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Northern Ubangi province is one of the 26 new provinces of the DRC after the 2014 division. It was part of the former great province of Equator; it borders the provinces of MONGALA, SOUTH UBANGI, BAS UELE and the Central African Republic (CAR). The province of North Ubangi has a population of 1,411,210 inhabitants with a density of 22 inhabitants per km; it has welcomed nearly 60,000 refugees from CAR since the beginning of the current year. Environmental dataNorth Ubangi is located in the Congo Basin and is furrowed by the great river UBANGI from which it takes its name and the many tributary rivers of the Congo River. It is 100% covered by the equatorial forest and has a rainfall of 2000 millimeters per year. It rains almost every day during the rainy season which lasts 8 months. Few roads are drivable.
The trip is largely done by the canoes. This equatorial environment makes access difficult in most parts of the province. Cultural social dataThe province of North Ubangi has 5 main ethnic groups which are: Ngbandi, Ngbaka, Ngombe, Mpakabete, Mbanza. The main language spoken is LINGALA. French is the administrative language. Although believing in the Christian religion, the population remains deeply attached to ancestral beliefs. Certain habits and customs hinder good health. The population uses mainly traditional medicine. Other practices constitute a brake on health: among others, polygamy with many consequent undesired births. The “Bwakelé” phenomenon: a tradition according to which the childbirth and the newborn do not leave their residence for several months to protect the mother from the bewitchment of evil spirits and heavy work in the fields and thus prevent the follow-up of the Consultations post-natal, preschool and immunization.
North Ubangi province is divided into 11 functional health districts, 172 health areas covering 99. 9% of the population. It has 11 General Reference’s Hospitals. There are 207 private structures established mostly in an anarchic way. It has 300,000 children from 0 to 59 months; The plan of action of the DPS Nord-Ubangi 2015 informs that malaria constitutes 31. 9% of infant mortality and HIV remain the most dominant pathologies with a very high mortality. Anemia comes in 3rd place with a death rate of 13. 2%. In 2017, health data reveal that the rate of utilization of services varies around 30 to 40% while all 11 health districts are covered in health centersImportance of immunization and partnership with the media. The second rounds of the last polio campaign in September and October 2018 reached 100% of children expected. The routine EPI vaccination coverage in the first half of the current year is 93. 8%; that of Penta 3 is 94. 6%; while Polio3 is 88. 8%.
These satisfactory results are achieved through an effective partnership with local media organizations that make a remarkable social mobilization. Thanks to Unicef and WHO, communication is receiving substantial support and trained staff are supporting local staff in raising awareness among mothers. Immunization equipment and the cold chain are made available by GAVI to storage sites in health districts. Despite this international support, cases of resistance and refusal are not lacking, especially in areas of difficult access. In general, the causes are poor access to information, lack of knowledge from parents about the importance of immunization, the use of traditional medicine in the first place. Statistics show that where mothers have access to information, where mothers are trained through local media, the vaccination coverage rate is quite high. Community media is an effective tool for promoting the use of health services in general and immunization in particular.
In rural areas, a rapid evaluation of local resources and communication partners allows the development of a communication plan adapted to the communities. The involvement of opinion leaders, municipal and traditional authorities is a catalyst to strengthen the use of services by mothers. The combination of outreach, routine and supplementary immunization activities provides a strong impetus for mothers to bring children to immunization, thus improving immunization coverage and ultimately children’s health. We recommend that global and child health actors, especially in health districts, integrate communication partners early in the micro-planning of immunization activities. These partners organized in integrated commission will add values and capitals.
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