ВОЗ и ЮНИСЕФ: Продолжение оказания услуг по плановой иммунизации имеет жизненно важное значение во время пандемии COVID-19
избежать дальнейшего воздействия COVID-19 на наши системы здравоохранения, обеспечив продолжение вакцинации людей всех возрастов в соответствии с национальными графиками. Я призываю страны даже в это трудное время продолжать оказание услуг по иммунизации и стимулировать спрос на вакцинацию на протяжении всей жизни человека. Обеспечение приоритетности иммунизации является одной из моих четырех основных областей моей работы и занимает центральное место в концепции ВОЗ в отношении здоровья в новой Европейской программе работы», – заявил д-р Ханс Генри П. Клюге, директор Европейского регионального бюро ВОЗ. ВОЗ и ЮНИСЕФ будут и впредь поддерживать усилия правительств по укреплению их программ иммунизации, в том числе посредством стратегического планирования для оказания услуг по иммунизации на справедливой основе, усиления эпиднадзора за болезнями, предупреждаемыми с помощью вакцин, а также обеспечения участия и просвещения местных сообществ. В новом будущем, в которое мы сейчас вступаем, вакцины будут по-прежнему служить основой для обеспечения здоровья и благополучия для всех. Именно благодаря солидарности, совместным действиям и неустанной приверженности принципу «не оставить никого без внимания» мы сможем вместе создать более здоровое будущее. #ВакциныРаботают Georgia immunization UNICEF/UN0326765/Georgia
Защита детей от кори в Румынии
Родители из общины рома, проживающей в городе Стрехае на юго-западе Румынии, кивают и с облегчением улыбаются после просмотра короткого видеоролика о пользе иммунизации для их детей, показанного местным врачом. Врач отвечает на вопросы родителей, прежде чем они вместе со своими детьми перейдут в следующий кабинет, где всем детям будет проведена вакцинация. Здесь дети разного возраста: те, кто только начинает ходить, и те, кому уже исполнилось 18 лет. Самые маленькие крепко держат своих мам за руку, а те, кто постарше, улыбаются и просят посмотреть фильм еще раз. Производство и показ данного фильма осуществляется в рамках программы ЮНИСЕФ в Румынии по поддержке усилий министерства здравоохранения страны, направленных на повышение показателей охвата иммунизацией и предотвращение распространения кори. С 2000 года показатели охвата иммунизацией в Румынии значительно снизились. В 2017 году только 75 процентов детей получили две дозы вакцины MMR - комбинированной вакцины против кори, эпидемического паротита и краснухи. Этот показатель намного ниже рекомендованных 95 процентов, необходимых для защиты всех детей. В результате низких показателей охвата иммунизацией в Румынии произошла вспышка кори. В 2016 году ею заболели более 15 000 человек, из которых 59 человек умерли. Большинство из них составили дети. В рамках непрекращающихся усилий по повышению охвата детей иммунизацией, в июле 2018 года стартовала организованная министерством здравоохранения Румынии кампания по вакцинации детей, которые не были привиты. Для информирования населения о важном значении иммунизации участники кампании ходили по домам. В целях поддержки данной кампании ЮНИСЕФ разработал серию информационных материалов, предоставляющих предоставить родителям фактическую информацию о преимуществах и самом процессе иммунизации детей в доступной для понимания взрослых форме. В состав этих информационных материалов входит короткометражный фильм, который посмотрели семьи в Стрехае. Фильм демонстрируется семьям из наиболее уязвимых общин Румынии - родителям, живущим в труднодоступных районах, семьям, пострадавшим от нищеты, и общинам рома. Показатели иммунизации среди детей в этих общинах чаще всего самые низкие по стране. В этом фильме рассказывается о необходимости и преимуществах вакцинации, и одновременно даются ответы на часто задаваемые и волнующие родителей вопросы относительно вакцинации: Безопасно ли делать прививку моему ребёнку? Что делать, если она/он заболеют другой болезнью? Что, если мой ребёнок заболеет после прививки? Эта прививка бесплатна? A girl is vaccinated at a community center in Buhuși, in Eastern Romania as part of the UNICEF and WHO supported immunization catch-up campaign. Девочка получает прививку в общинном центре в Бухуши, в восточной Румынии, в рамках кампании по проведению вакцинации детям, которые её не прошли. Эта кампания проводится при поддержке ЮНИСЕФ и ВОЗ. «Вначале родители не хотели прививать своих детей, но потом они доверились нам. Мы рассказали родителям о пользе прививок и попросили их задавать врачу все вопросы, которые могут возникнуть у них в ходе проведения кампании. Таким образом, родители смогли получить чёткое представление о пользе вакцинации», - сказала Габриэла Стан, медицинский работник в городе Бухуши, в Восточной Румынии. Габриэла была членом группы, ходившей по домам, для того чтобы информировать родителей из уязвимых сообществ о преимуществах вакцинации. И хотя за последние несколько месяцев в Румынии произошли положительные сдвиги в деле вакцинации уязвимых детей спасающей жизни прививкой MMR, дети будут по-прежнему находиться в опасности до тех пор, пока охват иммунизацией не достигнет 95 процентов. ЮНИСЕФ в Румынии будет и впредь помогать в проведении информационно-разъяснительных кампаний о важном значении и необходимости вакцинации и поощрять всех родителей и лиц, обеспечивающих уход за детьми, к своевременному проведению этой профилактической процедуры. Таким путём они смогут защитить своих детей от болезней, предотвратимых с помощью вакцинации.
