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Programme
04 Октябрь 2017
Immunization
https://www.unicef.org/eca/health/immunization
Immunization is a proven and cost-effective public health  intervention, saving the lives of millions of children and protecting millions more from illness and disability.  Immunization is also a wise financial investment - with every $1 invested in immunization returning an estimated $16 in health-care savings and increased economic productivity.  Most countries in Europe and Central Asia have immunization coverage of 95 percent or more for three doses of diphtheria, tetanus and pertussis (DTP), often seen as the measure of national performance on immunization. However, while most national averages for DTP vaccination may be adequate, the regional average is hovering at around 92 percent, a slight decrease from the previous year, which is not high enough to ensure immunity for everyone. Over 70 percent of the region’s unvaccinated infants are from middle income countries, with Ukraine presenting the lowest coverage rate and the greatest challenge. National averages also mask disparities, with Roma children  and those from other ethnic and vulnerable groups, including refugee and migrant children, all lagging behind. Measles outbreaks are a growing problem. Last year there were over 10,000 cases of measles in the region. Despite increased coverage of the first dose of the measles vaccine among children (up from 63 percent in 2000 to 93 percent in 2016) more work is urgently needed, as children are not fully protected against measles unless they receive two doses. Currently, second dose coverage is at 88 percent, which does not provide adequate protection.            In total, over 500,000 children in the region are still not protected against measles - a life-threatening, but easily preventable disease.   There are also concerns about ‘vaccine hesitancy’ – a growing mistrust of immunization among some parents, fuelled by myths and misinformation. Such hesitancy may stem from negative media stories linking a child’s death to immunization without the full facts. It may be influenced by the region’s anti-vaccine movements, which spread anti-immunization messages. Meanwhile, measures to counter vaccine hesitancy and build parental trust in immunization are hampered by a lack of discussion with parents about its importance and the minimal risks.  A baby girl receives her vaccination at a clinic in Serbia. A baby girl receives her vaccination at a clinic in Serbia. Donor support for immunization is falling in some countries that still require such support. Elsewhere, the concern is to ensure financial sustainability for immunization programmes once countries ‘graduate’ from the support provided by Gavi (The Vaccine Alliance). Ongoing reforms in some countries are affecting both the structure and financing of immunization programmes. Some countries, challenged by competing priorities at home and inaccessibly priced vaccines on the global market, experienced several vaccine shortages in 2015–2016, sometimes causing critical disruptions of services. These issues are particularly acute in middle-income countries, many of which self-procure vaccines and continue to face significant challenges in achieving financial sustainability of their immunization programmes. Some countries also lack adequate monitoring of vaccine coverage, which is critical to understand and address any gaps.   As a result of such challenges, the region faces outbreaks of vaccine-preventable disease, such as a polio outbreak in 2015 and an ongoing measles outbreak in Ukraine  – a country where conflict and economic recession have depleted stocks of vaccines and vaccine hesitancy is reducing immunization coverage. There is also an ongoing large measles outbreak in Romania, with over 10,000 cases of the diseases and 38 deaths. During the last five years, measles outbreaks have been registered in Georgia (2013), Kazakhstan (2014), Kyrgyzstan (2015), and Tajikistan (2017). Outbreaks in one country can spread rapidly to others, signalling the interdependence and vulnerability of all countries, whatever their stage of economic development.  
