Education boosting vaccination drive across the country
KABUL (Pajhwok): Currently, only two in five Afghan children are vaccinated, but this rate would go up if women were more economically stable and educated, finds a survey.
The Afghanistan Demographic and Health Survey was conducted in 33 provinces of the country in 2015 by the Central Statistic Organisation (CSO) and the Ministry of Public Health (MoPH) with the financial support of USAID and technical help of World Health and Demographic Surveys.
Conducted from May 2015 to March 2016, the survey polled 29,461 married women, 15 to 49 years of age, and 10,760 men, 15 to 49 years of age. This information was gathered with the help of child birth certificates and comments from mothers.
According to information from MoPH, tuberculosis (TB), diphtheria, whooping cough, tetanus, polio, measles, hepatitis-B and Pneumonia vaccines are administered to children unevenly across the country.
Dr. Gula Khan Ayub, public relations officer at MoPH, said the viruses could create a dangerous situation for the country if these vaccines are not administered to all children. Currently pneumonia among children was a huge challenge, he added. He confirmed pneumonia-caused fatalities among children were higher in Afghanistan at the moment.
World Health Organization (WHO) statistics show that most of children lose their lives to acute respiratory infections and diarrhea. Ayub said diarrhea vaccines would be also added to the mass vaccination program.
According to MoPH says there are about 9 million children in Afghanistan under the age of five who should be vaccinated.
But the 2015 survey showed, on average, only 43 percent of children were administered vaccines as part of the campaign.
The percentage of children covered by the vaccination drive was high in some provinces and low in others.
The survey could not be conducted in districts of Zabul province due to security concerns and the data collected in Qalat, the provincial capital, could not be included in findings.
The survey outcomes showed that 7 out of 10 children are vaccinated in in Paktika, Badakhshan and Maidan Wardak provinces; fewer than 2 in 10 children are vaccinated in Uruzgan and Paktia provinces. In Nuristan, almost no children receive vaccines.
Dr. Gula Khan Ayub said public awareness about the benefits of vaccination was an important factor in the administration of vaccine.
About the high level of vaccination in Paktia, he said: “Most of the people in Paktia traveled abroad and maybe it is why they understand the importance of vaccination.”
Some countries check vaccines cards before they let Afghans cross the border
He said most of individual from Paktia traveled to the United Arab Emirates (UAE), Saudi Arabia and other Gulf countries for work.
Peroz Khan, a resident of Sharan, the capital of Paktika, is a civil society activist. He said people of the province were eager to get their children vaccinated and it was one reason behind the high level of vaccination.
He said awareness programmes regarding vaccination were implemented through encouragement of institutions like mosques, media and by scholars. The awareness campaign was recently stepped up.
Public relations officer of the health ministry’s vaccination department said with the expanding awareness programmes regarding vaccination from 2003 the expenditures of the department was also on the rise.
He said during financial year that ended on December 21, $5.2 million spent on vaccination out of which 10 percent was the cost of awareness programmes.
But the public health official said most of public awareness programmes regarding vaccination were conducted in Pashto and Dari languages countrywide, but people in Nuristan mostly speak the Nuristani language. It was one reason for the low level of vaccination in the remote, mountainous province.
He said the communication issue in awareness programmes was a reason behind the unsuccessful vaccination programme in Nuristan.
He said the ministry planned to publish posters in Nuristani language. However, MoPH does not have the resources to print the posters so far.
However, the official said the ministry was striving to arrange money for printing the posters in Nuristani language and convey the message through media in the local tongue.
About other reasons behind low level of vaccination in Nuristan, he said: “People in Nuristan afraid of injections. I saw mothers who did not bring back their children for vaccination for the second time after witnessing her child suffered fever in the first time of vaccination and said it was dangerous and could killed their children. These are some of the incidents that I witnessed during visit to provincial health programmes.”
The survey showed that educated, economically stable mothers are more likely to vaccinate their children.
The survey showed that 9 out of 20 illiterate mothers, 11 out of 20 mothers with a primary education, 12 out of 20 mothers with a secondary, and 13 out of 20 mothers with higher education vaccinated their children.
According to Dr. Ayub, educated mothers better understand the importance of vaccination, compared to illiterate ones. And that was why the percentage of vaccination was 23 percent higher among children whose mothers are highly educated.
Anisa, a schoolteacher in the Nadir Shahkot district of Khost province where the level of vaccination is 27 percent, holds a similar view. She said uneducated women in Khost believed the vaccines had no benefit.
She said some women, who once administered vaccines to their child, did not come back for a second round of vaccination and believed that vaccines left their children ill.
She explained children generally suffered from fever after vaccination, which was nothing dangerous. She regularly brings her children to the health centre for vaccination.
“Unfortunately, there is no vaccine or staff at the health centres at times. But despite the problem, I try to vaccinate my children,” she added.
However, Dr. Ayub says, there is no lack of budget for vaccination drives. But economic conditions of families play a role to some extent in whether they vaccinate their children.
According to the survey, the level is higher among children whose families have better economic conditions and lower among those with fewer financial resources.
The survey indicates nearly two of every five children from poor families and nearly 3 of every five children from a rich background were vaccinated.
Dr. Ayub said some areas of the country were deprived of health centres and, therefore, some families had to travel a long distance to reach clinics.
He added poor families could not pay transport fares to take children to health centres while rich households had the resources to do so.
Syed Habib, head of the vaccination department in Nuristan, agreed that economic conditions played a role in vaccine administration.
Most people in Nuristan did not have money to pay transport fares to take their children to the public health centre. Some residents of the province still cling to the barter system, he added.
Habib said every district had a health centre, but dwellers of some remote villages with inadequate transport facilities found it difficult reaching the clinic.
According to an investigative report by Pajhwok Afghan News, in 2014 some people have to travel tens kilometres to reach a health centre. During the winter, movement becomes even harder due to the blockade of routes by snow.
Mohammad Ismael Kawosi, MoPH official, acknowledged the lack of health centres. In 2013, he recalled, 2,050 health centres were functional across the country, compared to 2,300 today.
He said efforts were on for creating more health centres. In the next six month, another 300 health centres, including hospitals, would be added.
The statistics from WHO also show that there was a significant decrease in mortality of kids under five years compare to the records in 2000, but 185 of each 1,000 children under five years still lose their lives to preventable diseases each year in the country.
Based on the statistics, 1,154 cases of measles, 432 cases of coughing up black, 20 cases of polio, 74 cases of Tetanus and 59 cases of rubella have been registered in Afghanistan this year.
Public relations officer of the health ministry’s vaccination department said Rubella was virus like measles that infected fetus in the womb of mothers
He said the Rubella vaccine would be soon including in mothers vaccination programme.
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