Scaling up routine immunization amidst Covid 19

Polio Workers at the frontline

Tamara Abu Sham
UNICEF Afghanistan/2020
16 May 2020

Jalalabad , Eastern Afghanistan: House-to-house polio immunization campaigns have been halted since the COVID-19 outbreak reached Afghanistan in late February, but the work of thousands of polio programme workers continues. Amidst the pandemic, workers are supporting families to ensure that children under one year receive childhood immunizations at health facilities, protecting them against numerous life-threatening vaccine-preventable diseases.

The polio programme’s support of routine immunization in Afghanistan has made important gains, especially in eastern Afghanistan, in the areas bordering Pakistan. Polio social mobilisers from the UNICEF-run Immunization Communication Network (ICN), support mother and child health referral services, and help families keep track of their children’s health records.  As the mobilisers are from the community, they know each family in their neighborhood quite well, and can trace each child’s planned immunization schedule from birth.

The mobilisers provide families with referral vouchers after they identify the mother and child’s health needs and then coordinate immunization sessions at the nearest health facilities. Since the COVID-19 outbreak began, the polio social mobilisers have provided routine immunization referral services to over 37,000 children in southern and eastern Afghanistan during the month of March.

UNICEF Afghanistan/2020
Polio social mobiliser Waheeda and her colleague have checked Faristan's child immunization card and are providing referral sheet for the needed immunization to be received at the health facility nearby

One of the most important activities is the tracking of children who miss appointments. As ICN workers are the linchpins connecting families with the health facilities, they are perfectly positioned to cross-reference who has received vaccines and who has not by comparing to their books and the health facility records of immunized children. During the outbreak, families attending the routine immunization sessions facilitated by ICN have received soap bars to encourage optimal hygiene practices to limit the spread of COVID-19.

Faristan, a mother of four children says, “the mobilisers visit the house and provide information about the coronavirus and hygiene, check the children and provide us with a referral card for immunization which is really helpful’’.   Another mother Zahida added, ‘It is good they check the card because if we visit the clinic ahead of time, we waste our time and transport and the children don’t get immunized. Having the mobilisers follow-up on the child vaccine schedule, it is a useful and cost-free process.’’

The work of polio mobilisers is even more valued during the COVID-19 response. Vaccinator Abdul Ghafar Azizi, who is based in Surkhud District, Jalalabad, says ‘’I used to announce the immunization sessions through the Mosque but not all the targeted children were brought to the health facility. Now through the ICN support to routine immunization, the number of missed children has reduced due to tracking of every child in the community and coordinating with the health facility. This is critical during the ongoing pandemic, as families are not sure if they can leave their homes to take their children to the health facility for immunization.  The polio mobilisers are their guide in the community.’’

UNICEF Afghanistan/2020
Children get vaccinated for RI after the immunization cards are checked and referal sheets are provided to caregivers by the polio social mobilisers.

Continued focus on routine immunization during COVID-19 is essential to keep children protected. ‘’Nowadays I am focused on two issues, coronavirus prevention and routine immunization.’’ says Medina, a social mobiliser.

Her colleague Maryam adds, “I mark my register when the child is vaccinated and ensure it is reflected in the immunization card. For those who are hesitant to vaccinate their children or worried about vaccine side effects such as pain and fever, I hold a special information session for them and facilitate their visit to the clinic. During COVID-19, I make sure they are also extra cautious about hygiene. All the information I provide is for the well-being of children during the outbreak.”