Diniho Paulette : at the heart of communities to protect every child through immunization

In the narrow streets of the Andafiavaratra fokontany, Diniho Paulette knocks on her tenth door this morning. Notebook in hand, she has come to update the register of children under five — but what she finds behind each door often goes beyond a simple census: a mother who has just given birth, a newborn who has not yet been registered, a family still hesitating to have their children vaccinated.

At 43, a sector head in the second district of Antananarivo City and mother of seven children, Paulette knows these alleyways by heart. She criss-crosses them with the patience of someone who knows that trust is built door by door.

In total, Paulette had to visit 65 households. A field visit which, despite the difficulties encountered, allowed her to observe an encouraging reality: families are increasingly aware of the importance of protecting their children against disease.

Every door she knocks on represents a new encounter, a new story, and sometimes even an urgent situation to address. Some mothers have just given birth, while others are still expecting their baby. Thanks to this community visit, several newborns who had not yet been registered were identified and included in the records.

“Despite the challenges and problems encountered during the visits, it was really important to carry out this outreach. We really need to do it more often. We were able to meet mothers who had recently given birth and identify newborns who weren’t yet registered. There are also still pregnant women, and I need to keep a close eye on the births of their babies so I can register them and update the register,” she explains.

On the ground, however, things aren’t always easy. Some families are still hesitant about vaccination. But Paulette never gives up. With calm and kindness, she takes the time to explain, reassure and address the concerns of parents.

Fortunately, out of the 65 households visited, only one refused to have their children vaccinated. A situation that did not discourage Paulette, quite the contrary. She tirelessly continues her awareness-raising work with every household she meets.

“Of the households I visited, only one refused to have their children vaccinated. But that doesn’t stop me from continuing to raise awareness, because vaccination is beneficial for children’s health. What also struck me deeply was that several parents asked if there would be a vaccination campaign soon. They want their children to be protected. When I ask them about it, they tell me that with all the diseases currently circulating, it’s important for the little ones to be vaccinated as soon as possible,” she says with conviction.

Through her visits, Paulette senses a real shift in attitudes. Discussions with families are becoming more open; parents are asking more questions and showing a growing interest in their children’s health. For her, this closeness is essential for building a lasting relationship of trust between health workers and the community.

Always driven by a desire to serve her community, Paulette hopes that these outreach visits can be organised more regularly. In her view, this would not only make it easier to register children under five, but also help parents get used to receiving health workers and discussing the benefits of vaccination with them.

This activity was carried out across the six districts of Antananarivo City as part of the inter-fokontany vaccination competition, implemented by the Ministry of Public Health with support from UNICEF. The aim of this initiative is to boost the motivation of community health workers through non-financial incentives, whilst supporting them in carrying out their vaccination-related responsibilities. It also aims to increase the involvement and commitment of the fokontany and sector chiefs in promoting child vaccination within their communities.

This initiative also benefits from the support of Gavi, the Vaccine Alliance, and the Gates Foundation, which support efforts to improve vaccination coverage and protect children against vaccine-preventable diseases. Thanks to this momentum, community actors are becoming more actively involved in bringing vaccination services closer to families and ensuring better follow-up for children.

With her commitment, courage and rapport with families, Diniho Paulette embodies those women on the ground who, every day, contribute quietly but powerfully to protecting children’s futures.