Motokwe is a village in the Kweneng District facing challenges such as alcohol abuse, which is largely linked to high unemployment and lack of opportunities.
However, while alcohol abuse is common in many villages around the country, in Motokwe, it has led to a surge in child negligence resulting in many children not taking their immunisation vaccines. Health authorities in the area say many children in the village and surrounding areas are prone to malnutrition.
Segohatsang Puleng, 25, has three children all below the age of five. She said having three children where two share the same birth date makes it more difficult to go to the Child Welfare Care (CWC) clinic for the monthly check-ups and vaccinations. Puleng has a slightly deformed leg and limps when she walks, a situation she says worsens her plight and that of her children.
“I have not been taking my children to the clinic because it is difficult for me to carry two children at a time,” she told Mmegi recently.
“However, I was lucky to be one of the mothers helped by Red Cross Botswana volunteers as they encouraged me to start taking my children to the clinic for CWC and taught me the importance of doing so.
“They told me that the monthly check-ups were important since health workers check if our children are growing well and also give them vaccinations that are vital for their growth as well as preventing infections.”
Puleng is a single mother who depends on Ipelegeng to take care of her and her children. She is one of many young women living in abject poverty in Motokwe who found herself having very young children all under five years old within a short space of time. Puleng explained that having young children made it hard for her to take care of them.
At one of the shebeens that the youth and other villagers hang out at every day is another mother by the name Kekopile. She is a regular at one of the shebeens in the village. Kekopile told Mmegi that she could not take her child to the clinic every month because her employer refused to give her off days for the CWC. However, she pointed out that the same employer takes their children to the clinic for CWC and immunisation consistently without failure.
“I work on a farm outside Motokwe, which is also far from the clinic.
“Things changed for the better when Red Cross Botswana engaged the owner of this shebeen to help encourage mothers to take their children for CWC every month.
“Even when I forget to take my children, the owner always calls and encourages me to take my children for CWC and immunisation.
“She does that for all of us and always has our children’s cards so she always checks them and reminds us to take our children to the clinic for routine check-ups.”
The shebeen owner, Moleti Obakeng, said she was engaged by Red Cross volunteers in November last year, who told her they were looking for mothers and guardians who did not take their children for CWC and immunisation.
Obakeng said she realised that most of her regulars were young mothers and she had also heard them teasing each other for not taking their children for the check-ups and immunisation.
“I got to know the young women who did not take their children to the clinic for CWC,” she told Mmegi.
“I took their contacts and every month I call them and remind them to take their children to the clinic for routine immunisation and check-ups. “If they refuse I report them at the clinic so that they pick them up and take them to the clinic,” she shared.
“Some who did not even have their children’s immunisation cards were given [the document].”
She continued: “I also realised that some children stopped taking their immunisations when they were three months old.
“Since I am a mother, I know the importance of children getting vaccines because mine got them,” she told Mmegi.
“I realised that if a child misses their immunisation doses, they might later be prone to some sicknesses.”
While it seems desperate, the initiative of engaging ‘shebeen queens’ comes after health authorities realised that many mothers and guardians in Motokwe spend most of their days drinking alcohol and failing to appropriately take care of their children.
In a bid to accelerate routine immunisation, UNICEF, the Ministry of Health, Red Cross Botswana and USAID engaged different stakeholders such as community volunteers and shebeen queens to encourage mothers to take their children for CWC and immunisation.
According to Red Cross Botswana community volunteer, Kelesitse Molale, they were assigned to do a house-to-house campaign to establish why parents and guardians were not taking children aged below five years for routine CWC and immunisation. During these visits, the volunteers realised that many young women spend most of their time at the shebeens where they drink alcohol. She added that they decided to engage Shebeen Queens to help them encourage their customers to take their children to the clinic.
Nursing Superintendent at Letlhakeng District Health Management Team, Antoinette Ramatsia, said due to alcohol abuse by parents, children in the area did not act well and the importance of CWC is not valued. She explained that if children were taken for CWC early, health practitioners would be able to detect some ailments at an early stage such as malnourishment and could give children supplements. She added that they realised that parents took their children late for CWC or when they were seriously ill. Others take them only when there is Tsabana (mophako) available.
“Vaccinations are very vital for a child’s growth,” Ramatsia said.
“If a child is given immunisation, these are a protection to the child.
“They help to protect a child from having opportunistic infections and I urge parents and guardians to bring children to the clinic for CWC.
“If a child has a problem (sickness) tell health practitioners so that they can assist.
“Our district has 23 areas with two 24-hour clinics, six clinics operating until 4:30pm, 15 health posts and two mobile stops.”
UNICEF representative, Dr Joan Matji, said the agency is extremely alarmed by the fact that in 2022 across the world, 20.5 million children missed out on one or more vaccines. Matji also pointed out that the trend was mostly attributed to disruptions escalated by the COVID-19 pandemic. She, however, said they were also aware that there were other factors contributing to the low child vaccination.
“Implementation research undertaken through a similar programme in five districts, including Kweneng in 2021, showed that for 49% of children who were not vaccinated, this was due to the lack of urgency by caregivers or child negligence.
“Another 25% cited unavailability of vaccines during the scheduled time while 24% of caregivers missed taking children to child welfare clinics.”
She said to address these challenges, community engagement and behaviour change approaches are essential to raise the awareness of caregivers and urge them to take up immunisation services as well as wider child welfare services.
“Please, take children for immunisation. Vaccines work for every child including children in Motokwe.
“It is up to you to ensure that your children grow up healthy and have taken all their vaccinations.”
