|© UNICEF 2005/Mackay|
|Toey (a Lao Women’s Union leader in Vang Xieng, northern Lao PDR) and her friends develop a poster warning about the dangers of measles.|
By Ruth Landy and Susan Mackay
VIENTIANE, Lao PDR, 15 September 2005 – Though vaccination is one of world’s most powerful tools for saving children’s lives, statistics on coverage in the Lao People’s Democratic Republic (Lao PDR) reveal an alarming trend.
Immunization has been on the decline since the year 2000 in this land-locked Southeast Asian nation, one of the world’s poorest. One in ten Lao children still dies before his or her fifth birthday, and less than half currently receive a full course of life-saving immunizations. Unless current trends are reversed, Lao PDR cannot meet the 2015 Millennium Development Goal target of reducing child mortality by two thirds.
“The health workers come, inject, and leave…without saying anything.”
“Usually they have no time to talk to the women. They just stick in the injection and then on to the next one.”
These comments by village women in northern Lao PDR, collected during a UNICEF-supported participatory village research study in 2004, confirmed that communication lies at the core of the country’s immunization challenge.
|© UNICEF 2005/Granger|
|Villagers from the Yao ethnic group in northern Lao PDR help develop the country’s new communication campaign to promote immunization.|
Many barriers must be overcome to deliver immunizations to the children of Lao PDR. The country’s population of 5.7 million is spread across an area almost as large as the United Kingdom. Infrastructure is poorly developed. Eighty per cent of routine immunization services must be delivered through mobile outreach teams. Poorly paid health workers sometimes walk for days to reach a small number of children in isolated villages. Health workers themselves admit they often lack the communication skills to engage families from different ethnic groups to bring their children to the immunization sessions.
The villagers’ comments from northern Lao PDR have now reached the ears of government leaders, following a high level advocacy meeting held in the nation’s capital, Vientiane, last April. Realizing the threats the country faces – including the re-emergence of polio, which has come back to haunt Indonesia and other countries – leaders committed to addressing the immunization challenge head on.
Vang Xieng, a remote upland village near the border with Viet Nam, was the starting point for the effort to revitalize immunization in Lao PDR. It’s one of six Luang Prabang communities involved in last year’s participatory learning and action study. Many families left the rice fields to spend five days looking at the health challenges they face and proposing their own community-developed solutions.
|© UNICEF 2005/Granger|
|‘Immunization is an act of love’ – One of the new community-developed posters for the immunization campaign in Lao PDR.|
When the Lao government/UNICEF team returned a year later they were elated to learn that immunization rates had almost doubled in the six villages. Toey, a mother of four and the Vang Xieng Women’s Union Leader, explains, “Now mothers come quickly because they understand how important immunization really is.” The power of community mobilization is showing results.
This year the visiting team harnessed the villagers’ ideas to design a much wider communication initiative. The most compelling theme was developed by the villagers themselves: ‘Immunization is an act of love’. A skilled creative team engaged the villagers as actors, where they become ambassadors for health, Lao style. The communication drive will rolled out in select provinces by the year’s end. It’s a small step given the magnitude of the challenges. But in Lao PDR, even a small step is a big step in the right direction.
Progress for Children