How a measles outbreak triggered investment in health systems strengthening and demand generation

Kazakhstan Case Study

Kazakhstan Measles vaccination


When coronavirus disease (COVID-19) cases were first reported in Kazakhstan in March 2020, lockdown measures disrupted access to healthcare, including routine immunization services that were temporarily suspended at the primary health care level for six weeks during April and May 2020. In 2020, coverage for the first dose of the measles vaccine (MCV1) fell below the 95 per cent threshold required to protect against outbreaks of vaccine-preventable diseases, to 93 per cent. By 2021, there were 8,000 unvaccinated children and 20,000 were under-vaccinated, and the emergence of increasing gaps in immunization and the demand for information through digital platforms meant that many people turned to social media for advice, which was a source of negative messaging and false information. As of February 2023, 33,691,195 doses of the COVID-19 vaccine had been administered in the country, with a coverage rate of 69.6 per cent for two doses of the vaccine.

The measles outbreak triggered investment in health systems strengthening and demand generation through a series of research and studies. Although UNICEF Kazakhstan was not heavily involved in the COVID-19 vaccine roll out, the evidence that was generated was highly beneficial to the overall process and improved immunization programme. While low demand and vaccine uptake is often attributed solely to those members of the population who are anti- vaccination, in Kazakhstan the work that UNICEF has undertaken with partners demonstrated that it is a more nuanced, complex issue. The root cause analysis of the measles outbreak kick started a series of other important assessments of the entire health system during the pandemic and those recommendations have resulted in real policy change. The experience in Kazakhstan shows that investing in evidence generation and building reliable data can have a significant impact beyond understanding the situation and contributing to legislative reform and the evolution of the health system, to build trust with an overall vision to enhance the well-being and health of children.

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