries. “I was aware of the polio campaign because my friends were getting their kids vaccinated, but since I was on the move I did not get the chance to get my baby to a health facility to get the jab. It’s good that a fixed post is set here so that I can protect her against polio now” - she concludes, as Douglas marks her daughter’s finger to confirm her vaccination status after administering the oral vaccine.

Joint collaboration was critical this past week during the first round of the vaccination campaign, and it will still be very important in subsequent vaccination rounds, especially since all 4 countries involved in the response will start vaccinating again on April 21st. In the image, WHO STOP (Stop Transmission of Polio) consultant Mr. Fitwi Meles meets Douglas to follow up on number of babies vaccinated and on the status of the cold chain to preserve the vaccines. Mr. Meles recognizes the importance of each border health authority to pay special attention to its border communities, facilities and high-risk mobile populations to mitigate the risk of cross-border importation of Wild Polio Virus.

Together, they saw Meriam and her baby Dulis (6 months old) crossing the border in their bicycle. Meriam had not heard about the ongoing polio vaccination campaign: “I come from Mozambique, since my husband is based there. I leave in a small district across the border but I did not know about this vaccination campaign. I was crossing to buy some things and I got my child vaccinated as Douglas called me, because my closest hospital is still far from my place in Mozambique: it’s easier to get her vaccinated now in Malawi”. – she affirms.

Dulis (6 months old) got her vaccine and she is now protected against Polio. Mass vaccinations, or supplementary vaccinations, aims to interrupt the circulation of poliovirus by immunizing every child under 5 years with oral polio vaccine regardless of previous immunization status. The objective is to reach children who are either not immunized, or only partially protected, and to boost immunity in those who have been immunized.

In the image, GPEI partners support national authorities and vaccination teams to put in place harmonized vaccination strategies in order to reach under 5 children that cross borders at official and unofficial points of entry and make sure no one is left behind in this campaign.

The Global Polio Eradication Initiative (GPEI) in 2011 began cross-border interventions to improve cooperation, coordination, and collaboration between neighboring countries. At the center of this effort was the development of a Joint Strategic Action Plan for Polio Outbreak Preparedness and Response, with a specific focus on intensified AFP surveillance at the international, national and local borders.