Interpersonal Communication for Immunization
Health providers have always been an important and trusted source of information for parents and caregivers in the Europe and Central Asia (ECA) region and beyond. The way they interact with families and the quality of their communication and engagement may have a positive or negative influence on caregivers’ decision to immunize their children. Research in ECA has shown that health workers do not always engage with caregivers in an open and supportive way, often using a patronizing and top-down approach in communication. As a result of time constraints and limited communication capacities, they often fail to understand the immunization-related concerns, fears and expectations of caregivers and fail to identify and address vaccine hesitancy. To help strengthen the communication and community engagement skills of front-line workers, the UNICEF Regional Office for Europe and Central Asia (ECARO) has developed this interactive and evidence-based training package to identify and address their own biases and misconceptions and to equip them with the essential knowledge, skills, and attitudes they need for positive and meaningful interpersonal communication. It consist of a Facilitator Guide, Participant Manual and a set of Presentations. Options Available options Facilitator guide Participant manual Presentation Download file (PDF, 5,62 MB) (PDF, 5,57 MB) (PDF, 11,88 MB) November 2019
Interpersonal Communication for Immunization. Presentation
Health providers have always been an important and trusted source of information for parents and caregivers in the Europe and Central Asia (ECA) region and beyond. The way they interact with families and the quality of their communication and engagement may have a positive or negative influence on caregivers’ decision to immunize their children. Download file (PDF, 11,88 MB) November 2018
Interpersonal Communication for Immunization. Participant manual
Good interpersonal communication can mean the difference between a child being fully immunized or not at all. This Interpersonal Communication for Immunization Participant manual seeks to help health workers value, acquire, and consistently use the knowledge, skills, and attitudes needed to communicate effectively with caregivers and communities about childhood immunization. Interpersonal communication for immunization capacity development is critical. Almost every study of health worker practices in the region finds that interpersonal communication for immunization overall is weak. Yet, at the same time, the vast majority of caregivers of young children cite health workers as their primary source of information about immunization. Health workers and health services must close this gap if nations and the world are to achieve universal immunization. Download file (PDF, 5,57 MB) November 2019
Interpersonal Communication for Immunization. Facilitator Guide
Health providers have always been an important and trusted source of information for parents and caregivers in the Europe and Central Asia (ECA) region and beyond. The way they interact with families and the quality of their communication and engagement may have a positive or negative influence on caregivers’ decision to immunize their children. Research in ECA has shown that health workers do not always engage with caregivers in an open and supportive way, often using a patronizing and top-down approach in communication. As a result of time constraints and limited communication capacities, they often fail to understand the immuni-zation-related concerns, fears and expectations of caregivers and fail to identify and address vaccine hesitancy. To help strengthen the communication and community engagement skills of front-line workers, the UNICEF Regional Office for Europe and Central Asia (ECARO) has developed this interactive and evidence-based training package to identify and address their own biases and misconceptions and to equip them with the essential knowledge, skills, and attitudes they need for positive and meaningful interpersonal communication. Download file (PDF, 5,62 MB) November 2019
Maintaining routine immunization services vital during the COVID-19 pandemic – WHO and UNICEF
