The life of an immunization officer in Lao PDR
A health hero's door-to-door journey to vaccinate every child.
About 50 kilometres north of Lao PDR's capital city, Vientiane, lies the KM52 health centre. The health centre encompasses nine villages comprising more than 2,000 children. One of the health centre nurses is 37-year-old Chansi Chandala, who is one of the people responsible for administering the routine immunization programme in the villages.
For the past 11 years, she has been vaccinating women and children in the villages near the KM52 health centre. From birth until a child turns two, the children receive routine immunization.
“My team and I are responsible for vaccinating all 2,000 children in the 400 households in the nine villages," says Chansi.
Every month, the health centre administers routine immunization for all children in the district. However, the challenge is that parents and their children often do not show up for their appointment.
"A lot of families do not show up to the health centre when it's time for their children's routine vaccination. Many families are busy in their farms, while some don't understand the importance of getting their children fully vaccinated."
To ensure that no child is deprived of life-saving vaccines, a team of four members, including Chansi, visits each household in the village whose children did not receive the monthly dose. She puts about 90 doses of vaccines in her portable cooler box and takes the town's round.
She travels on her motorbike to visit each home to deliver vaccination to the children. Sometimes, when the roads are too challenging to navigate, she leaves her motorbike at the village office and must walk instead.
Chansi administers vaccines such as Hepatitis B, BCG, Measles, IPV, OPV, Penta, Tetanus, etc. She received training on maintaining the temperature of the vaccines and how to deliver vaccine injections for children.
Once the child receives their first dose, they are registered in the health centre's vaccination records. In return, the health centre also provides a yellow vaccination card to the parents.
In the past, Lao PDR has faced the brunt of diseases such as Smallpox, Polio, Measles and Rubella. With the objective of vaccinating children and end preventable diseases, the National Expanded Programme on Immunization (EPI) was launched in 1982, targeting children under two and women between 15-45 years old throughout the entire country. UNICEF is a leading agency in Lao PDR's vaccine management and communication.
Thanks to generous support from donors such as the Japanese Committee for UNICEF, the EPI programme has successfully eradicated Smallpox and Polio. However, the battle is still on against measles and rubella.
The EPI programme has set an ambitious target to reach 95 per cent of children with routine vaccines. For this target, planning for integrated outreach, training for health staff, training for communities and advocating for advocacy and social mobilization are being carried out across the country.
"I will continue working to ensure that children receive their routine vaccination. However, I think there is room for improvement. More efforts to raise awareness about the importance of vaccination to parents, starting from when the mother is pregnant, is needed to reach every child," says Chansi.
With support from development partners such WHO, GAVI – the Vaccine Alliance, KOICA, Lao Lux-Development, Save the Children Australia, Swiss Red Cross, the Government of Lao PDR provides routine vaccination to all children for free. However, the country's immunization drive is still in need of financial support for training, management, communication etc. The need for financial assistance will only go up as Lao PDR is preparing to inroduce COVID-19 vaccines in the country in early 2021.