01/08/2020
Interpersonal Communication for Immunization
https://www.unicef.org/eca/reports/interpersonal-communication-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
04/17/2020
Maintaining routine immunization services vital during the COVID-19 pandemic – WHO and UNICEF
https://www.unicef.org/eca/node/5936
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
01/24/2019
Protecting children against measles in Romania
https://www.unicef.org/eca/stories/protecting-children-against-measles-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.  
11/30/2018
HIV-positive… and fearless
https://www.unicef.org/eca/stories/hiv-positive…-and-fearless
During the first TEDxYouth event organized on 17 November in Kazakhstan, Baurzhan, age 13, and his mother Aliya spoke about living openly with HIV.  This is his story. Standing before more than 100 people, Aliya asks if anyone in the audience remembers the incident in 2006 when 149 children in southern Kazakhstan were infected with the human immunodeficiency virus (HIV) at a local hospital. A few hands go up.  Hesitantly. “Not too many,” sighs Aliya. “That’s 149 families facing profound pain, shock, complete lack of support and understanding.” Indeed, when the news first broke at the time, there was very little by way of public understanding and sympathy.  On the contrary, the families affected have spoken about the pervasive rumors – including one suggesting that a special area would be built to quarantine the families – that they had to endure.  Some families were even broken up.  The sense of isolation still persists for many. “In our society,” Aliya says, “HIV is still perceived to be a ‘plague’ of the 21 st century. These families and children are hiding.  They do not open up about their HIV status. These children are still invisible to society.” Then she adds, “They all live in great fear. All, but one.” A voice chimes in.  “I am one of those 149 children.  I am HIV-positive and today, I am the only teenager in Kazakhstan with HIV who is living openly,” says Baurzhan, age 13. Baurzhan and his mother at their home in Kazkhstan. Working towards acceptance Aliya’s son Baurzhan was just nine months old when she learned that the blood transfusion he had received for treatment was infected with HIV.  When he started going to school, Baurzhan understood that there were different kinds of viruses and one of them happened to be living in him.  He did not feel different, until teachers asked him not to play during recess or physical education class. “We realized that for school to be an understanding environment, we needed to organize training, raise awareness among teachers on the importance of tolerance towards children with such illnesses,” his mother says. The lanky teenager remembers crying in the school gym changing room after his classmate called him offensive names related to HIV.  “I was not ready to hear it.  It hurt a lot.” The incident made Aliya realize that students needed awareness training, too. She helped the school organize lessons on child rights and responsibilities explaining the universality of rights.  After the first session, the boy who had offended Baurzhan apologised for what he had said. “For 11 years, I have been taking medications every day to control the amount of virus in my blood. My immunity is 900 cells. Do you know that the immunity of a healthy person is 1200 cells? So, my immunity is that of a healthy teenager,” he says.  “My viral load is less than 50 copies. This means that I am just a carrier, but I cannot transmit the virus while I am taking medications.” Together with friends, Baurzhan created a self-help group called “Asian teens” where they share their experiences of living with HIV. “I want to support other kids who are living in fear because of their HIV status. I want to be a role model of living openly and without any fear.”  As Baurzhan says these words, the audience erupts in standing ovation. After the TEDx talk, Baurzhan and his mother said that many people approached him and asked if they could give him a hug. “I really liked the feeling of speaking in that room – it was filled with warmth, the audience showed that they cared”, he said. “My friends who are also living with HIV cannot wait to see my video, I think they will be surprised to see the positive reaction my story received.” Baurzhan with his sibling at the family home. Baurzhan with his sibling at the family home. HIV today and steps for the future Since the outbreak in 2006, the HIV/AIDS situation has changed. By 2010, UNICEF helped decrease the rate of HIV transmission from mother to child in south Kazakhstan, which at the time had the highest number of deliveries by HIV-positive women. At country level, joint efforts of the Ministry of Health and UNICEF led to dropping the HIV transmission rate from 10.9 per cent in 2007 to 1.8 percent in 2014. Kazakhstan is now submitting a request to be certified as a country that virtually eliminated mother-to-child HIV transmission. However, more work remains, says UNICEF Health and Nutrition Officer Kanat Sukhanberdiyev. “Globally, we still see that many children are dying from HIV/AIDS. We have a long way to go until children and adolescents with HIV receive the full package of healthcare and psychosocial support.” On this World AIDS Day, UNICEF is calling on the world to increase investments in HIV prevention, testing and treatment programmes.  Otherwise, by 2030, the lives of some 360,000 adolescents will be at risk of AIDS-related diseases. Find out more about UNICEF’s work on HIV in Kazakhstan.
