At the heart of Mluwira Village in Machinga District, 18-year-old Fatima Jawadu holds her seven-month-old daughter with a newfound sense of relief.
For months, little Sauda had not received a single vaccine, making her one of Malawi’s at-risk children with zero dose children of routine immunizations. But that is no longer the case for Sauda.
With a health passport in hand, Sauda is catching up on the vaccines she had missed, thanks to a project funded by Gavi, the global vaccine alliance, through Unicef in partnership with the Ministry of Health.
Barriers
Jawadu’s journey to getting her child vaccinated was not easy. Like many women in her community, the teen mother delivered the baby at home with the assistance from her grandmother and an elderly neighbour.
a vaccine. | Unicef Malawi
“When you have delivered at home and you go to the hospital, you pay a penalty,” she says. “I didn’t have the money.”
Without the means, Jawadu avoided the health facility. As a result, Sauda missed her routine immunisations.
Although healthcare workers regularly visited the village for under-five clinics, she hesitated to attend.
“I knew vaccines help prevent diseases, but I felt ashamed and feared being asked why I was attending the clinic when I had not paid the penalty,” she says.
A turning point
Fatima’s story took a different turn when the Zero-Dose Project reached her village. The initiative aimed to identify and support caregivers like her, ensuring no child is left behind in immunisation efforts.
Local community health workers played a crucial role. Esnart James, whom Fatima had known from Namandanje Health Centre, took the time to speak with her.
“I kept engaging Fatima on the dangers of not presenting the child to the hospital. As a newborn, she needed to get the vaccine to prevent diseases. It told her it was not too late, for a baby could still receive vaccines even at five months.”
James also engaged health surveillance assistant (HSA) of the area to support the mother to get the child vaccinated.
“The penalty she needed to pay to the chief was K1 500. After the health worker approached her, all she needed was to get her child a health passport worth K500 to go to the hospital,” says the health worker.
Steven Njoka, the HSA responsible for 1 500 people in Jawadu’s area, made several follow-ups until the mother was convinced to take her child for vaccination.
Njoka did not give up on Fatima despite his huge workload.
“It was not a single day job to convince her to come to the clinic and she kept giving excuses. The day that she came was one of the most exciting moments of me as a health worker,” he says.
Apart from the healthcare workers, community leaders, including the village head, stepped in to support Jawadu even though she had not paid the penalty.
“Our chief said every child in the village must be vaccinated,” Fatima says. “With the chief’s blessings, I confidently took Sauda to the hospital under-five clinic.”
A tale of determination
She says the experience was not as daunting as she had feared.
“The nurses welcomed me. They gave Sauda her first vaccines and even provided me with a health passport,” she says, smiling. “Now the 10 months-old baby has received all the vaccines she was supposed to get at her age and I make sure we attend all the clinic appointments.”
The health passport helps her and health workers track Sauda’s immunisation progress.
With each visit, Jawadu marks a milestone, ensuring her child is protected from preventable diseases.
Looking Ahead
Sauda’s catch-up illustrates the power of community-driven initiatives to confront the barriers many young mothers face in accessing healthcare in Malawi.
“Most zero-dose children come from single-mothers,” says Njoka.
However, Jawadu is excited that Sauda is no longer at risk of vaccine-preventable illnesses.
“I feel proud knowing my baby is protected,” Fatima says. “I tell other mothers that it’s indeed important to vaccinate our children.”
