Children First: Routine Immunisation

Immunisation saves lives

The situation

Diphtheria, pertussis, tetanus, tuberculosis, hepatitis B, polio and measles are potentially fatal diseases to which children are particularly vulnerable. All seven of these diseases are vaccine–preventable yet, according to the Turkey Demographic and Health Survey 2003 (TDHS), only 45% of children under five years of age — 34.4% in rural areas — received all of the necessary vaccinations before their first birthday. Although infant mortality rates are dropping, they remain four times higher than the OECD average.

Low awareness of how children benefit from immunisation during infancy means that many parents do not actively seek health care services. Unfounded rumours and speculation about potentially harmful effects of vaccinations have negatively affected opinion amongst uneducated sections of the population. Since access to health care in rural areas is limited in the first place, it is unsurprising that demand is generally low.

In the past, health care workers have relied on nationwide campaigns to raise immunisation rates. For example, a successful series of National Immunisation Days led to Turkey being certified polio–free in June 2002. Significant progress has also been made in combating measles — the major worldwide cause of preventable childhood deaths — whereby 83% of children have been immunised since 2003.

Although immunisation campaigns are helpful in raising vaccination coverage rates, they are not cost effective and maximum coverage is never guaranteed. Meanwhile, an additional 1,400,000 infants are born each year and their chances of being fully immunised before their first birthday are less than fifty–fifty.

The solution

A standardised system of routine immunisation would be a more efficient and cost–effective means of obtaining maximum coverage of children with the necessary vaccinations before their first birthday.

In order to establish routine immunisation procedures within the health system:

• additional resources and health workers need to be allocated to areas where immunisation rates are lowest;
• special attention should be given to low income families who are wary of out–of–pocket expenses and avoid seeking any form of health care as a matter of course;
• health care workers need to be trained to communicate with and encourage mothers to ensure their children complete the full course of routine immunisation;
• mobile health care teams need to be set up to make regular visits to remote rural areas and follow–up vaccination procedures on infants;
• community and religious leaders need to be trained to combat prejudice, clarify the benefits and support the routine immunisation of all local children by qualified health workers.

Routine immunisation procedures could be tied to a ‘control’ mechanism ensuring birth registration of all newborn children, which is problematic in rural areas. More complete birth registration would help to improve monitoring of children’s progress and their development needs in general.

The activities

Implementation of routine immunisation will achieve a minimum 90% coverage rate and will help to ensure the survival, healthy growth and development of every child in Turkey. This nationwide initiative will involve:

• providing technical resources and support to the Ministry of Health in order to sustain the initiative;
• obtaining additional financial resources from the private sector;
• raising public awareness through the media of the benefits of immunisation;
• mobilising community–level advocacy to inform parents of the benefits;
• targeting all new and expectant mothers in order to ensure that newborn babies are immunised before their first birthday;
• increasing the capacity of health workers to develop and follow–up plans of action for routine immunisation for all children;
• producing training kits for health centre staff explaining how they can improve access to the service for low income and excluded groups.

The result

The establishment of routine immunisation against the major childhood diseases for all children before their first birthday will ensure that:

• infant and child mortality rates will be reduced;
• instances of physical and mental disorders in children will be reduced;
• healthier children will achieve more at school;
• the quality of primary health services will be improved.

For Turkey, routine immunisation for every child will mean that:

• the country will achieve measles–free status;
• the fourth Millennium Development Goal (MDG) — to reduce child mortality — will be met;
• the current generation of children will grow up to be happier, healthier adults who will contribute their best to the economy.

For sponsors

Routine immunisation is a new concept for Turkey signalling exciting new developments in the care and protection of children from birth onwards. The programme requires a high public profile in order to reach its massive target group and as such it promises a large audience for sponsoring brands to make their mark.

All public information material and training kits for health centres will feature the brand of sponsoring agencies, businesses and corporations.

Sponsoring routine immunisation will provide an ideal opportunity for the public sector to help lay the foundations of growth and development for today’s children and Turkey’s future.

Private sector investment in a basic social service that will reduce child mortality not only benefits children and their families but it will also improve the sponsor’s standing with the public.

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Download the Routine Immunisation brochure in pdf format [PDF 88KB] or alternatively download a zipped porfolio of the seven funding brochures [ZIP 1.8MB].

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