Article
25 Апрель 2018
#VaccinesWork to protect children in Ukraine, amid measles outbreak
https://www.unicef.org/eca/stories/vaccineswork-protect-children-ukraine-amid-measles-outbreak
As a mother of two young children, Natalia was once told by her doctor that vaccinations were unnecessary. Now – with a measles outbreak gripping Ukraine –Natalia is glad she chose to ignore the doctor’s advice and instead vaccinate her children. This recent national outbreak has affected 16,500 people and killed 13, including nine children. According to a UNICEF poll taken in 2016, 16 percent of parents in Ukraine have refused vaccinations for their children.  Natalia with her two children in a park in Kyiv. Natalia, with her two young children in a park in Kyiv. “Many parents I know still refuse to vaccinate their children,” says Natalia, whose children received the MMR vaccine against measles, mumps and rubella. “They say the vaccines are bad, that they have adverse effects. My children are fine and I think their health is more important.” Ukraine’s Ministry of Health has been leading the outbreak response since 2017 with support from UNICEF and other partners. While less than half of all children in the country were vaccinated against measles as part of routine immunization in 2016 (via the MMR vaccine), the number more than doubled in 2017 to over 90 percent, according to the Ministry. Valentyna Ginzburg, a doctor who heads Kyiv’s state healthcare department, says she and her team have been working to combat the measles outbreak since first being alerted to a rise in infections following the New Year and Orthodox Christmas celebrations in 2018. “We received information on the incidence rates of measles in Kyiv,” Dr. Ginzburg says. “We knew we needed to take rapid action to prevent a situation similar to other regions, such as Odesa, where there had already been fatalities amongst both adults and children from the illness.” Measles is one of the most contagious diseases around and we understood that if we were not proactive and did not control it, it would have not been long before we had the same situation as in other regions. Dr. Ginzburg Dr. Ginzburg explains how she and her colleagues had to act quickly to stop the spread of the disease in Kyiv. UNICEF/2018/Krepkih Dr. Ginzburg explains how she and her colleagues had to act quickly to stop the spread of the disease in Kyiv. In the four days that followed, 11,000 children were vaccinated in Kyiv. Around 48,000 children were immunized from January to March, a tally that would normally take 12 months to reach. Following national recommendations on outbreak response, authorities in Kyiv launched a ‘situation room’ to collect the latest information and coordinate response actions. Being vaccinated was also made a pre-condition for children attending schools and preschools to help stop the spread. The city administration also encouraged medical specialists to visit schools and raise awareness of vaccination among both teachers and parents.  Maryna Stefanenko, a pediatrician at a clinic on the left bank of Kyiv, gives more details. “We had a lot of people coming in, even those who normally go to private clinics,” she says. Dr Stefanenko’s clinic usually administers around 80 vaccines per day, but during the outbreak they were immunizing around 1,200 people each day.   On the other side of the city, in Obolon district, another clinic rushed to meet demand. A pediatrician there, Dr Natalia Yatsenko, explained that as part of her job, she must sign the paperwork for parents who refuse to vaccinate their children. She says she spends a lot of time explaining the benefits of vaccination, as well as the risks for children who do not receive their shot. Before the measles outbreak, she managed to talk some 10 per cent of objectors into changing their mind. However, during the outbreak, she did not even have to persuade them – many parents who were once against vaccinations were very keen to bring their children to the clinic. A young boy receives several vaccines at a time at Dr Natalia Yatsenko clinic in Kyiv. A young boy receives several vaccines at a time at Dr Natalia Yatsenko clinic in Kyiv. Another factor in the response? The effects of armed conflict in eastern Ukraine. “We had some internally displaced people from the eastern regions who came to our clinic,” says Yatsenko. “They told us that their children’s vaccination records had been falsified, and now they wanted to vaccinate them for real. So we vaccinated them.” “We also vaccinated some parents,” adds Stefanenko. “The parents bought the vaccines for themselves from the pharmacy then brought them to us and we administered the shots.” Dr. Ginzburg also advocated with the Kyiv authorities to address one of the biggest issues the country is struggling with - access to vaccines for adults and health workers. “All health workers had to be checked and those who required vaccination had to be immunized,” she says. “Then we were sure that, no matter what, the doctors wouldn’t be incapacitated.” The city administration also made sure the municipal pharmacy chain had measles vaccines available for adults. Artem, six, receives his second dose of the MMR (mumps, measles, rubella) vaccine in Kyiv. Artem, six, receives his second dose of the MMR (mumps, measles, rubella) vaccine in Kyiv. Although vaccines for children were available in 2017, increased demand had depleted stocks in some regions. To help replenish stocks, a new expedited supply of MMR vaccines was delivered by UNICEF at the request of the Ministry of Health at the end of February 2018, and another 800,000 doses are due this month, to ensure sufficient vaccines for both routine immunization of children and those who may have missed their immunizations in previous years. Significant progress has been made in reaching more children with vaccines, yet still an estimated 1.5 million children die globally from vaccine preventable diseases every year and an estimated half a million children in the region are still not immunized. Millions of lives can be saved by extending basic health services like routine immunization to the most vulnerable and disadvantaged, and UNICEF is on the ground immunizing millions of children each year . Vaccines protect children against disease and death, saving up to three million lives every year. In short, #VaccinesWork. 