The COVID-19 pandemic is a stark reminder that infectious diseases know no borders. All countries are vulnerable, regardless of income levels or the strength of their health care systems. Across the European Region, where tens of millions of people have been living in lockdown for weeks, and over 100,000 people have died, the speed and devastation of the novel coronavirus has completely upended lives. The urgent need for a COVID-19 vaccine underscores the pivotal role immunizations play in protecting lives and economies. As scientists around the world work to develop a vaccine against the novel coronavirus and health care capacities are stretched in responding to COVID-19, national routine immunization programmes are more critical than ever before. Governments across the Region must use every opportunity possible to protect people from the many diseases for which vaccines are already available. When routine vaccinations are missed, the risk of disease outbreaks increases. In 2018, approximately 527 000 children missed their first-dose of measles-containing vaccine in the WHO European Region. One year later in 2019, the measles virus exposed immunity gaps in Europe, infecting over 100 000 people, across all age-groups. Protecting children, adolescents and adults from vaccine-preventable diseases through vaccination is a must for the sustainability of health care systems. “We know that vulnerability to infectious diseases anywhere is a threat to public health everywhere,” said Ms. Afshan Khan, UNICEF Regional Director for Europe and Central Asia. “It is critical that routine immunization programmes continue during this crisis, while adequately protecting health workers and individuals receiving vaccinations. Reaching the most vulnerable children who have missed routine immunizations in the past should be prioritized.” If, during these unprecedented times, local COVID-19 response measures cause temporary interruptions of routine immunization services, countries should plan to resume immunization services as quickly as possible after the situation stabilizes. Countries should be prepared to vaccinate those at higher risk and ensure everyone, including the most marginalized, will have equal access to a COVID-19 vaccine when it becomes available. “ We can prevent further impact of COVID-19 on our healthcare systems by assuring that individuals of all ages remain vaccinated according to national schedules. I urge countries to maintain immunization service delivery and drive demand for vaccination, through the life-course even at this difficult time. Prioritizing immunization is one of my four flagship areas and central to WHO’s vision for health in the new European Programme of Work” said Dr Hans Henri P. Kluge, WHO Regional Director for Europe. WHO and UNICEF will continue to support governments’ efforts to strengthen their immunization programmes, including through strategic planning for equitable provision of immunization, strengthening vaccine-preventable disease surveillance and community engagement and education. As we step into a new future, vaccines will continue to serve as a foundation for health and wellbeing for all. It is through solidarity, joint action and tireless commitment to leaving no one behind that we can create a healthier future together. #Vaccineswork Georgia immunization UNICEF/UN0326765/Georgia
Going for a vaccination with my cousin Emina
“Don’t worry, it doesn’t hurt, it just stings a little. It’s easier if you look the other way,” says Emina to Irma as they fix each other’s hair. This is an important day for Irma Fafulić, who has already prepared a clothing combination to wear and asks us to wait for her while she changes in another room. Both girls soon return to the living room of Irma’s humble home, dressed up and with their hair done to their liking, but now they are faced with another dilemma: they are not sure if their protective facemasks will match the rest of their outfits so they deliberate on which one to wear to the vaccination point. The atmosphere in the living room of the Fafulić family in the village of Varda near Kakanj is almost festive: they are visited by Edin Sejdić, mediator from the Kakanj-based Roma Support Centre “Romalen”. Six-year-old Emina and her mother Fatima Dedić from Visoko are currently visiting the Fafulić family, so the girls have been inseparable for days. “I call her sister even though we’re actually cousins, and I’m a little older than Emina,” says Irma with a smile full of crooked milk teeth and explains that she has completed her second grade online due to the COVID-19 situation. Now, she says, she is deservedly enjoying her school holidays after a very challenging period when she had to compete with other relatives for access to a single shared mobile device so that she could attend her online classes. When asked what she liked most about school this year, she retorts right off the bat: “My teacher Dženita!” The rest of the Fafulić-Dedić household listens attentively to Edin, whom they have known for a long time, and who has stopped by today to escort their Irma to the local health centre for a vaccination. Statistics show that only four percent of Roma children in BiH