One ‘zero-dose’ child is vaccinated—but there’s a million more to go

From village health workers going door-to-door, to investing in solar-powered fridges, and imams encouraging vaccination through their sermons, BARMM is reducing its number of ‘zero-dose’ children

UNICEF
13-month-old Jonaila
UNICEF and U.S. CDC/UN0723144/Martin San Diego/Highway Child
24 October 2022

The Philippines ranks fifth globally among countries with the highest number of unvaccinated children, with one million children across the country who have not received a single childhood vaccine. Within the country, 60% of ‘zero-dose’ children live in the Bangsamoro Autonomous Region in Muslim Mindanao (BARMM).

One of those ‘zero-dose’ babies is 13-month-old Jonaila who was born in August 2021. “When I gave birth during the pandemic, people here helped me during labor. As soon as I saw my baby, I felt happy, I immediately felt like I was a mother,” says Jamila.

 Jamila brings her 13-month old daughter Jonaila to the nearest health center to receive her first vaccine doses.
UNICEF and U.S. CDC/UN0723262/Martin San Diego/Highway Child Jamila (center) carrying Jonaila outside their home in Marantao, approximately 20km from Marawi City. “She’s a very friendly baby,” says Jamila, who earns some money selling noodle dishes. “I have handed her to people to hold since she was born, so that she gets used to different people.”

Jamila explains how: “Because my baby was born at home, she doesn’t have a birth certificate. I haven't taken her to the health center because I was worried that the nurses would scold me for not vaccinating her.”

“Also, because I am 7 months pregnant with my second child, I’m discouraged from going to the health center as I’ll have to walk in the heat, which is very tiring, or pay 50 PHP (approx $0.85 USD) for a tricycle each way, which I can’t afford.”

Jamila with her 13-month-old daughter Jonaila
UNICEF and U.S. CDC/UN0723249/Martin San Diego/Highway Child Jamila gave birth to Jonaila at home during the coronavirus pandemic in August 2021.
 Jamila looks after her 13-month old daughter Jonaila
UNICEF and U.S. CDC/UN0723266/Martin San Diego/Highway Child Jamila walks with 13-month-old Jonaila through town. “I’m happy to be pregnant with my second child. It’s hard to take care of two but it will be well worth it.”

Jamila also began to question the necessity of vaccines, because Jonaila has remained unvaccinated up until this point and, thankfully, has not experienced any health issues.

Evelyn Saro, midwife and manager of the Marantao Rural Health Center, says: “This is a challenge to us, when we encounter parents who think that vaccination is not necessary. We say, ‘yes, they’re healthy now, but that’s because the illness hasn’t arrived yet’.”

Thanks to village health workers taking the time share the information that Jamila needed to make an informed decision about vaccination, she has decided to take Jonaila to the health center to catch up on the immunizations she has missed.

13-month-old Jonaila at home
UNICEF and U.S. CDC/UN0723267/Martin San Diego/Highway Child Jonaila relaxing with her mother at home. “In my spare time, we mostly play. When I show her baby music videos on my phone, she lies there laughing,” says Jamila.

A well-connected response

Village health workers, who bring essential services to families like Jonaila’s, are part of a truly multisectoral team responding to the need. This involves the central coordination and strategy role of the provincial health team; religious leaders; police trucks for transporting vaccines over rocky and other challenging terrain; and non-governmental organizations, including UNICEF.

It’s a Wednesday, which means rural health centers across the region are providing routine childhood vaccinations and check-ups. It’s busy, with around seven caregivers and babies waiting for services at any one time.

Jamila brings her 13-month old daughter Jonaila to the nearest health center to receive her first vaccine doses.
UNICEF and U.S. CDC/UN0723252/Martin San Diego/Highway Child Wednesday is vaccination day at rural health centers across the region.
Jonaila, 13 months old
UNICEF and U.S. CDC/UN0723151/Martin San Diego/Highway Child Jamila and Jonaila on their way to their appointment.

Jamila is among the parents waiting. Until today, Jonaila had missed out on five recommended childhood vaccinations, which in total are designed to protect her against 12 diseases.

 Jamila brings her 13-month old daughter Jonaila to the nearest health center to receive her first vaccine doses, where she is measured during a check-up.
UNICEF and U.S. CDC/UN0723150/Martin San Diego/Highway Child Jonaila, looks a bit worried while she is measured during her check-up. She is being reassured by her mom and the nurse.

Jonaila is registered, receives a full check-up and catches up on all of her immunizations.

A health worker assesses 13-month old Jonaila, who is carried by her mother, Jamila.
UNICEF and U.S. CDC/UN0723257/Martin San Diego/Highway Child 13-month-old Jonaila receives a number of vaccinations so that she is caught up and protected against 12 diseases. She receives: The BCG vaccine to protect against TB; Pentavalent to protect against Diptheria, Pertussis (Whooping Cough), Tetanus, Hepatitis B, Haemophilus Influenza Type B, Pneumonia, and Meningitis; the Oral Polio Vaccine; PCV to protect against Pneumococcal Diseases and Meningitis; and the MMR to protect against Measles, Mumps and Rubella.

Back home, Jonaila is quickly back to her usual self, laughing and playing with other children. Jamila can now relax, knowing that her child is protected against preventable, potentially life-threatening illnesses. Jonaila is one in a million—both to her proud mother, and to the health workers striving to reach every unvaccinated child.

Jonaila (right) playing at home with her aunt, Nihaya (center), and neighbour, Sittie, (left).
UNICEF and U.S. CDC/UN0723152/Martin San Diego/Highway Child Jonaila (right) playing back at home with her aunt, Nihaya (center) and neighbour, Sittie, (left).
UNICEF staff member Resa Salvador plays with 13-month-old Jonaila.
UNICEF and U.S. CDC/UN0723159/Martin San Diego/Highway Child Behind-the-scenes: Jonaila looks at the pictures that have been taken of her, with UNICEF volunteer, Resa Salvador.