Ghana’s Economic Crisis Affecting Childhood Immunisation – Excerpts from the Daily Graphic Investigation, and the restocking of the vaccines.

By: Aishah Fadila Adamu and Worlako Biese-Macarthy

“Sometimes, about 40 children are brought to our facility to be vaccinated but due to the shortage, only 10 children get immunised, with the rest turned away to come back later when new ones are received. Since January this year, there had been a shortage of BCG and instead of opening two vials a day, only one vial is opened, especially on Thursdays, to vaccinate 20 children.”  Nurse- Bolgatanga.

Ghana launched the Expanded Programme on Immunizations (EPI) in 1978 in response to a national strategy to reduce maternal and infant morbidity and mortality from vaccine-preventable diseases. Generally, the EPI has been successful, increasing child immunization rates from 5% at the inception of the initiative to 83% in 2014.  Unfortunately, the current situation of vaccine shortage risks a reverse of the gains made over the past 7 years under SDGs.

The Daily Graphic, in February, investigated reports of erratic supply of vaccines to several regions of the Country. The investigation, which was conducted in health facilities in 8 of the 16 regions, revealed a mass shortage of vaccines in the country.

In Accra, the managers of some of the health facilities that are popular for their child welfare and public health services confirmed the shortage but declined to give details.

When pressed, some of them for fear of victimisation, blurted out: “Madam, please I love my job”, and “Please, I don’t want to be transferred”, among others. Some of the managers kept pushing the responsibility to speak to the next person, saying “I am not the right person to speak on the issue”.

In Koforidua, the Medical Director at the Eastern Regional Hospital confirmed the shortage of Measles-Rubella, Penta, Rota and Oral Polio vaccines since the beginning of the year.

The Eastern Regional Deputy Director of Public Health said the directorate took delivery of some of the vaccines a fortnight ago. He also dispelled suggestions that if the shortage of the vaccines persisted for some time, it could pose a serious threat to the children, saying they could be vaccinated at a later date and remain safe.

In Bolgatanga, vaccines such as Bacillus Calmette-Guerin (BCG), Oral Poliovirus Vaccine (OPV), Measles-Rubella, Yellow fever vaccine, and Men A were short in supply in the region for the past two months.

A nurse, speaking on condition of anonymity, said: “Sometimes, about 40 children are brought to our facility to be vaccinated but due to the shortage only 10 children get immunised, with the rest turned away to come back later when new ones are received”.

The source said, “since January this year, there has been a shortage of BCG and instead of opening two vials a day, only one vial was opened, especially on Thursdays, to vaccinate 20 children.”

In Wa, several District Disease Control Officers in charge of the Expanded Programme on Immunisation who spoke to the Daily Graphic, on condition of anonymity, confirmed that BCG, Measles-Rubella, Oral Polio and Rotavirus were not administered regularly since November 2022. They said their first monthly supply for the year came without the four vaccines mentioned.

In Kumasi, Oral poliovirus vaccine (OPV), Inactivated Polio Vaccine (IPV), measles, yellow fever, rotavirus, BCG, meningitis and Vitamin A 1000 and 2000 were in short supply.

Hospitals such as the Maternal and Child Health Hospital (MCHH), popularly known as Children’s Hospital, the Manhyia Government Hospital and the Suntreso Government Hospital had all run out of some vaccines. Some of the facilities said the phenomenon was not new as it had happened before.

In Cape Coast, a source at the Central Regional Health Directorate told the Daily Graphic that while there were shortages at some of the facilities, the situation was not widespread. The Central Regional Director of Health, Dr Akosua Sarpong, however, said the issues relating to the shortages were reported last year but had since been generally resolved in the region. She said the recent issues the directorate picked up were not about dire shortages but challenges with the effective redistribution of the vaccines at the district level.

The Public Relations Officer of the Cape Coast Teaching Hospital, Mr Fred Nyankah, told the Daily Graphic that the hospital did not have the Oral Polio vaccine and Rotavirus vaccine.

“We do have all the other routine childhood vaccines, including BCG. However, we do not have BCG syringes which are short in supply nationwide, but we have improvised with insulin syringes.”, he noted. He said the vaccines were also not available for private purchase, so once the government did not supply them, the facility itself could not procure them.

In Takoradi, vaccines in short supply included Penta.

However, the Western Regional Health Directorate debunked the finding and said the region received vaccines just last Friday and that the vaccines were currently at the regional medical stores.

The Deputy Director of Public Health, Dr Gifty Amugi, said facility managers telling clients that the vaccines were not there did not mean they had run out completely. “Vaccines are kept under a particular temperature in negative numbers and they are released to a health facility. When they come out of the cold room at a plus number, it results in shortening the time,” she said.
Dr Amugi added “We keep the bulk at the storage, therefore if clients visit the facilities and the managers say they are out of vaccines, it means they did not reorder.”

REASON FOR SHORTAGES

Ghana Health Service said the shortage is a result of the depreciation of the Ghana Cedi. The Director-General of GHS, Dr Patrick Kuma-Aboagye explained that efforts are underway to restock the vaccines. “We have acknowledged that there has been a shortage, we were anticipating we will get it much earlier [but] it was delayed …we are working with UNICEF and their other partners to ensure that within the next two weeks, we can bring you the vaccines,” he said in an interview with Citi FM.

Meanwhile, the Paediatric Society of Ghana says it has noted with grave concern, reports of shortages of vaccines across the country. Ghana Health Service has reported an outbreak of Measles in the Northern region involving 50 children.

The Paediatric Society of Ghana recommended, “Ring fencefunding for vaccines used against vaccine-preventable diseases to enable a constant supply of vaccine commodities in Ghana to avoid similar challenges.”

RESTOCKING OF THE VACCINES

In a communique released on March 12, 2023, by the Ghana Health Service, BCG, OPV, and Measles vaccines with their associated devices (syringes, needles, safety boxes, etc.)  have been received and disbursed to the various regional cold rooms for subsequent distribution to districts and facilities from 13th March.

​The Service also cautioned the public against the purchase of the vaccines, validated the eligibility of children who missed scheduled vaccinations, and assured the availability of enough vaccines.

​We hope to see more of this timely intervention from our government to continually improve healthcare delivery and access across the country.