are vaccinated Roma girl UNICEF/ Majda Balić Raising awareness about the importance and effectiveness of immunization in Roma communities is one of the regular activities implemented by the Kakanj-based Roma Support Centre “Romalen” Edin is kind of a link between the health-care system and the residents of this small community, and as a true man of the people, he explains the advantages of immunization, dispelling misconceptions and rebutting arguments of even the most fervent opponents of vaccination in the audience. He is one of the 16 mediators trained to do outreach work and help Roma communities with vaccination procedures in four cantons with sizeable Roma population (Zenica-Doboj, Sarajevo, Central Bosnia and Tuzla). Raising awareness of the importance and effectiveness of immunization in Roma communities is one of the regular activities implemented by the Kakanj-based Roma Support Centre “Romalen” under the project Immunization for Every Child in Bosnia and Herzegovina (BiH), in cooperation with UNICEF BiH. Edin is a link between the health-care system and the residents of this small community. Edin is a link between the health-care system and the residents of this small community. He admits that doing outreach work is not always easy, adding that people often confuse going to the doctor for an injection for receiving vaccines, and that there are still those who remain unconvinced of the benefits of immunization. But Edin has a way with people, patiently walking them through the entire process, emphasizing benefits and dispelling fears. By the end of the project, as many as almost 1500 families in the four cantons will have been informed about the benefits and effectiveness of immunization, as well as vaccination procedures and options. Mediators like Edin also provide assistance by escorting the youngest members of the community to vaccination points. “Thanks to this project, you can also retroactively receive the vaccines you missed,” says Edin, adding that many Roma are not at all aware of what needs to be done, or when. Mediators are therefore an invaluable asset to the community as they motivate, inform and mobilize people, and prepare the ground for the child’s immunization. Each mediator has a vaccination schedule for every child, and reminds parents when it is time to go to a health facility. Mediators are carefully selected from among their communities, they are persons of trust, and are usually involved in supporting the community through other projects – so they are familiar to the people they interact with and have already gained trust of the local residents. The same is true of the Fafulić family, who are now ready to have their Irma vaccinated after receiving relevant information from Edin. Mujo Fafulić Mujo Fafulić, president of the Kakanj-based Roma Support Centre “Romalen” “Roma mediators have a vital role to play in Roma communities. Statistics show that only four percent of Roma children in BiH are vaccinated. This project aims to raise this immunization rate, even using statistics on the mortality of unvaccinated children as one of the arguments,” explains Mujo Fafulić, president of the Kakanj-based Roma Support Centre “Romalen”, the organization implementing the project. “These are one-on-one conversations, with mediators visiting communities to check on the spot what the vaccination rates are and whether children are vaccinated at all, as well as which vaccines they have received, while also motivating parents to have their children immunized if they have not done so before. "By the time they reach adulthood, children should complete the vaccination cycle, and mediators are doing outreach work to explain the benefits of on-schedule immunization, as well as the adverse consequences of failing to do so." Mujo Fafulić Emina has already received the vaccines scheduled for her age, and she confidently shares her last words of advice with her cousin Irma before they leave, so that there are two parallel conversations going on in the living room – adults talk about the benefits of immunization and health care, and the little girls, holding hands, have their own conversation about what the needle looks like and where on the hand the nurse will give Irma a jab. Rubbing their hands with disinfectant, with their facemasks on, the girls extend their hands to the mediator, ready to go – Emina, being more experienced, will escort Irma to help her go through this whole experience as painlessly as possible. Irma’s parents Jasmina and Nermin are staying at home and waving to the girls from the window. Holding hands, with their fingers intertwined in a clasp that shows care and love, the children set out together on their trip to the health centre. The trip they are taking is one that is recommended to everyone as it promises better health and protection against diseases that are still lurking about and are far from being eradicated. Dr. Rownak Khan, UNICEF Representative in BIH confirms that