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Immunization for all children

Although it was raining in the village of Nusa in Aceh Besar district, in the westernmost corner of Aceh Province in Indonesia, this does not keep mothers from bringing their children to the health care session at the local village health post or Posyandu. As the building could not accommodate such a big group, midwife Ibu Khairiah and the cadres who support her, are welcoming the mothers and children on the front porch, where they patiently wait for their turn. The mothers are happily chatting with each other holding their babies in the arm, the toddlers are crawling about, and the older children are playing, all safely sheltered from the rain.

One by one, the cadres measure and weigh the children to make sure they grow and develop according to their age, and record the information in the children’s health books. Should one of the kids be ill, they also attend to this, saving the family the extra time and expense of taking the child to the health centre or Puskesmas in Lhoknga village.

Ibu Ermi's son Febri just received his third dose of DPT vaccine at Posyandu Nusa. © UNICEF / 2012 / Gerber.

In cooperation with the immunization staff of Puskesmas Lhoknga, Ibu Khairiah keeps track of all the pregnant women and babies born in her village. Based on this data, they establish immunization plans so that all the children receive the required vaccination doses at the right age. Immunization is proven to be the most cost effective public health intervention to date, preventing diseases such as polio, measles, hepatitis B, tetanus, pertussis, diphtheria, and childhood tuberculosis, as well as disabilities, deaths and other negative effects on health resulting from them. Unlike in some other areas of Indonesia, the community in Nusa and the other 27 villages served by Puskesmas Lhoknga is well aware of this. “Immunization is important as it prevents certain diseases and helps the children to stay healthy,” says Ibu Erni, whose five-month old son Febri is one of the three children receiving their third dose of DPT* today in Nusa.

The high level of community awareness in combination with a solid tracking system, regular house visits, supportive supervision from the District and Provincial Health Offices and UNICEF, and above all highly motivated staff like Ibu Khairia and her cadres made Nusa achieve exceptionally high immunization coverage of almost 100 per cent in 2011. Twenty-three of the 28 villages served by Puskesmas Lhoknga had achieved UCI* status in 2011, meaning that all children in these villages have been fully vaccinated by all antigens and required doses before they are one year old. While there is still room for improvement, this is nevertheless a very good results as compared to national and province level numbers: In the Province of Aceh, only 72 per cent of children were fully immunized in 2008. In 2007, about 10 per cent or almost half a million of all children younger than one year in Indonesia were not immunized at all. And about 40 per cent or 1.8 million children younger than one year were only partially immunized, meaning that they had not received all recommended doses but only one or two. Both unvaccinated and partially vaccinated children are at the unnecessary risk of contracting vaccine-preventable diseases.

All pregnant women and children in the area of Puskesmas Lhoknga are tracked through village mapping. © UNICEF / 2012 / Gerber.

“The District Health Office officially recognized our great success in coverage last year which is motivating and the Head of the Puskesmas passed it on: All midwives who have reached UCI status in their villages received a special pin. Of course they are very proud of this and we notice that this year, they are trying even harder to reach each and every child in their area!” reports Ibu Ema, the immunization coordinator of Puskesmas Lhoknga.


* [The DPT vaccine protects against diphtheria, pertussis and tetanus.]

* [UCI stands for Universal Child Immunization and means that a child has received the full doses of all recommended vaccinations before the first birthday.]



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