Great practices: Five Highlights from Myanmar’s Measles Campaign
It wasn’t in the news much, but Myanmar ran a nationwide measles vaccination campaign during the last ten days of March. The objective? To reach 6.4 million kids aged 9 months to 5 years with measles vaccine.
I spent last week in Myanmar monitoring the campaign which was supported by the Measles Initiative. This was a strong campaign where health workers had clear plans everyday about how many children to reach, how to bring them to the post, and immunize them as safely and efficiently as possible. There were many highlights from this campaign, and here are just five that really stood out:
1. Inviting the people:
You may be formally invited to a party, to the theatre, to an event – but have you been invited to be immunized? In Myanmar health workers and village leaders went house-to-house and personally invited every family to the immunization post, marked with the date and time of the post along with information about measles. We talked to 100 households and found these invitations were the number one reason they knew about the campaign.
2. Smooth flow at the post
Health posts are meant to flow smoothly from screening and registration of names, to injection, to rest for thirty minutes. The posts I saw in Myanmar, even the smallest ones in rural areas, practiced this perfectly.
One of dozens of young children vaccinated at this post on this day. People in Myanmar mix shavings from the bark of the “tanaka” tree with water to form a paste – used on the skin to keep it cool.
Each vaccination takes seconds. The midwives safely put every used auto-disable syringe into a safety box like the one on the table.
After injection, children rest for thirty minutes so they can be observed for any reactions. It’s the recommended practice worldwide but it’s rare to see this implemented so well.
Children rest with their mothers for thirty minutes in the shade outside the health post.
3. Motivated health workers and volunteers
Midwives are responsible for immunization in Myanmar, and they’re backed by supervisors, cold chain managers, community leaders and volunteers. These women went to pick up vaccines at 6 a.m. at the cold store every morning so they could open their post by 7 a.m.
These young nursing students below spent a lot of time learning at the posts, and helped to keep the flow moving smoothly.
4. Meticulousness
In a vaccination campaign every child counts as does every dose of vaccine. Health workers here were meticulous about ensuring every vaccine dose was perfectly drawn and every child immunized was recorded. If kids missed the post, volunteers and community leaders would go to the parents’ house to remind them to bring in their children.
This midwife draws exactly 0.5 ml of vaccine to ensure that every one of the ten doses in the vial vaccinates a child.
These nursing students show how they record every child’s name associated with one vial of vaccine. If children didn’t come to the post on the assigned day, volunteers would go to their houses to remind the parents to bring them.
5. Results for Families and Communities
When we talked to households we found almost every single child had been immunized. Parents knew about the campaign from many sources including directly from health workers and village leaders who personally delivered the invitation cards, town announcements and television. This demonstrated the power of community mobilization.
We asked kids to show us where they had been vaccinated. Most remembered very well.
Here we talk to parents about whether their children are immunized and how they learned about the campaign.
This girl shows us where she was vaccinated.
This boy and millions more children under five in Myanmar may only remember the vaccination for a few days, but it will help to protect them against measles for a lifetime.
About the author:
Christine McNab is a consultant working with the Measles Initiative
