5 innovations helping children in South Asia stay healthy
Countries are bouncing back from the pandemic to get every child vaccines
The last few years in South Asia have brought countless challenges for children. But they’ve also given us opportunities to do things differently to improve the health of children and their families.
One area where innovation has flourished is childhood vaccinations.
During the COVID-19 pandemic, disruptions to healthcare services for children meant over 5 million children in South Asia missed the lifesaving childhood vaccines they needed to keep them healthy and alive.
But since then, thanks to valiant efforts of health worker heroes, commitment by governments, science, innovation and engagement of communities, childhood immunization rates have bounced back to pre-COVID-19 levels in Bangladesh, Bhutan, India, Pakistan, and the Maldives.
Nearly 2 million more children got the vaccines they needed in 2022, compared to 2021.
The job is far from finished. We’re especially concerned about the 1.9 million children in the region, who haven’t had a single dose of life-saving vaccines since being born.
But we’re also hopeful about what is possible.
Innovations across South Asia are helping more children stay healthier and happier right now — and can be harnessed whatever the future may bring.
Here’s a selection of some of the ones we’re most excited about.
- Solar power helps safely deliver vaccines to children in the most remote areas of Nepal
- New mobile applications help health workers in Bangladesh protect over 36 million children against Measles and Rubella
- Health workers bring healthcare to families struggling in Sri Lanka
- Creating places for all vulnerable children’s health needs in Pakistan
- Building trust to reach zero-dose children across India
Solar power helps safely deliver vaccines to children in the most remote areas of Nepal
Life-saving vaccines need to be kept cold at all times, or risk being spoiled.
Sounds simple? Unfortunately, it’s not.
Vaccines need to be stored at between –90°C to 8°C, depending on the vaccine. And they need to be kept at this temperature for their entire journey, as they’re transported by road, air, boat and on foot to the most remote, hard to reach places — in often sweltering outdoor temperatures, across treacherous terrain.
To do this, vaccines travel along a ‘cold chain’ - a series of precisely coordinated steps that keep vaccines cold in temperature-controlled environments as they’re stored and transported.
But in remote areas that struggle with reliable electricity, power outages can mean the difference between vaccines being kept cold and potent, or spoiled and unusable.
This is where solar power comes in!
38 specialised vaccine refrigerators are now harnessing solar energy to store vaccines in remote areas across Nepal — keeping them cold during power outages.
The solar-powered refrigerators were provided by the Government of Japan through UNICEF, along with 9 walk-in-coolers, 1,109 long-range vaccine carriers and 53 cold boxes to accelerate the COVID-19 vaccination rollout in Nepal.
And what’s really exciting is that these innovations are now benefiting children.
Reliable electricity makes it easier to store childhood vaccines in remote areas, as they journey to communities unreachable by cars — meaning more of the hardest-to-reach children are now getting life-saving vaccines.
Around-the-clock electricity also means health facilities are better able to perform medical procedures, like emergency care during pregnancy and childbirth. And it makes it easier to stockpile essential medication for newborns, children and mothers.
This has all made health systems better prepared in case of future crises.
Health worker hero Basanta Malla who has been working to get vaccines to children in remote far-western Nepal for 27 years admits that the process can seem long and arduous:
“But I think we should count ourselves lucky that thanks to the technology, we have the ability to do all this and to serve families,” she says.
New mobile applications help health workers in Bangladesh protect over 36 million children against Measles and Rubella
Measles and Rubella are highly contagious diseases that can devastate the lives of children and their families. Both diseases can be prevented, if children are vaccinated against them early on.
However, in a country as dense and diverse as Bangladesh, vaccinating every child against Measles and Rubella has historically been a huge challenge.
Back in 2019, thousands of children living in the hardest to reach areas — like hill districts, tea gardens, urban slums and settlements next to or on rivers — were missing out on lifesaving protection against Measles and Rubella.
To tackle this, the government planned an intense campaign to vaccinate every child in the country from 9 months up to 10 years old — and help stop the spread of the diseases in the country.
But then, in 2020, the COVID-19 pandemic hit, and the campaign was cancelled.
Undeterred, the government used the extra time to adapt and improve the campaign strategy. With the support of UNICEF, they set about creating two mobile applications to support the campaign, with a special emphasis on the hardest to reach children.
Later that year, for the first time ever, the campaign went digital!
An e-Tracker app tracked individual children's vaccination progress while a GIS-based microplan app provided real-time data and reporting on vaccination campaigns.
Health workers first had to make door to door visits across the country to let families know about the upcoming campaign and collect information about eligible children. This information was then entered into an online registration system that monitored unvaccinated, partially vaccinated and fully vaccinated children, and identified low coverage areas, in real-time.
This was a gamechanger.
Not only did it make life easier for families living through the unprecedented COVID-19 pandemic, it also transformed the way vaccination data was managed to make decisions and take action.
Previously all checklists and forms were paper based, making it near impossible for health workers and managers to analyse campaigns and adapt them.
But now, health workers across the country and at all different levels could work together to swiftly track how vaccination campaigns were going, identify children who missed their vaccines and make plans to reach them in future.
Critically the apps work both online and offline, meaning they could be used in no network areas where most hard-to-reach children could be found.
One of these children was Samirul Islam, who lives in Char Tilli, an area surrounded by the Kaliganga River, a tributary of the mighty Ganges. During the dry season, the locals use the land for farming, but during the monsoon the entire area is flooded with water, so some raise their houses on bamboo platforms and others move to higher grounds — making keeping track of children for vaccination very difficult!