by saying: “Vaccination is the best protection from communicable diseases. Unfortunately, Bosnia and Herzegovina’s low immunization rates, 68% full immunization and only 4% among Roma children, mean that children in this country are at high risk of getting vaccine preventable diseases resulting in outbreaks, particularly measles outbreaks. Currently, UNICEF is working with two Roma NGOs, Kali Sara and Romalen, to raise awareness on the importance of vaccination in Roma communities, by connecting with health institutions, Public Health Institutes and ministries with Roma communities through Roma health mediators to reach the most vulnerable children. This will also reduce equity gaps and will protect all children in BiH from vaccine-preventable diseases.” All children, regardless of the country or circumstances in which they live, have the right to develop and thrive. As a key component of the human right to health, immunization saves millions of lives and protects children against vaccine-preventable diseases. Immunization saves two to three million lives each year. Vaccines now protect more children than ever before, but nearly one in five infants miss out on the basic vaccines they need to stay alive and healthy. Low immunization levels among poor and marginalized children compromise gains made in all other areas of maternal and child health. This material is produced within the initiative Increase awareness on the importance of vaccination with special focus on Roma communities - Immunization for every child! UNICEF Country Office in Bosnia and Herzegovina’s programme on immunization, funded by the Centers for Disease Control and Prevention (CDC) through UNICEF Headquarters. We would also like to thank UNICEF Europe and Central Asia Regional Office for their support.
Protecting children against measles in Romania
Parents living in Strehaia, a Roma community in South-West Romania, nod and smile in relief after watching a short video shown by their local physician on the benefits of immunizing their children. The physician answers questions from the parents before they gather their children and move to the next room where all of the children are vaccinated. The children range in age from young toddlers to 18 years old. The young ones hold their mothers’ hands tightly, but the older ones laugh and ask to watch the film again. The film is part of UNICEF Romania’s ongoing support to the Ministry of Health’s efforts to increase immunization coverage and prevent the spread of measles. Vaccination coverage in Romania has declined since 2000. In 2017, only 75 per cent of children had received two doses of Measles, Mumps and Rubella (MMR) vaccine – a coverage rate far below the recommended 95 per cent needed to protect all children. As a result of low immunization coverage, Romania has experienced a measles outbreak, with over 15,000 people affected since 2016. This includes 59 deaths, the majority being children. As part of ongoing efforts to increase immunization coverage, in July 2018 Romania’s Ministry of Health launched a door-to-door catch up campaign to vaccinate children who missed their vaccinations. In support, UNICEF developed a series of materials to provide parents with easy to understand, factual information about the benefits and process of children being immunized. These materials include the short film watched by families in Strehaia. The film is shown to parents and families in the most vulnerable communities in Romania - people living in hard to reach areas, those affected by poverty, and Roma communities. These communities often have children with the lowest rates of immunization. The film talks about the necessity and benefits of vaccination and, at the same time, addresses the most common vaccine-related questions from parents: Is it safe to vaccinate my child? What if she/he catches another disease? What if my child gets sick after the vaccination? Is the vaccine free of charge? A girl is vaccinated at a community center in Buhuși, in Eastern Romania as part of the UNICEF and WHO supported immunization catch-up campaign. A girl is vaccinated at a community center in Buhuși, in Eastern Romania as part of the UNICEF and WHO supported immunization catch-up campaign. “In the beginning parents did not want to vaccinate their children, but then they put their trust in us. We told them vaccines are good and we encouraged them to ask the doctor all the questions they have during the campaign. So they were able to have a clear picture on the benefit of vaccination,” said Gabriela Stan, a health mediator in the town of Buhuși, in Eastern Romania. Gabriela was part of the team that went door-to-door to inform parents from vulnerable communities about the benefits of vaccination. Although there have been positive developments in reaching vulnerable children with lifesaving MMR immunizations over the past few months in Romania, until the coverage rate reaches 95 per cent, children will remain at risk.
