What is the "Plus" in Immunization Plus?

“Vaccination is widely recognized as one of the most powerful and cost-effective public health tools. Often immunization is a child's first - sometimes only - contact with the health system.” — UNICEF Executive Director, Carol Bellamy.

Immunization reaches further than any other health intervention for children. The “Plus” is about using the vehicle of immunization to deliver other life-saving services for children. It is about making health systems stronger and promoting activities that help communities and families to improve child-care practices.

Immunization “Plus” refers to the delivery of a set of essential and cost-effective maternal and child health interventions. As a minimum, the “Plus” should include vitamin A supplementation in countries where vitamin A deficiency is a public health problem.

At least 100 million children under five suffer from vitamin A deficiency (VAD), which is essential for the functioning of the immune system. High levels of VAD can cause blindness and greatly increase the risk that a child may die from diseases such as measles or diarrhoea.

As a partner in the Vitamin A Global Initiative, UNICEF works with a coalition of governments and United Nations agencies to provide children with twice-yearly vitamin A supplements. This simple supplement, costing only two cents per capsule, can improve a child’s chance of survival by up to 25 per cent. Providing vitamin A to pregnant women can also reduce maternal mortality.

The polio eradication campaign has provided an important vehicle for delivering vitamin A capsules. Immunization outreach services are also opportunities for providing vitamin A supplements.

Other elements of the “Plus” are included according to local conditions and are decided upon by health officials with support from partners like UNICEF and ideally the communities themselves. Thus, countries like Uganda and Iraq, among others, use immunization as an opportunity to ensure children are registered. In Tanzania, immunization is delivered to more remote communities during Child Health Days that include weighing children to monitor growth and nutritional status, distribution of treated bed nets to help prevent malaria, as well as vitamin A supplementation.



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