Resuming immunizations in Kayin State

Mother’s wish comes true

Nay Tun Kyaw
UNICEF
UNICEF Myanmar/ 2020
18 September 2020

“My wish is coming true” Nang Khin Nyunt exclaimed joyfully.

Nang Khin Nyunt and her seven-month-old daughter Nang Myat Su were the first to arrive at the vaccination post in Hpa-an, Kayin State, on 1 June 2020, the day community-based routine immunizations resumed after being suspended for two months, April and May, due to the COVID 19 pandemic.  

“My wish is coming true” Nang Khin Nyunt exclaimed joyfully.

Nang Khin Nyunt and her seven-month-old daughter Nang Myat Su were the first to arrive at the vaccination post in Hpa-an, Kayin State, on 1 June 2020, the day community-based routine immunizations resumed after being suspended for two months, April and May, due to the COVID 19 pandemic.  

"My daughter received her first vaccination when she was born and the second doses back in February. She should have received the third round in April, but she missed it because the immunization service was halted. I was concerned that she might not have full immunity to the diseases because she didn’t follow the programme,” remembers the dedicated mother.

Nang Khin Nyunt contacted the midwives in her township frequently to find out when the immunization services would resume. She was told that when immunization starts again on 1 June, she should come to the vaccination posts with both mother and baby wearing protective masks. So, Nang Khin Nyunt got busy sewing and made masks for her baby and herself.

The thoughtful mother is aware of the threat of the pandemic, but she is more concerned about the more common vaccine-preventable diseases her baby might be susceptible to if she did not complete her required vaccine doses.

Resumption of routine immunizations

Regular immunization services are provided on the first Wednesday of every month at the Maternal and Child Health Centre in Hpa-an.

To prevent COVID-19 transmission during the resumed immunization sessions, the Central Expanded Programme on Immunization (cEPI) revised the Standard Operating Procedures for immunization. Zoom meetings with state public health teams and township medical officers from every state and region helped in the revision process.

In early May 2020, these new procedures were presented via a video posted on YouTube and shared throughout the Ministry of Health and Sports network to reach all basic health staff.

Now is a time for ‘catch up’, to make sure all the children who missed out during the two months get vaccinated. Mothers and children are following the revised procedures at immunization sessions.

Hand washing is a must to protect from COVID-19

Prior to the outbreak of the COVID-19 pandemic, routine immunizations were undertaken at the Hpa-an Township Health Office building. However, new Standard Operating Procedures mean that that building is no longer spacious enough to facilitate the physical distancing required for safe immunizations.

UNICEF
UNICEF Myanmar/ 2020
A woman washes her hands in front of vaccination post at Kyar Taw Ya monastery in Hpa-an

Hpa-an Township Medical Officer Dr. Khin Moe Aye asked the head monk at the Kyar Taw Ya monastery next to her office if they could move the immunization sessions there for the seven days it takes to vaccinate the children in that catchment area.

Posters raising awareness of COVID-19 are now on display at the immunization post at the monastery. Markings on the floor and signage guide mothers to stay six feet away from each other, promoting physical distancing to prevent virus transmission. The hand washing facilities donated by UNICEF have been moved from the Township Health Office to the monastery.

Physical distancing to prevent COVID-19 transmission

“When the immunization service was suspended two months ago, many mothers kept asking me when their children would get their next vaccinations. They worried their children were missing the immunization protection,” said the local Hpa-an midwife, Nang Hnin Thandar Oo.

UNICEF
UNICEF Myanmar/ 2020
Social distancing measures taken at the vaccination post in Hpaan, Kayin State.

In the middle of May, when it was announced that routine immunization would resume from 1 June, the midwife together with the Township Medical Officer and the health team reviewed the guidance instructions for the revised Standard Operating Procedures sent out by the cEPI. Two rounds of regular immunizations were missed, so Nang Hnin Thandar Oo’s list of target children eligible for immunization in June was much longer than usual.She also had to revise her immunization micro-plan according to the 50-child limit imposed on the number of children to be immunized in one day.

Body temperatures of all mothers and children are checked at the preliminary screening point. The children and mothers are checked that they are wearing the appropriate face shields and masks and supplied with that personal protection equipment if they have not already managed that.

A health worker first registers each child for vaccination, then the mother and child go to the vaccination table where one midwife gives the vaccination.

 

Wearing of face masks and face shields is essential for self-protection  

“When the local midwife informed me to come to the vaccination post with my daughter wearing a face shield and me wearing a mask, I went to buy the protective items at the grocery shop and turned up here to our appointment at 9am. I washed my hands with soap and water at the basin before entering,” said Khine Hnin Wai holding her 10-month old baby Shin Thant May.

UNICEF
UNICEF Myanmar/ 2020
Khine Hnin Wai and her 10-month-old baby Shin Thant May at the vaccination post in Hpaan, Kayin State.

Khine Hnin Wai wants her child to be healthy and strong and get a good education. She believes that the immunization will prevent her baby from diseases and illness and is concerned about COVID-19.

Buying protective items was not easy for all.  “I didn’t know where to get the protective equipment that the midwife requested me to wear, so I didn’t do it,” said six-month-old Naw Thuzar Thin’s mother. At the vaccination post, a mask was given to the mother and a face shield for her baby and the midwife helped them put them on, so they were comfortable to wear, though it was a challenge to breastfeed the baby with the shield in place.

“We needed to put up vinyl posters around the community to let people know that immunizations were resuming and that some extra measures, such as physical distancing and mask wearing would be required, under the cEPI’s new Standard Operating Procedures, to protect people from COVID-19,” explained the Township Medical Officer.

In Kayin State and further, UNICEF Myanmar supports the national immunization programme with vaccines, syringes, cold chain equipment, refrigerators, temperature monitoring devices and information, education and communication materials.