Protecting young children from vaccine-preventable diseases
Vaccination is one of the world’s safest and most cost-effective public health interventions. Yet growing distrust in science, coupled with misinformation, means that vaccination coverage rates are declining in some countries and communities, resulting in an upsurge of vaccine-preventable diseases. Research shows that those caring for children…
Improving health literacy among refugee and migrant children
UNICEF has worked with partners and with young refugees and migrants on the ground to identify information gaps – work that has, in turn, guided the development of health literacy packages across all five countries on a range of crucial health issues, from immunization and nutrition to sexual and reproductive health (SRH) and gender-based violence (GBV). The assessment has shaped the development of detailed plans on how to ensure that health messages reach their audience and have an impact. The health literacy packages have also drawn on existing materials, including Facts for Life , My Safety and Resilience Girls Pocket Guide and an adapted version of the UNFPA curriculum: ‘Boys on the Move’. Refugees and migrants face a chronic lack of health information in their own languages, and a lack of information that reaches them through the channels or people they trust health navigation Some common priorities have been identified by refugees and migrants across all five countries, including access to immunization and other primary health care services, breastfeeding and young child feeding, and the prevention of GBV. They have also flagged up the pressing need for more mental health and psychological services. Other issues have emerged as priorities in specific countries, including cyberbullying and online safety in Italy, and substance abuse among young people In Serbia – the focus of a new in-depth UNICEF study. Not surprisingly, the COVID-19 pandemic is a new and urgent priority for refugee and migrant communities – and one that has heightened the health risks they already face by curtailing their movements and their access to health services. A consultation with refugee and migrant adolescents and young people living in Italy has revealed major gaps in their knowledge about sexual and reproductive health, drawing on an online survey, a U-Report poll and a series of focus group discussions. It has highlighted some common misunderstandings, such as the myth that masturbation causes infertility, and continued perceptions around the importance of a woman’s virginity at marriage, as well as knowledge gaps around menstruation, pregnancy and sexually transmitted infections. The consultation also found, however, that the young participants want to know far more about this crucial area of health. As one young man from Guinea noted during a focus group discussion: “often young people do not want to know if they have an infection, also because they are not aware that these can be treated. It is so critical to raise awareness on STIs tests and treatment options.”
‘RM Child-Health’: safeguarding the health of refugee and migrant children in Europe
More than 1.3 million children have made their way to Europe since 2014, fleeing conflict, persecution and poverty in their own countries. They include at least 225,000 children travelling alone – most of them teenage boys – as well as 500,000 children under the age of five. In 2019 alone, almost 32,000 children (8,000 of them unaccompanied or separated) reached Europe via the Mediterranean after perilous journeys from Syria, Afghanistan, Iraq and many parts of Africa – journeys that have threatened their lives and their health. Many have come from countries with broken health systems, travelling for months (even years) with no access to health care and facing the constant risks of violence and exploitation along the way. Many girls and boys arriving in Europe have missed out on life-saving immunization and have experienced serious distress or even mental health problems. They may be carrying the physical and emotional scars of violence, including sexual abuse. The health of infants and mothers who are pregnant or breastfeeding has been put at risk by a lack of pre- and post-natal health services and of support for child nutrition. Two girls wash a pot in the common washing area of the Reception and Identification Centre in Moria, on the island of Lesvos, in Greece. Two girls wash a pot in the common washing area of the Reception and Identification Centre in Moria, on the island of Lesvos, in Greece. Child refugees and migrants also face an increased health risk as a result of crowded and unhygienic living conditions during their journeys and at their destinations. Even upon their arrival in Europe, refugee and migrant children and families often face continued barriers to their health care, such as cultural issues, bureaucracy, and a lack of information in their own language. Southern and South East European countries are at the heart of this challenge, struggling to meet the immediate needs of vulnerable refugee and migrant children. And now, an already serious problem is being exacerbated by the COVID-19 pandemic. Refugee checks on his son