07/02/2020
‘RM Child-Health’: safeguarding the health of refugee and migrant children in Europe
https://www.unicef.org/eca/rm-child-health-safeguarding-health-refugee-and-migrant-children-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
05/04/2020
With financial support from the European Union UNICEF launches the ‘RM Child-Health’ project to strengthen vulnerable refugee and migrant children’s health
https://www.unicef.org/eca/press-releases/financial-support-european-union-unicef-launches-rm-child-health-project-strengthen
– Under the Health Programme of the European Union, the Directorate General for Health and Food Safety has committed a project grant to  UNICEF to support work ensuring refugee and migrant children and their families have access to quality health care and accurate health information in Bulgaria, Greece, Italy, Spain, Bosnia Herzegovina and Serbia. Refugee and migrant children and their families often have more health-related risks and face a number of barriers accessing quality health care. Many children and families also live with severe emotional distress due to the trauma of fleeing home, undertaking dangerous journeys and experiencing abuse and exploitation, including sexual and gender-based violence. The global COVID19 pandemic further exacerbates these health challenges.  “With the ongoing pandemic, protecting every child and adult’s right to health care and accurate heath information is paramount. This collaboration with the EU Health Programme will help ensure the most vulnerable refugee and migrant children will have better access to primary healthcare services, psychosocial support as well as violence prevention and response services,” said UNICEF Regional Director for Europe and Central Asia and Special Coordinator for the Refuge and Migrant Response in Europe, Ms. Afshan Khan. The project ‘RM Child-Health’ will help improve the health of refugee and migrant children by improving their access to life-saving immunizations, mental health and psychosocial support, gender-based violence prevention and response activities as well as maternal and newborn health care and nutrition support. Information materials on health-related risks and services available for refugee and migrant populations will be created and shared. Medical interpreters and cultural mediators will be deployed to support communication between children and families and health care providers. The project ‘RM Child-Health’ will also support training programmes so frontline health care workers can better respond to the specific needs of refugee and migrant children and their families. In parallel, national health authorities will benefit from technical support to develop, update and improve the implementation of health policies and address bottlenecks in national health systems that currently prevent refugee and migrant children from accessing services. Refugee mother feeding her baby at ADRA community centre in Belgrade. UNICEF/UNI220342/Pancic
04/08/2021
Navigating pregnancy during the COVID-19 pandemic
https://www.unicef.org/eca/stories/navigating-pregnancy-during-covid-19-pandemic
Many expectant mothers are fearful of going to appointments while they are taking precautions, such as staying home and practicing physical distancing when outside. “You do see a lot of adaptation happening at the moment in the world where midwives are doing clinics or certain appointments by phone, so that the actual looking at the baby and the growth of the baby appointment can be short,” says Cadée. “I expect that pregnant women will find they’re seeing their healthcare professional less, to protect them and the healthcare professional from getting infected and that they will be seen live when it’s necessary.” Modifications may also be tailored for individual patients depending on their respective conditions, for example lower vs. higher-risk pregnancies. Cadée advises mothers to find out what options are available to them from their healthcare professional and in their communities. “The person who’s taking care of you is perfectly geared to you and your own needs, so your midwife or obstetrician will know best.” After your child is born, it is also important to continue receiving professional support and guidance, including routine immunizations. Speak to your healthcare provider about the safest way to have these appointments, for you and your baby. >>  How to get routine childhood vaccinations during COVID-19