Ensuring access to routine vaccinations for children during COVID-19

How UNICEF supported outreach workers to keep children protected in even the most remote and difficult-to-access areas

Navy Kieng
© UNICEF Cambodia/2021/Antoine Raab
UNICEF Cambodia/2021/Antoine Raab
25 October 2021

Santepheap Commune in Stung Treng Province is about as remote as Cambodia gets. This beautiful, densely forested area sits at Cambodia’s northernmost limit, tucked tightly against the border with Laos. Sparsely populated, most of the villages here are only connected by dirt tracks, which often turn to rivers of mud during rainy season. Yet Cambodia’s dedicated rural healthcare workers have managed to travel even to these villages throughout 2021, ensuring that remote communities are vaccinated against COVID-19, while also protecting the routine immunisations which are so important to young children’s health and future lives.

“To be honest, it was very hard to get out to the villages,” laughs Phat Sovann, the Immunization Program Chief at Siem Pang Health Centre, just south of Santepheap. He is back at the Centre after he and his immunization team returned from a 32 kilometre trip to villages inhabited by people from the Kuoy ethnic minority. As well as braving dirt roads, the team had to cross rivers and go off track, often wading through mud with vaccine supplies on their shoulders. “Our bikes kept falling, but we persevered.”

Much attention has been paid to the importance of COVID-19 vaccinations, but less has been paid to the importance of maintaining routine immunizations. One of the many effects of the pandemic was that restrictions put in place to reduce spread also limited the normal movements of the population to obtain such health services. This led to some disruption to routine immunizations, as people from remote areas couldn’t bring their children to health centres .

Lorn Chan Phal is Immunization Program Chief of Stung Treng’s Provincial Health Department and explains the challenge. “All health centres have a monthly outreach plan to provide routine immunization and safe motherhood services, using the national budget. However, it is not enough to reach those hard to reach villages.”

© UNICEF Cambodia/2021/Navy Kieng
UNICEF Cambodia/2021/Navy Kieng

Aware of the urgent need to catch up and to ensure these children did receive protection against diseases such as measles, diptheria and typhoid, UNICEF and partners worked closely with the Cambodian Ministry of Health’s National Immunization Program. UNICEF provided additional support to healthcare outreach teams in Stung Treng and four other North-Eastern Provinces, so that they could increase their capacity to deliver routine vaccinations to children aged 0-2, alongside other health services including safe motherhood care and COVID-19 vaccinations for adults.

It was often a daunting task. Outreach healthcare staff frequently worked overtime to make sure the most distant communities received services. Delivering routine immunizations and antenatal care to 837 people in the six villages of Santepheap Commune took the outreach team six full days. “But if we don’t go to places like Santepheap Commune, then all these small children and women wouldn’t get their health services and their routine immunizations on time,” Mr Phat says. “We were very motivated, because we knew some children had missed out on routine immunizations earlier.”

Despite being tired after their trip, the team were proud of the work they were able to do. They knew from speaking to parents in the communities how grateful they were for the exceptional efforts the teams had made to bring services to them.

Moung Toeur is one example, a mother of a 10-month-old girl who received vaccinations against diptheria, typhoid and measles. She says she was very glad when she heard from the village chief that the healthcare outreach team would be coming to their village soon.

“Our village is too far from the nearest health centre and the road is very difficult to travel at this time,” Ms. Moung says. “If the outreach team did not come to my village my daughter might not have had the opportunity to get vaccinated, because she is too small to travel on this long difficult road in the rainy season. I really want to thank the vaccination team who tried so hard to reach villages like mine.”

It is indeed thanks to their efforts that as Cambodia recovers from the pandemic, it can do so knowing that its children have also been protected against other diseases as they grow up. UNICEF is proud to continue supporting The Ministry of Health and its many outreach teams in maintaining routine immunizations: this is one of the less told success stories of the pandemic, but it’s a significant one.