Question NW2157 to the Minister of Health

Reply:

(1) The following table reflects the details in this regard:

Year	Measles 1st dose		Measles 2nd dose
(a)	2019	966,002	84,1%		920,084	80,2%
(b)	2020	974,179	84,8%		888,383	77,2%
(c)	2021	1,000,082	87,5%		939,138	82,2%

(2) The following table reflects the details in this regard:

PROVINCE	MEASLES	2019	2020	2021
Eastern Cape	1st dose	115,357	111,609	114,320
	2nd dose	118,254	108,060	110,055
Free State	1st dose	41,999	43,710	44,670
	2nd dose	38,634	38,721	39,406
Gauteng	1st dose	228,967	224,802	234,553
	2nd dose	203,020	197,829	218,545
KwaZulu-Natal	1st dose	208,524	208,825	213,695
	2nd dose	216,419	213,090	223,628
Limpopo	1st dose	113,671	121,443	114,731
	2nd dose	102,155	103,199	101,441
Mpumalanga	1st dose	78,956	81,911	94,505
	2nd dose	82,248	73,931	83,496
Northern Cape	1st dose	21,038	19,875	20,802
	2nd dose	18,404	17,596	18,007
North West	1st dose	57,099	57,225	57,624
	2nd dose	54,368	49,922	55,187
Western Cape	1st dose	100,391	104,779	105,182
	2nd dose	86,582	86,035	89,373

(3) The Department is implementing four streams of the primary health care (PHC) re-engineering which contribute to the increase in uptake of measles vaccination, namely, PHC Ward-Based Outreach Teams (WBOTS), Integrated School Health Programme (ISHP), the District Clinical Specialist Teams (DCST) and contracting of private healthcare providers. Each of the streams significantly contribute to the immunisation program in the following ways: the WBOTS have a potential role in defaulter tracing. ISHP provide immunisation catch-up at schools to increase coverage. The DCSTs have a role to play in clinical governance (ensuring implementation of all policies and guidelines). The private healthcare providers help in identifying and referring children who have missed immunisation doses.

In order to address long-standing inequities in immunisation access thereby reducing the number of zero-dose children, the Department of Health is implementing the followings:

• Reach Every District (RED) Strategy to reduce missed opportunities in childhood vaccination uptake. The RED Strategy emphasizes important areas for vaccination uptake in the country: (1) reducing inequity in immunisation coverage, integration of health services, delivering vaccines beyond infancy using a life course approach, focusing on urban, poor and marginalized populations, and paying special attention to poor performing districts.
• Under-5 Side-by-Side campaign by the Department that ensures all children survive and thrive, by improving coverage of key promotive, preventive and curative interventions with inclusive of measles vaccination and childhood vaccination in general. Five key themes of under-five are: (1) good nutrition to grow and be healthy; (2) love, play and talk for healthy development; (3) protection from preventable childhood illnesses and injuries; (4) health care for sick children and (5) special care for children who need a little more help. This campaign also focuses on the supportive relationship between child and caregiver, as well as the relationship with practitioners, including health-care workers, who help and advise the caregiver
• In November 2020, the country intensified immunisation catch-up drive in all districts. The catch-up drive reduced number of zero-dose children from 125,923 in 2020 to 104,153 in 2021. The delivery of both routine and catch-up immunisation doses forms part of a coordinated effort to improve access to high-quality, affordable primary health to achieve universal health coverage and accelerate progress towards the 2030 Sustainable Development Goals (SDGs)
• The country as a member state of the global community has endorsed the global Measles and Rubella Strategic Plan (MRSP) 2021 - 2030 which outlines guiding principles that provide a foundation for all measles and rubella control efforts. The Department is using this strategic plan as a guiding principle to secure the commitment and action required for a country free of measles transmission. In line with global measles strategy, the Department has endorsed international measles coverage target of reaching 90% of children with both 1st and 2nd dose in all districts to reach desirable population immunity levels. As part of implementing Global Measles and Rubella Strategic Plan, the Department together with NICD implement Integrated Disease Surveillance and Response (IDSR) system. The system makes case-based surveillance and laboratory data more usable and strengthen outbreak response measures at all levels of healthcare. Through implementation of IDSR, the country is utilising Notifiable Medical Conditions Surveillance (NMC) Application (NMC APP) for mobile devices. The NMC App enable healthcare practitioners to promptly report NMCs for appropriate and timely public health response. The IDSR uses outbreaks as an entry point to identifying unvaccinated communities and strengthening immunisation system.
• The Department is also using Stock Visibility System (SVS) that enables the electronic communication of medicine availability data from PHC level into upstream electronic stock management systems. The SVS helps to monitor availability of vaccines in facilities and expedites vaccine deliveries to prevent stock outs.

(4) The following table reflects the details in this regard:

PROVINCE	MEASLES	2019	2020	2021
Eastern Cape	1st dose	80.3%	80.1%	85.2%
	2nd dose	82.3%	77.2%	80.9%
Free State	1st dose	78.6%	83.3%	87.3%
	2nd dose	72.3%	73.5%	76.4%
Gauteng	1st dose	89.4%	86.5%	89.5%
	2nd dose	79.1%	75.9%	83.4%
KwaZulu-Natal	1st dose	83.3%	82.5%	83.9%
	2nd dose	87.1%	84.9%	89.0%
Limpopo	1st dose	85.7%	93.4%	90.4%
	2nd dose	76.7%	78.5%	78.6%
Mpumalanga	1st dose	83.7%	85.6%	97.9%
	2nd dose	87.6%	77.8%	87.7%
Northern Cape	1st dose	82.8%	77.5%	80.8%
	2nd dose	73.0%	69.2%	70.8%
North West	1st dose	70.9%	70.6%	71.1%
	2nd dose	67.7%	61.9%	68.7%
Western Cape	1st dose	89.5%	94.0%	95.5%
	2nd dose	76.8%	76.6%	80.3%

END.