UNICEF supports women and youth to spread the #VaccinesWork message in Homs and Hama

Empowering women is critical to improving vaccines coverage

Lina Alqassab
Two women talking
UNICEF/ Syria 2019/Abdulaziz Aldroubi
25 April 2019

Three-month-old Basma has never been immunized, her mother Amani*, 35, was too afraid to vaccinate her. “Our neighbour lost her baby because of a fever,” recalls Amani, “We rushed him to the hospital at night, but it was too late; he died before our eyes.”

When it was time to vaccinate Basma, Amani worried that vaccines would give her daughter fever. “I had this unfounded fear in my head that vaccines can cause fever and I was too afraid that what happened to our neighbour will happen to my own daughter. I got reluctant about the whole thing.”

Amani, was not the only reluctant parent in Hama. A UNICEF outreach initiative earlier this year found that at least 1,260 children in more than 50 villages and neighbourhoods in Homs and Hama had missed out on some or all of their vaccinations. The further the outreach teams went into rural areas the more children lagging in their vaccinations were identified.

Mother holding baby
UNICEF/ Syria 2019/Abdulaziz Aldroubi
Basma, 3 months, from Hama after receiving her first lot of vaccinations, thanks to Communication for Development workers who eventually convinced her mother to immunize her after 3 home visits.

Finding out why people refrain from vaccinating their children, particularly where vaccination is accessible, and devising strategies to change this behaviour is Nour Alswaid’s work and passion. She is UNICEF’s Communication for Development (C4D) officer in Homs and Hama and has been coordinating with partners the intensive door-to-door outreach activities to raise awareness at homes, schools and health clinics on the importance of vaccines.

“Entrenched misconceptions are sometimes hard to change. With Amani it took three home visits with the UNICEF-supported mobile teams to address the root of her concerns about how vaccine work and their safety. But we got there in the end. Basma received her missed vaccines and her mother is bringing her regularly for routine immunizations.”

UNICEF/ Syria 2019/Abdulaziz Aldroubi
Huda, one years old, from Hama, receives her first vaccine ever after being reached by UNICEF-supported Communication for Development workers.

Empowering women is critical to improving vaccines coverage

In most of home visits conducted by UNICEF’s teams, the reluctance and hesitancy to vaccinate is directly linked to the status of mothers and women caregivers in their communities and the level of awareness these women possess.

When Bayan, an outreach worker in Hama, met Salma*, a 35-year-old housewife and mother of two, she was shocked to find that not only Salma’s four-year-old daughter, Rana, hadn’t completed her vaccinations but her one-year-old sister, Huda, had not been vaccinated at all since her birth.

“It was the last place I expected to find dropouts,” says Bayan, “A middle-class neighbourhood in Hama city where vaccinating children was the norm.”

Salma broke into tears as she explained why her daughters were not vaccinated: “I want to protect my children, but my parents-in-law wouldn’t allow me.” Salma used to live with her parents-in-law in one house; they had full control over her life, “Shortly after I gave birth to my first daughter I sneaked her out to a clinic and she got her first vaccine. But my in-laws found out and stopped me from going again.”

It was only when Salma moved out with her husband and children to a new neighbourhood that she reclaimed control over her and her children’s lives. Soon after moving out Salma was contacted by an outreach worker and a visit was scheduled to her new home. “The outreach worker gave me the best news; not only can my younger daughter get her immunizations, but I can also immunize her older sister even though she is four now. I thought it was too late!”

Thanks to close follow up by the outreach worker, Rana started receiving her missed vaccines, and Huda finally received her first lot of vaccinations ever.

People talking
UNICEF/ Syria 2019/Abdulaziz Aldroubi
Hozaifa talks about immunization to a family in Sunaysil, rural Homs, during door-to-door visits to reach unvaccinated children in areas of low immunization coverage

Partnering with young agents of change: a win-win

Two year ago, 22-year-old Hozaifa kickstarted a networking initiative at his medical university in Homs. “I wanted to go beyond our curriculum by incorporating more research and hands-on training and be more active within our communities.” says Hozaifa, “We started with a team of ten and today we are eighty.”

This enthusiasm caught the attention of UNICEF’s C4D officer in Homs. Hozaifa’s team was just what was needed to spread the ‘Vaccines Work’ message further into the community.

“We started working with this team of young enthusiastic community members because they have the medical background and they are eager to make a change.” explains Nour, UNICEF’s C4D officer. “In turn, we were just what they were looking for to gain more practical experience and boost their engagement in their communities; it’s a win-win situation!”

After training them on communication skills and equipping them with messages on vaccines, their safety and importance, UNICEF supported Hozaifa and 40 young students from different medical specializations to reach 930 children in rural areas with low vaccine coverage in Homs. The young team were exceptional in their innovative interaction with people of different levels of immunization awareness and interest. Through them, UNICEF has brought 330 children back to immunization in rural Homs since the beginning of this year.

Group of people talking
UNICEF/ Syria 2019/Abdulaziz Aldroubi
Hozaifa (left foreground) checking vaccination records of a family in Sunaysil, rural Homs, with two other young volunteers during their door-to-door visits to reach unvaccinated children in areas of low immunization coverage.

Moreover, during their outreach work, the team collected crucial information on awareness levels and most effective community-tailored communication methods. It was evident that people, especially in some of the most disadvantaged communities, are more likely to respond positively to young people who tend to listen to them and engage them in friendly solution-generating conversations.

“Interacting with families in rural disadvantaged communities that we’d never encountered before has been such an eye-opening experience,” Hozaifa says, “It changed many preconceptions we had and helped us understand what great responsibility falls on us as future doctors to serve these people and their children.”

*names have been changed at the request of the interviewees.