Meet the immunisation champions
Vaccines are one of humanity’s greatest achievements—in the last 50 years, vaccines have saved 154 million lives. That’s six people’s lives saved every minute, for the past 50 years.
Yet, millions of children are still missing out on the routine vaccinations that can keep them safe through infancy and childhood. And millions more people die every year from vaccine-preventable diseases.
We know that reaching more people with the vaccines that protect them from diseases including tetanus, measles, malaria, polio and more, will help save millions more lives. But, global funding for immunisation outreach has been abruptly cut back, risking the progress that has been made over the past 50 years.
Community health champions
Community health workers (CHWs) are the backbone of the immunisation workforce. Not only do they deliver important health prevention messaging to households, but they are trained to administer vaccines, and provide critical follow-up services to mothers and young children to ensure they follow the routine immunisation schedule to keep them safe from disease. Nurse-midwives based in health facilities are of critical support to mothers and children, ensuring that from conception to childbirth and the first 1,000 days of childhood, mothers and children are protected.
Below, read more about the people delivering these services in Malawi and Zambia - two countries dealing with severe reduction in global funding for this essential work.
Emmanuel Qongwane, Health Surveillance Assistant, Malawi
Emmanuel Qongwane has been a Health Surveillance Assistant (HSA) for 18 years, serving Chidongo catchment area in Kasungu District, central Malawi. He says that over the years, his greatest joy has been helping people access the healthcare they need.
One of the key ways Emmanuel delivers this service is through integrated outreach clinics. These are designated days every month where Emmanuel cycles his bike to every community which falls within his catchment area. There, he provides a clinic to people living in that community, usually between 185 and 215 people per clinic. The clinic offers:
- Antenatal and postnatal care,
- Family planning,
- HIV testing and counselling,
- Growth monitoring and nutrition assessment,
- Immunisations, and
- Health education sessions
These services ensured that children received vaccinations to protect them from diseases, and their growth was monitored to detect malnutrition early. Health talks conducted at these clinics educated the community on disease prevention and healthy living. The outreach clinics also helped identify malnourished children who could then be referred for treatment, preventing future complications.
Pictured right: Emmanuel cycling with his vaccine cool storage box secured to the back of his bike, to deliver essential health services to his community. (c) Amref Health Africa/CNfilms
Distance to healthcare
One of the biggest obstacles in Emmanuel’s work is the vast distance between communities and the health centre. Many people struggle to travel to healthcare facilities because the journey is simply too costly – way beyond their means.
This makes it impossible for them to access essential services, even in an emergency. This can lead to severe health complications that could have been prevented with early intervention.
The impact of aid cuts
The last outreach clinic in Chidongo catchment area was conducted in January 2025. Cuts to international aid mean that the future of these integrated clinics is under threat. If there is no logistical support provided to Health Surveillance Assistants, they will not be able to cover the often large distances needed to deliver health services to communities.
For many community members, they simply cannot afford to travel to health centres, leading to delayed treatment and worsened health outcomes.
Without regular monitoring, cases of malnutrition may go undetected, leading to severe health issues. Without outreach clinics, many children may miss their routine vaccinations, putting them at risk of preventable diseases, and leading to high numbers of unvaccinated children.
Emmanuel is a dedicated health worker, and the outreach clinics allowed him to do his job effectively and ensured even the most remote communities received the healthcare they needed. Without the clinics, he says that it will be hard for him to see preventable complications arise in his community due to the suspension of outreach clinics.
Fanizo Simenti, community health worker, Malawi
Simenti is a trained Community Health Worker (CHW), and for the people from villages in his district (he is responsible for 21 in total) he is usually the only health worker they will have access to. He’s become known as the "village doctor".
Simenti provides preventive services like infant and child immunisation under the National Expanded Program on Immunisation, and treatment for illnesses such as malaria, pneumonia, diarrhoea, and eye infections in children under five. He also monitors their growth and nutrition, teaching parents how to care for their children. The services he provides are essential.
Pictured left: Fanizo Simenti administers an oral vaccine to a child at an outreach clinic (c) Amref Health Africa/Amuru Photography
I play a key role in connecting the health centre to the community.
"Each [of the 21 outreaches] has its day in the month," Fanizo explains. Covering such a wide area by bicycle is no easy task - but without a bicycle or other form of transport it would be simply impossible. The logistical and training support that Fanizo gets means that he can deliver quality services to 21 different communities.
Amref Health Africa is expanding outreach clinics in hard-to-reach areas like Katenje, where essential healthcare is often provided under trees or in informal setups. These makeshift clinics are crucial lifelines in areas where hospitals are over 20km away.
"Yes, I love the community," he says. "When I call them to talk about health issues, they come."
Patricia Moonde, midwife, Zambia
Patricia Moonde has been a midwife and a nurse for over twenty years. She comes from Ndola in central Zambia's Copper Belt Province.
Being a midwife involves providing maternity care from preconception to post-natal services. It is a discipline which requires attention to support mothers throughout their journey – as each woman’s journey is different. It also means supporting new mothers and their children including making sure that mothers understand the importance of routine childhood vaccinations in disease prevention.
Here she is pictured providing one of the many services she’s responsible for: immunisation outreach drives for infant routine immunisations. In Zambia, only 70% of children are fully immunised (Ministry of Health, Zambia 2024).
Amref works with midwives like Patricia to provide tailored refresher training courses to ensure they are equipped with the knowledge and skills they need to provide the services their communities need.
Image (c) Amref Health Africa/David Brazier
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