Article
27 Сентябрь 2018
Astana Global Conference on Primary Health Care
https://www.unicef.org/eca/stories/astana-global-conference-primary-health-care
What is the Astana Global Conference? On 25-26 October 2018, world leaders, government ministers, development partners, civil society and young people will meet in Astana for the Global Conference on Primary Health Care, jointly hosted by the Government of Kazakhstan, UNICEF and WHO. Participants will renew their commitment to primary health care as the means of achieving universal health coverage, SDG3 and other SDG goals to which health is a contributing factor. The Conference will mark 40 years since the first Global Conference on Primary Health Care, held in 1978 in Almaty (then Alma-Ata), Kazakhstan. The Declaration of Alma-Ata endorsed at that conference was a seminal document that founded a movement and advocacy for primary health care. The 2018 Conference will endorse a new Declaration of Astana which emphasizes the critical role of primary health care in promoting good health, social and economic development and global security. It aims to refocus efforts to ensure that everyone everywhere can enjoy their right to the highest standard of health. What is primary health care? Primary health care is an approach to designing and delivering frontline health services that lays a foundation for achieving universal health coverage. Universal health coverage is one of the targets of the third Sustainable Development Goal (SDG3): Ensure healthy lives and promote well-being for all at all ages. Primary health care includes three core elements: Affordable and accessible health services, including quality primary care, and essential public health functions that promote health and well-being, prevent illness and protect populations against outbreaks of disease. Empowered people and engaged communities, to whom health services are accountable, and who are also responsible for their own health. Inputs (policies, actions, resources) from all sectors that influence health and well-being, ranging from agriculture, manufacturing, education, water, sanitation and hygiene, transport and the media etc. A one-year-old girl is administered her first dose of the mumps, measles and rubella (MMR) vaccine at a clinic in Kyiv, Ukraine. A one-year-old girl is administered her first dose of the mumps, measles and rubella (MMR) vaccine at a clinic in Kyiv, Ukraine. How does primary health care contribute to universal health care? Universal health care is based on the principle that all individuals and communities should have access to quality essential health services without suffering financial hardship. Primary health care contributes to this by ensuring that health services are available, accessible and affordable – including services that prevent illness, cure disease and promote good health. How is UNICEF contributing to the event in Astana and to primary health care? UNICEF is working closely with WHO and the Government of Kazakhstan to support and prepare for the conference. All UNICEF offices are mobilizing government and civil society partners, and making sure the core elements of primary health care are prioritized in the allocation of funding and resources, and in follow up actions. UNICEF is coordinating a Youth Forum that will be held on the day prior to the main event to bring the voices of young people into the conference. UNICEF is also part of a core group of global and regional partners working to support primary health care at country and sub-national levels. The group, which includes UN agencies, donor governments, philanthropic foundations, multilateral agencies like the Global Fund, Gavi and others, is developing a set of operating principles that will prioritize the three core elements described above, and ensure primary health care remains in place after their support has ended. This will be reflected in UNICEF’s own programmes with governments and partners. Ahead of the Global Primary Health Care Conference in Astana, 25-56 October, UNICEF Executive Director Henrietta H. Fore shares the path to achieving “Health for all” – the vision of the SDGs. In her address, UNICEF Executive Director Henrietta H. Fore, highlights the importance of investing in the quality of primary health services and extending their reach to ensure access for the most vulnerable and underprivileged communities. #PrimaryHealthCare #HealthForAll #Astana2018 Success stories: How primary health care helps families and children In remote Kyrgyzstan simple solutions save newborn lives How visiting nurses help prevent child deaths in Kazakhstan Fathers in Turkmenistan carve out their immediate and long-term parenting roles Investing in better care during baby’s first days is saving lives in Kyrgyzstan Saving newborn lives in remote mountainous areas of Kyrgyzstan   “In Focus” reports: A healthy start in life for every child Immunization   More information about the Astana Global Conference WHO Global Conference on Primary Health Care website The Declaration of Alma-Ata Provisional conference programme

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