UNICEF Supports the Lao Government in Strengthening Communication for Immunization
Sub-national workshops organized to strengthen communication
In Lao PDR, especially in 2020, there has been a significant drop in pentavalent vaccine (Penta 3 – the vaccine protects children under the age of one from five life-threatening diseases) coverage to below 50 percent and earlier in 2020, the southern provinces of the country also experienced a measles outbreak. Many Lao children can be protected from these vaccine-preventable diseases and instances of outbreaks like the aforementioned one could have been reduced if children receive full immunization.
However, due to the lockdown and social distancing measures implemented in response to COVID-19, it has become very difficult for health workers to conduct outreach and mobile services for those who cannot access health facilities or have difficulty doing so, thereby hindering efforts to expand immunization coverage in the country.
Dr. Panome Sayamongkhoun, Acting Director of Mother and Child Health Center, has expressed her concern over both the low immunization coverage and the impacts of COVID-19. “We could have accelerated the progress of our work at the beginning of this year, but our work was disrupted by the COVID-19 pandemic. As a result, many children remain unvaccinated as health workers could only provide services at fixed sites (health facilities) because of the lockdown,” she stated.
Following the National Advocacy Meeting on Immunization held on August 4 in Vientiane Capital, the Center of Communication and Education for Health (CCEH) of the Ministry of Health (MoH), with support from UNICEF, conducted a three-day sub-national workshop on communication for immunization in three zones – central (Vang Vieng), northern (Luang Namtha), and southern (Pakse) zones - from August 19 to September 4.
The workshops were aimed at strengthening communication and partnership with non-health sectors to step-up the immunization programme at the provincial level. These series of workshops signal a sense of urgency in ramping up the national immunization programme in Lao PDR, and this was reinforced by Dr. Panom Phongmany, Deputy Director of the Department of Health Promotion and Hygiene, who highlighted a recently issued statement from the Minister of Health in which the minister called for the step-up of immunization programmes to achieve the target of 95% immunization coverage by the end of 2020, a task that requires effective communication about immunization to succeed.
The workshops enabled participants to discuss and address the challenges in expanding immunization programmes that most provinces face. These include the lack of parental cooperation (including lack of knowledge and understanding of the vaccines), poor coordination between sectors, limited communication skills of health providers, information about immunization failing to reach intended targets and language and geographical barriers, particularly in high-risk and hard-to-reach areas, among others.
“Reaching out to every child is not easy, especially in remote and hard-to-reach areas,” shared Ms. Silima Keopaseuth, an Expanded Programme on Immunization (EPI) officer from Xayabouly province, during a workshop discussion. She said, “many people still do not know about immunization and its benefits. I think our information is not reaching them and our communication skills are also limited.”
Indeed, communication is one of the core elements of immunization service delivery and effective communication must be based on an understanding of people's behaviors and the factors that can influence it. Mr. Visith Khamlusa, Director of CCEH, told us "it is essential that we analyze the problem and find out its root causes so that we know what communication approaches we can use to address the problem accordingly." To help participants understand the problems relating to immunization service delivery, participants practiced using analysis tools during workshop exercises.
Furthermore, involving various sectors at all levels is essential for the programme and as such, major organizations like the Lao Women’s Union (LWU), Lao Front for National Development (LFND), and local authorities can play an important role in expanding immunization programmes as they have well-established relationships with local communities, which can help motivate and encourage people to use immunization services, either at the outreach or at fixed sites.
When asking about her thoughts on the workshop, Ms. Silima Keopaseuth expressed her excitement: “This is my first time participating in this workshop with officials from LWU and LFND. Normally, the topic of immunization is just discussed within the health sector.” She acknowledged that LWU and LFND have well-established connections with communities and that can help health officials better reach out to parents about immunization.
Like Ms. Silima, it was also the first time that Dr. Keosomsavanh, Head of Vientiane Provincial EPI Unit, participated in this workshop. She sees the role of LWU, LFND, and local authorities as central to community mobilization. “We cannot implement this (immunization programme) alone, that is why we have involved the non-health sectors in our work.” She added that through this workshop, “I can learn from the other provinces and this is a good thing. I hope there will be more workshops like this where we can exchange our ideas and work together more.”
These workshops are expected to yield concrete provincial communication action plans outlining the priorities for each province and helping them achieve targets for immunization coverage. The action plan will be implemented accordingly with support from UNICEF and other potential donors.