Never too late

Parents renew hopes for their children’s immunization as Indonesia launches nationwide catch-up campaign

Ardila Syakriah
23-year-old Desti holds her one-year-old daughter Naura at their home in Tanjungpinang, Riau Islands.
UNICEF/2022/Clark
26 July 2022

Leaving behind the close-knit community where she grew up, new mother Desti Tritania dreamed of a better life for her family as they frequently moved across the Riau Islands for her husband’s work. But after two years, those hopes began to dim as she watched her daughter Naura become underweight and fall sick. Since she was two months old, the jolly little girl had little to no access to free posyandu (village health post) sessions, forcing her to miss most of her basic immunizations.

“I wanted to get her immunized, but I didn’t know where to go. It was difficult living in an unfamiliar area,” Desti, now 23, lamented.

Mounting concerns over Naura’s health, in addition to Desti’s second pregnancy, eventually led the family to settle back with her mother in early 2022, which brought Desti relief. Now, she not only had her mother to help support her two young children, but also the village midwives and volunteer community health workers.

Desti holds her one-year-old daughter Naura in her neighbourhood in Tanjungpinang, Riau Islands
UNICEF/2022/Clark
Desti holds her one-year-old daughter Naura in her neighbourhood in Tanjungpinang, Riau Islands

In early May, a village midwife at Puskesmas Melayu Kota Piring, the nearby community health centre, called Desti to inform her about the upcoming catch-up immunization session at her village’s posyandu. A couple weeks later, a volunteer health worker helped Desti bring Naura to the health post to receive the oral polio vaccine that she had missed, supplemented with the measles-rubella (MR) vaccines.

“With my second child, I hope that as a mother I won’t make the same mistakes as I did with Naura before,” Desti said, brimming with new hope.

A volunteer community health worker holds one-year-old Naura as she receives her measles-rubella immunization at the village health post.
UNICEF/2022/Clark
A volunteer community health worker holds one-year-old Naura as she receives her measles-rubella immunization at the village health post.

Protecting children from vaccine preventable diseases

May 18 marked the first catch-up immunizations for Naura, and also for many other children as Indonesia launched its National Childhood Immunization Month (BIAN) in 27 provinces. The first phase of the campaign, which runs from May to July 2022, aims to ensure millions of children are caught up on their routine and MR vaccinations. A second phase of the campaign is planned for August across Java and Bali.

Although Indonesia has been going the extra mile to maintain its polio-free status and eliminate other childhood diseases through vaccinations, the COVID-19 pandemic has laid bare some gaps. During the BIAN launch, the Ministry of Health (MOH) revealed that amid the pandemic, approximately 1.7 million children like Naura had missed their complete basic immunizations.

Naura was also among the zero dose cases – children lacking any dose of diphtheria, tetanus and pertussis immunization. That number almost doubled from 471,000 in 2019 to 798,000 Indonesian children in 2020. The Riau Islands, where the launch took place, was able to maintain its routine immunization coverage at over 80 per cent in the past two years, although it still marked a decline from 96.8 per cent in 2019 due to the pandemic. The pandemic forced closure of posyandu, where these immunization services are delivered for free, in many parts of the country.

An MOH and UNICEF assessment in 2020 found that in nearly 84 per cent of reporting health facilities, immunization services were significantly disrupted due to the COVID-19 outbreak and physical distancing measures. These disruptions have exposed vulnerable young children to the risks of life-threatening diseases like polio, diphtheria, tetanus and hepatitis B that could be prevented with vaccines.

UNICEF has been advocating for the safe resumption of routine immunization services and supporting the MOH to rollout of the BIAN campaign. Findings from the MOH and UNICEF’s rapid quarterly assessments on pandemic impacts on routine immunization services in 2021 have served as lessons for continuous programme improvement. The report revealed the concerns of health staff regarding vaccine stock-outs, difficulties in implementing school-based immunizations and perceived reluctance among parents and caregivers to get their children vaccinated, among others.

 

One-year-old Naura walks with her parents on the pier next to their house.
UNICEF/2022/Clark
One-year-old Naura walks with her parents on the pier next to their house.

The BIAN campaign offers a second chance for parents and caregivers like Desti to protect their children against vaccine-preventable diseases that may result in disability, or even death, and prevent other pandemics. As health workers in her village told her:

"There is no such thing as too late.”

“I hope that parents in my position will not dwell on regrets and know that they can always ask people who know better. There will always be village and volunteer health workers to turn to,” Desti said.