MOBILISING COMMUNITIES FOR IMMUNIZATION SERVICES
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1 MOBILISING COMMUNITIES FOR IMMUNIZATION SERVICES Photo of VHT conducting a community meeting What VHTs and community mobilisers need to know and do Printed with support from UNICEF and partners
2 2
3 1. Introduction Immunization is the most important health programme that protects children from vaccine preventable diseases. You as Village Health Teams have a responsibility to mobilize communities and give them correct messages on immunization so that parents and caretakers can take their children for immunization and complete immunization schedule. This booklet therefore is aimed at providing you with basic facts about immunization, its benefits and the basic messages to deliver to the parents and caretakers to promote immunization services in your communities. 2. What is immunization? Immunization is a means of protecting a person against specific diseases by building the body s defense system so that it is able to fight off diseases. This is achieved through giving vaccines to a child by mouth and by injections. The act of giving vaccines to the child either by mouth or by injection is called vaccination. 3
4 3. Who should be immunized? All children below one year should be immunized against the vaccine preventable diseases. However, children above one year but below five years and have not been immunized should receive the doses they missed at the earliest opportunity. Children should complete the immunization schedule before their first birthday. You should mobilize parents and caretakers to take them for immunization 5 times before they are one year old. All girls and women of child bearing age (15-49 years) including pregnant women should be immunized against tetanus. This protects them and their unborn babies against tetanus. Immunization against tetanus for girls should start at the age of 15 years. 4. How is Immunization done? Polio vaccine is administered by putting drops in the mouth of the baby while all other vaccines are given by injections. 4
5 5. How effective is Immunization? All vaccines are very effective in preventing diseases only when all recommended doses have been completed. These vaccines have been approved by Ministry of Health, World Health Organisation and UNICEF. 6. Immunisation schedule for children Parents should immunize their children Five times before one year old. 5
6 i) Immunization schedule for children CONTACT AGE VACCINE DISEASE PREVENTED 1 st At Birth Polio 0 BCG Polio Tuberculosis 2 nd At 6 weeks (1 1/2 months) Polio 1 DPT1-Hep B1+Hib1 PCV 1 Polio Diphtheria, Whooping, Tetanus, Hepatitis B, & haemophilus influezae type b Pneumonia 3 rd At 10 weeks (2 1/2 months) Polio 2 DPT2-HepB2 +Hib2 PCV 2 Polio Diphtheria, Whooping, Tetanus, Hepatitis B, & haemophilus influezae type b Pneumonia 4 th At 14 weeks (3 1/2 months) Polio 3 DPT3- HepB3+Hib3 PCV 3 Polio Diphtheria, Whooping, Tetanus, Hepatitis B & haemophilus influezae type b Pneumonia HOW AND WHERE VACCINE IS GIVEN Drops in the Mouth Injection on the right upper arm Drops in the mouth Injection on the Left thigh Injection on the right thigh Drops in the mouth Injection on the Left thigh Injection on the right thigh Drops in the mouth Injection-Left upper thigh Injection on the right thigh 6
7 5 th At 9 Months Measles Measles Injection on the Left upper arm At 6 months and every 6 months until child is 5 years Vitamin A Supplement Prevent blindness and strengthen resistance against other diseases Drops in the mouth ii) Immunization schedule for women against tetanus Age Minimum interval between doses At 15 years/first contact nonpregnant women Vaccine given Disease prevented Nil Tetanus Toxoid Tetanus 1 st contact with pregnant woman Nil Tetanus Toxoid Tetanus 2 nd contact At least 1 month after TT1 Tetanus Toxoid Tetanus 3 rd Contact At least 6 months after TT2 Tetanus Toxoid Tetanus 4 th contact At least 1 year after TT3 Tetanus Toxoid Tetanus 5 th contact At least 1 year after TT4 Tetanus Toxoid Tetanus 7
8 8 7. What are the benefits of Immunization? Immunisation strengthens a child s ability to fight diseases Reduces chances of children suffering from childhood immunizable diseases Protects children from liver disease and cancer later in life Prevents complications such as lameness and blindness in children and burden to parent, community and nation Contributes to child s proper growth and development Reduces costs in terms of time and money spent on treatment. This contributes to socioeconomic development Protects the entire community from the 9 childhood vaccine preventable diseases Protects the mother and her unborn baby from tetanus
9 8. What are the possible body reactions of immunization and how should they be managed? Note that not all children experience body reactions after immunization. However, should they occur, they present as follows and should be managed in the following way: Possible side effect/body reaction Rise in body temperature Local reaction (swelling, pain and redness at the site of injection) Possible action Cool the body with a wet piece of cloth (tepid sponging). Dress child with wet clothing and give extra fluids to the child Do not apply any medication. Leave it to heal by itself If temperature or swelling persists, or any other severe reactions occur, refer the child to the nearest health facility for proper management 9. Roles of VHTs in mobilizing communities for immunization Educate parents and caretakers on 9
