Stone by stone, vaccination is gaining ground with reluctant parents

In Bamako, Roukia and other members of the association of women leaders meet with families to promote routine immunization.

Bintou Abdoulaye
Roukia during an awareness session with Hamadou and his wife on the importance of vaccination.
UNICEF/UN063935/Bintou Abdoulaye
18 May 2022

It is 10 a.m. when Roukia Kaba Diakite enters the compound where Hamadou is for a home visit. The 49-year-old traditional healer is a father of four children. They all live on the hills of Yirimadio in Bamako, a hard-to-reach district. Roukia is a member of the women leaders’ platform which supports routine immunization. They walk the neighborhoods in search of children who have not completed their vaccination schedule, and those who have never been vaccinated. After talking to the household members about vaccine-preventable diseases and the importance of respecting the vaccination calendar, Roukia asks to see the vaccination card of nine-month-old Ali, who is being cuddled by his mother. To her greatest surprise, Hamadou replies that since birth baby Ali has never been vaccinated.

Impact of misinformation and rumors

Roukia then asks the head of the family the reasons for not vaccinating his child. He states that neither Ali nor any of his other children have ever received a vaccine. According to him, he never accepted any form of vaccination because:

  • Before his marriage, he suffered a shoulder pain and was told that "anyone who has been vaccinated against Tuberculous at birth will have joint pain in the shoulder after 'a certain age’ as a result.
  • He later watched a video on social media that claimed that vaccines have been created to make African children sick.

In Mali, according to the last Demographic and Health Survey in 2018, 45 per cent of children have received all routine vaccines while 14 per cent have not received any form of vaccination. They therefore have no protection against common and vaccination preventable childhood diseases.

To improve the demand and use of vaccination services, representatives of women's associations supported by UNICEF and GAVI, have committed to actively support child vaccination. This led to the creation of support platforms for routine immunization in urban areas. They are composed of activists identified from among associations under the aegis of the decentralized Regional Directorate for Social Development and the Directorate for the Promotion of Women, Children and Family.

These women leaders have five mandates:

  • Regularly carry out local communication and monitor the vaccination status of children aged 0-23 months during their home visits.
  • Regularly organize educational debates on the importance of vaccination and the safety of vaccines among women's groups in their areas of intervention.
  • Request user feedback on the use of vaccination services.
  • Ensure active tracing of missed children as well as unvaccinated or partially vaccinated children identified during their home visits, using the monthly lists put together by the vaccination teams.
  • Continuously follow-up with parents of children identified until their vaccination schedule is complete.

This is how Roukia tries to convince the father of the child about the benefits of vaccination. She begins with the genesis of the numerous cases of polio, measles, and meningitis, explaining the devastation caused by these diseases on children before the advent of the Expanded Vaccination Program in Mali in 1986. She then compares this to the current situation, which has significantly improved, thanks to routine immunization.

"I am committed to working for the cause of vaccination, by raising awareness among all my acquaintances who refuse vaccination," she declares while conducting an education session with the help of her flip charts.

"I am committed to working for the cause of vaccination, by raising awareness among all my acquaintances who refuse vaccination."

Roukia Kaba Diakite, leader and routine immunization champion
The woman leader showing a flip chart to a family seated outside.
Roukia during an awareness session with Hamadou and Fatim on the importance of vaccination with the help of her flip charts.

Immediately said, immediately done

A few weeks earlier, one of Hamadou's sons had suffered from measles and was cured thanks to the treatment received. Roukia seizes the opportunity to remind him that measles is a deadly disease, especially when complications arise, but that thanks to vaccines, millions of children are protected from it today. Hamadou regretfully says: “I realize that I was on the wrong path, now I intend to correct my mistakes and have all my children vaccinated, if it is still possible”.

Hamadou and Fatim decided to go immediately to the community health center to have their child vaccinated, now that he is convinced of the benefits of vaccination. Fortunately, the community health center of Yirimadjo vaccinates every day, including the weekend, and all types of vaccines are available. This is to address the concerns from parents and guardians of children about the availability of vaccination services. Baby Ali received the first missed doses of vaccines against the following diseases: tuberculosis, poliomyelitis, rotavirus diarrhea, diphtheria, tetanus, whooping cough, hemophilus influenzae type b infections, hepatitis B, pneumonia, meningococcal A, meningitis, yellow fever and measles.

A few weeks later, Ali's mother went to the health center to honor the appointment for the second dose of vaccines. Good communication, coupled with a blend of patience, self-sacrifice, willpower, and diplomacy overcame the barrier erected by misinformation between a parent and his child’s protection through vaccination.

A man and a woman holding a baby and a vaccination certificate.
Hamadou and Fatim at the Yirimadio community health center of proudly displaying their nine-month-old son Ali's vaccination record.