How UNICEF support for cold chains systems helps build healthier communities in Belize
Punta Gorda, BELIZE – A hallmark of the maternal and child health programme in Belize has been the success of the national immunisation coverage. However, with the onset of the pandemic, immunisation rates significantly decreased from 95 per cent to as low as 71 per cent in 2020 at the height of the pandemic. This has reverted hard-fought primary health care gains that have ensured low infant and child mortality and mobility levels making babies less healthy and more susceptible to preventable diseases.
Senior Public Health Nurse for the Toledo District, Deborah Ramirez Mariano, has given 11 years of service to the Punta Gorda Polyclinic. Toledo District is one of the most deprived districts in southern Belize with immunisation coverage at 45 per cent. With a little over 200 mothers attached to her clinic, her insights explain the challenges health workers have encountered in maintaining the national coverage.
“We noted that mothers were not coming to the clinics, so we ensured our mobiles went out to them in their communities. Though we made some gains, we still experienced a drop in our immunisation rates because many mothers were refusing to give their babies the vaccines. They had the mentality that the vaccines we were giving the babies were the COVID-19 vaccines. Even though we explained that this was the same vaccines from before COVID they were still skeptical and refused to comply.”
Despite their assurances to the concerned mothers those beliefs contributed to the decrease in the babies vaccinated. Nurse Ramirez Mariano explains that to date the only vaccine schedule on track is the BCG vaccine. All other vaccines are below an average of 70 per cent in her district.
UNICEF has accelerated its support to the Ministry of Health & Wellness to address these challenges as a national priority. Through the provision of UNICEF Global HAC over $300,000 Belizean dollars has been invested in strengthening the cold chain system in health facilities. The Punta Gorda Polyclinic and community hospital in Toledo District are among the facilities that have benefited from this support. Cold chain equipment has been provided to improve vaccine management within the district facilities and to support health care workers to increase mobile clinics conducted to take the vaccines to the community. State-of-the-art equipment were purchased to bolster the national cold chain including freezers, cold boxes, temperature monitors and cars to enable transportation of vaccines and nurses to ensure uninterrupted service delivery.
Nurse Ramirez Mariano shares that the cold chain equipment provided has been very critical to managing the bulk supply of vaccines provided to Punta Gorda and San Antonio. She explains, “the 3 nurses that work in this area, we have over 20 villages to cover to ensure mothers and children are getting the health services they need."
"In some instances, we must walk 2 hours to reach the communities because the roads are impassable by vehicles. Our small coolers and temperature monitoring devices helps us to maintain the cold chain as we take the vaccines to the community.”
With the equipment provided to the Ministry of Health & Wellness each health care worker can reach 50 families per week taking lifesaving vaccines to mothers and their babies to restore the coverage to pre-covid immunisation rate. The support of the HAC global partners has been timely and invaluable in scaling up and accelerating recovery response to reach children and mothers especially from migrant, host and vulnerable communities.