Samirul’s mother, Sultana, delightedly tells us that her son has now been vaccinated along with all the other children in the area.
“All the kids of our neighbourhood went to the centre to get the vaccines.”
Through the campaign, over 36 million children were vaccinated against Measles and Rubella — the highest number ever, despite the challenges of the pandemic.
With the measles campaign completed there are now plans to adapt the apps and use them to help children and mothers get all the routine vaccines that they need, saving immeasurable lives!
Health workers bring healthcare to families struggling in Sri Lanka
Children and their families in Sri Lanka are facing crises not of their making.
The COVID-19 pandemic was followed by a devastating economic hardship and fuel shortages leaving many families feeling strained, hopeless and unable to get the health care they needed.
With many families unable to travel, the Sri Lankan Ministry of Health acted swiftly to bring healthcare to their homes.
With UNICEF’s support, over 6,000 health worker heroes went mobile, travelling to homes and communities to provide lifesaving health services to mothers and children who needed it the most.
During these home visits, health workers gave health checkups, provided nutrition support and made sure children were caught up on their missed childhood vaccines.
Health workers also seized the opportunity to check if parents and family members were up to date on COVID-19 vaccines and give them any that they had missed — helping keep the whole family safe and protected.
Outreach clinics were also set up in rural areas, making it easier for families to visit and get help when they needed. And when children were brought for their childhood vaccines, their parents were offered missed COVID-19 vaccines here too, reducing the number of times families needed to visit!
The initiative was so successful that nearly a quarter of a million COVID-19 vaccines were delivered to parents and caregivers seeking other health services like childhood vaccination and treatment for malnutrition.
The approach not only made sure that children got the healthcare that they needed, but also made life easier for families struggling with multiple pressures and helped significantly increase COVID-19 vaccination in Sri Lanka, helping keep us all safe.
Creating places for all vulnerable children’s health needs in Pakistan
Take a peek inside this hospital in Gujro, Pakistan.
Just 4 years ago, this health facility was an abandoned building. Now, it’s somewhere families can go for antenatal services, newborn delivery, child nutrition support, water, sanitation and hygiene services, life-saving vaccines and to register births — all in one place!
It’s an approach known as ‘Integrated Service Delivery’ — and it's become a game-changer for children’s health and well-being.
Before the hospital opened, basic health facilities in Gujro were sparce. So was accurate information and trust. Many families were hesitant to vaccinate their children.
But families had been asking for basic health services, water and sanitation services — and the facility was launched in response to these requests.
When the facility launched, community leaders and mobilizers went door to door to encourage families to visit the hospital for care.
Once parents set foot in the hospital and saw the life-changing health services for themselves, they often came back with their entire family. Seeing is truly believing.
“When we started, we had 25 patients a day...It has gone up to 500 or 600 a day now.” - Dr. Quratulain Janjua, paediatrician at Jannat Gul hospital in Gujro
The efforts not only helped parents seek healthcare for themselves and their families, but also built trust to encourage them to vaccinate their children against devastating diseases.
So much so that the initiative led to a huge drop in the number of parents in Gujro who refused to have their children vaccinated.
The number of people who refused to have their children vaccinated against polio dropped by 72% between 2019 and 2022.
Building trust to reach zero-dose children across India
Making sure every child gets life-saving vaccines, especially in the most deprived communities, is a big feat — especially for a country as large as India.
But over the past few years, India has made huge strides in reducing the number of children who have not received a single dose of childhood vaccines — also known as ‘zero-dose children’.
And one way they’ve done this is by building vaccine confidence.
For instance, in the slums of Mumbai, rumours and vaccine distrust are common — and so are zero-dose children.
A team of UNICEF supported vaccine champions, including doctors, social health activists, midwives and health volunteers have been going door to door to talk to families about vaccination and directly address their questions and concerns.
19-month-old Zikra from Kabir Nagar, Osmanpura was one of these children. Zikra had pneumonia and been generally in ill health, so her mother Shirin had been unsure about vaccinating her.
However, after speaking to the vaccine champions, her mother took her for her first vaccination at the Kabir Nagar health post in Aurangabad.
And there are stories like Zikra’s from across the country.
In Jharkhand, in the east, local influencers and religious and tribal community leaders joined the Measles-Rubella vaccine campaign.
As trusted and influential leaders, they helped to address misconceptions around vaccines and change opinions.
Thanks to their relentless efforts, more than 74,500 initial vaccine refusals were turned into successful vaccinations!
Vaccine champions in communities are also fuelling change.
In a remote village in Odisha, Bhanupriya Nayak, a member of her community’s Self-Help Group heard that a new mother was reluctant to vaccinate her son, Krishna.
Bhanupriya was determined to change her mind — and more importantly, that of her mother-in-law, Asamati.
She rallied the support of neighbours and health activists to share their own experiences of vaccinating their children. This helped address Asamati's concerns — and she agreed to vaccinate little Krishna.
“I was opposed to vaccines first. I am not anymore. I am happy my Krishna is healthy and safe. I am also thankful to Bhanupriya who, despite my strongest opposition, did not give up on me, on us.” - Asamati
These tenacious efforts, across the country and at all levels, are paying off. In 2022, India successfully reduced the number of zero-dose children by an outstanding 1.6 million!
Every one of these vaccinations is a child’s life protected.
It’s also testament to the power of never giving up and trying new approaches to tackle modern challenges.
And we’re excited about the potential of this progress for every child in South Asia today and in the face of whatever the future brings.