10 the benefits of taking their children for immunization and completing immunization schedule before children are one year old. Advocate and lobby for local leaders commitment and support for immunization services Work closely with health workers to identify problems related to low coverage and dropout rates so that communities are mobilized to overcome them Conduct home visiting to educate parents and caretakers about immunization and remind them about the date, time and place of outreach and static sessions for immunization Act as role models by taking your own children for immunization and complete the immunization schedule Follow-up the dropouts and unimmunized children and mobilize parents and caretakers to take them for immunization. Immediately report any suspected Adverse Events Following Immunization (AEFIs) to the nearest health facility 10
11 In liaison with the LC1 chairperson, keep track of children in the village who are immunized and non-immunized Register all new borns under one year and under five years old children Distribute IEC materials to the right audiences and display them in strategic places in the community Report notifiable diseases occurring in your communities Collect immunization data from the community and submit to the health facility and give feedback to communities to improve and promote immunization services Announce/publicize the locations and dates for the outreaches in places of worship, markets, burial places, weddings Identify other mobilisers working on health issues e.g. women groups, youth, drama groups, and other social groups and forge linkages for working together to mobilize for immunization services 11
12 10. Key messages The Village Health Team members or any other mobiliser should communicate key messages to parents and caretakers about immunization on the following key areas so they can take their children for immunization and complete the immunization schedule. The targeted immunisable diseases Immunisation protects children against the following vaccine preventable diseases: Polio, Tuberculosis, Whooping Cough, Diphtheria, Tetanus, Hepatitis B (Liver disease), Haemophilus Influenzae type b, measles and pneumonia. Benefits of immunization Explain the benefits of immunization to children, parents, caretakers and the nation Importance of bringing a child health card Tell the parents and caretakers that they should always bring child health cards with them to the health facilities each time they take their children for immunization. The child health card will help the health worker to check the immunization 12
13 status and growth of the child. Number of doses of the vaccine and visits required to give the child full protection For the child to be fully immunized against nine vaccine preventable diseases, parents and caretakers should take them to the health facility five times to receive the required doses of the vaccines during the first year of life. Number of doses of tetanus vaccine required to give women full protection For a woman to have full protection against tetanus (self and new born baby) she must receive TT vaccination five times beginning at 15 years until 49 years. Probable body reactions after immunization and their management Educate parents and caretakers about the probable body reactions that are likely to occur after each vaccine has been given. Advise parents and caretakers on how to manage the body reactions resulting from each vaccine, where and when to seek medical assistance in case of prolonged body reactions. It is possible that a child may develop mild body reactions after 13
14 immunization. e.g. fever and pain or a swelling at the site of injection; do not apply any medicationit will heal by itself. Return date Tell the parents and caretakers about the exact day and date when they should return for the next immunization session, say how many weeks ahead the date is. The place/venue of the next immunization Tell the parents where to go for the next immunization session by announcing in places of worship, markets, weddings and other social events. Safety of vaccines Emphasize to the parents and caretakers, the fact that vaccines are safe and effective and have been tested and approved by Ministry of Health, WHO and UNICEF. They do not cause lameness and diseases. Availability of vaccines Immunisation is free and available at all government, some NGO and private health facilities as well as some outreaches. 14
15 Immunisation is a government priority Immunisation is a government priority. Every child has a right to be immunized and it s the duty of parents and caretakers to immunize their children. Immunisation of sick children It is safe to immunize a child who has a minor illness, a disability or who is malnourished. Very sick children should be treated first and immunized on discharge. 15
16 16
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