Community outreaches boosting children immunisation

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For Phebe Nakidde, a mother of six-month-old twins, accessing immunisation services used to mean travelling long distances, a task made harder by the absence of a helper at home. But that has changed.

“The immunisation point is now a few minutes from my home,” she says, "The babies are heavy, but with the outreach nearby, I can easily walk and get them vaccinated.”

Her twins, who had already received other routine childhood vaccines, were on Thursday, May 15, 2025, immunised with the malaria vaccine for the first time. Nakidde, a resident of in Katikamu Proper, said immunisation has made a difference in her children’s health.

“I can’t skip immunisation. Even when my babies fall sick, the illness doesn’t get severe,” she explains.

Prosy Nakyejwe a mother who has embraced immunisation speaking. (Photo by Violet Nabatanzi)

Like her, Prosy Nakyejwe, another mother from Luzzi village, Wobulemzi Town council, also appreciates the benefits of the broader impact of bringing immunisation services closer to communities. 

“I have six children. I took each one for immunisation right after birth,” Nakyejwe says, “Even when they fall ill, it’s never as bad as for children who aren’t vaccinated. During measles outbreaks, I have seen unvaccinated children suffer badly”.

She urges fellow mothers not to delay immunising their children and welcomes the rollout of malaria vaccines, which she believes will save more lives.

Village Health Teams (VHT), too, are witnessing the change. Carolyn Nalugo, a VHT member in Katikamu Proper, says immunisation coverage in Luwero District has improved.

“We hold outreach clinics every second week of the month,” she explains. “Mothers can now bring their children without worrying about long distances or transport costs.”

She added that beyond immunisation, the outreach services offer family planning and other primary health care services. She said for many families, saving sh4,000 in transport, the money they can barely spare is a major relief.

“I can’t afford sugar for my children’s tea,” one mother lamented. “How do you expect me to spend sh4,000 on transport. The outreach programme is a blessing,” She said.

The immunisation services are part of the “Saving Lives and Livelihoods (SLL)” project, implemented by the health ministry with support from the Africa Centres for Disease Control and Prevention and Amref Health Africa-Uganda, with funding from the MasterCard Foundation.

The project, which is in its second phase, started in December last year and is running for 13 months. It covers eight districts, including Luwero, Nakaseke, Nakasongola, Kiboga, Kyankwanzi, Mubende, Mityana and Kasanda.

Joseph Kisakye, the assistant district health officer in charge of environmental health, said the project builds on the COVID-19 response to provide a full life course approach to health.

Joseph Kisakye, the Assistant District Health Officer in charge of Environment Health, speaking. (Photo by Violet Nabatanzi)

Kisakye said the integrated outreaches under SLL offer a comprehensive package, immunisation, antenatal care, family planning, screening for non-communicable diseases like diabetes and hypertension, health education, HIV testing, nutrition monitoring, and more.

“We take a team of health workers to the community with the capacity to deliver these services. The goal is to make health care accessible for everyone, children, youth, adults and the elderly,” Kisakye adds.

With this model, Uganda is showing how taking health services to the people, especially in rural and underserved areas, can lead to healthier, more resilient communities.

In April, malaria vaccines were launched and included in the routine immunisation. The vaccine is proven to reduce severe malaria cases and hospitalisations. The R21/Matrix-M malaria vaccine is administered in four doses at 6, 7, 8, and 18 months.

Malaria burden in Uganda

Uganda is among the 11 nations contributing to 70% of the global malaria burden. In 2024, the country recorded 10.9 million malaria cases and 3,582 deaths. Every day, 16 lives are lost to malaria, 10 of whom are children under five years old. Malaria accounts for 30-40% of outpatient consultations, 20% of hospital admissions, and 10% of all hospital deaths.

Challenges

Experts said the biggest challenge to vaccination uptake stems from misinformation that spread during the COVID-19 pandemic.

“There was a lot of propaganda on social media claiming that vaccines were harmful, that people were being given just water or that there was a hidden agenda to harm them,” she said. “This misinformation seriously affected public trust during the COVID-19 vaccination campaign,” Kisakye said.

He noted that such misconceptions continue to affect the introduction of new vaccines. For example, while the yellow fever vaccine had existed for a long time and it is now made freely available to the general public. This, however, has raised suspicions among some community members. Similarly, with the rollout of the malaria vaccine, questions have arisen.

‘’There remain some pockets of resistance, but at least we have been able to see some improvement with the efforts we have put in, in terms of ensuring that we encourage the health workers to health educate the mothers and tell them how they can deal with certain side effects,’’ he said.

Drucilla Ssekandi, Epidemiologist at Uganda National Expanded Program on Immunisation (UNEPI) at the Ministry of Health, said, “The project was introduced to support and strengthen Expanded Program on Immunisation (EPI) vaccination services by increasing uptake, raising awareness, and identifying the reasons behind poor vaccine coverage.

She said that districts, including Luwero and Nakasongola, among others that were struggling with the performance in EPI.

Some of the challenges they identified include issues with data entry, data capture, and data utilisation.

Namanya Winniefred, an enrolled nurse and EPI focal person at Bukolwa Health Centre II in Wobulenzi Town Council, said some parents are still unsure why children as young as six months are being immunised against malaria.

She urged the government to increase efforts to sensitise the public, especially about the malaria vaccine, to address doubts and improve acceptance.

The proportion of Out Patient Department (OPD) cases in Luwero district due to malaria was 27.02%, while the proportion of OPD cases due to malaria under 5 years was 22.65% in the ten months.