Sanyogita Dhamdhere
The health department of Malegaon had begun intensive preparations for the polio vaccination campaign scheduled for March 3rd. Medical officers and nurses were in discussion regarding the arrangements. In 2010, four cases of polio were reported in Malegaon. As far as routine immunization is concerned, a number of wards here consist of pockets of highly vulnerable populations. Therefore, special efforts are made for the successful execution of every vaccination campaign. Dr. Alka Bhavsar, the Reproductive and Child Health Officer of the Malegaon Municipal Corporation, spearheads this planning. Her effective implementation and the participation of Health Center staff, Anganwadi workers, and local social organisations have been steadily improving vaccination coverage.
Dr. Alka Bhavsar took charge of the Reproductive and Child Health Department in 2021. She focused primarily on marking coordinates of the Health Department. The Municipal Corporation here consists of 5 wards, with 14 Urban Health Centres. These centres conduct 54 regular vaccination sessions per month and 630 routine immunisation drives annually. Additionally, the Municipal Corporation, in collaboration with the Central Government, runs a special vaccination campaign called ‘Mission Mehfuz’, alongside the ‘Indradhanush’ initiative. The campaign targets children right from neonates to those upto seven years of age, vaccinating them against nine life-threatening diseases. These diseases include BCG, Polio, Hepatitis B, Pentavalent, FIPV, RVV, PCV, and MR vaccines. For every 10,000 to 12,000 people in the ward, one nurse was appointed. Regular vaccination sessions were planned in advance, with each session and the geographical area that it catered to was meticulously organised. Vaccinations are recorded in three separate registers, where data for both children and pregnant women in the area is religiously maintained. The entries in the registers make it evident who needs to be administered the vaccine, who has received it, and reasons for those who haven’t, enabling follow-up actions. One register contains entries of married and fertile couples in the area, another register maintains records of children up to the age of 10 years. Between April 2022 to March 2023, Malegaon Municipal Corporation’s Health Department aimed to vaccinate about 14,000 children between 0 to 7 years, in which it was successful in reaching up to 60% of its targeted goal. While this achievement is commendable, there is still an important milestone of reaching up to 95 percent completion that needs to be achieved.
Due to ignorance, misconceptions, and vaccine hesitancy, there is a significant lack of acceptance towards vaccines like DPT and Pentavalent, hindering the achievement of complete vaccination coverage. Therefore, training sessions are conducted for healthcare workers on how to communicate with individuals who show rejection or denial. Women’s meetings are organized monthly to address these issues.
“As a former Medical Officer, I have an understanding of the problems that health centres face. Keeping that in mind, I made some changes. A separate fund has been allocated to publicize vaccination sessions. Information about vaccination sessions is disseminated through loudspeakers across the entire area,” stated Dr. Bhavasar.
“When the target for complete vaccination coverage is achieved, some incentive is provided to the Auxiliary Nurse and Midwife (ANM) workers for motivation. It is crucial to monitor children for any reactions post-vaccination and provide follow-up care if needed. Even after administering the vaccine, continued vigilance over the children’s health builds trust amongst parents, ensuring an improvement in delivery of quality care. Information, Education, and Communication (IEC) vehicles equipped with audio-visual aids such as street plays, posters, etc., are used to spread awareness. Additionally, some incentives are provided to those involved in vaccination improvement efforts,” she added.
“A vaccination drive is organized after providing information to schools, mosques, and engaging with doctors, social workers, and local leaders. In areas where we earlier saw 20-30% vaccination coverage, we now observe 55% vaccination coverage. Maintaining data collected over the past few years has helped us track improvements. It is also crucial to recognize the importance of timing, location, proper documentation, and follow-up after vaccination,” stated Dr. Bhavasar.
“However, there are still some challenges to overcome,” Dr. Bhavasar expressed. “In many families, decisions are predominantly made by men, who may not always be available or cooperative. Having male speakers for nighttime meetings could facilitate dialogue and emphasize the importance of vaccination, thus addressing this issue effectively.”
Gulam Bhai, the Chairman of the Muslim Unnati Seva Foundation, stated, “If someone doesn’t listen, we make efforts to educate them. We accompany poor people to the Urban Health Centres. There is a lack of literacy here, individuals often do not visit healthcare centers. Due to hearing certain rumors, they sometimes mistrust healthcare workers, and we work to dispel such misconceptions.”
Members of the Muslim Unnati Seva Foundation
“Various reasons contribute to people’s refusal of vaccination for their children – the slums are not clean, there is an absence of nearby Anganwadis, there are no sanitation sprays to get rid of mosquitoes here often leading to resentment among affected individuals, resulting in opposition to vaccination,” added Ajeesh bhai.
“When administering vaccines to children, we ensure their well-being. Just as we provide assistance, we also need to conduct meetings in schools, wards, and neighborhoods. It’s essential for all treatments to be available at government hospitals. Gutters need to be cleaned,” demanded Mohammad Ismail bhai on behalf of the community.
“Many people feel weakened after vaccination. We invite ASHA workers to our homes to vaccinate our own children. Seeing our children receive vaccinations, encourages others to vaccinate their children too.” Workers from the Muslim Unnati Seva Foundation also engages in activities like accident prevention, suicide prevention, and cleanliness efforts.
“In areas where there are Anganwadis, Anganwadi workers actively participate in vaccination efforts as well. “The people in our area are displaced and extremely impoverished. Vaccination is a conspiracy, they believe. Who needs immunity before an illness, they ask,” expressed Salma Bano Abdul Wadud from Azim Nagar.
Salma Bano
Mehrunnisa Mohammed Mustafa has been serving as an anganwadi worker in Rajanagar for the past 35 years. Being located in the vicinity where the anganwadi is situated, every household and the children therein are familiar to her. As they listen to her, no child in her area remains deprived of vaccination. “Whenever a new family arrives, I provide them with information and explain about vaccinations. So far, I have received primary and advanced training three times,” she said.
Mehrunissa Mohammed Mustafa
Salma Aziz Ur Rahman, came to Islampur through marriage, and since the Anganwadi is located in her own house, she has been working as an anganwadi worker for the past 15 years. “In our locality, there are around 4-5 households with reluctance towards vaccinations. Just today, there was a delivery in my neighbourhood. I immediately provided the mother with the initial dose. Similarly, if these vaccines are administered in private health clinics, it will greatly contribute to the full coverage of the vaccination drives,” she stated, reflecting the sentiments of others as well.
Salma Aziz
Surekha Jagtap works as an Anganwadi helper in Ayeshanagar. On vaccination days, she goes door-to-door providing information. “To ensure that no child is left without vaccination, I call both the child’s mother and grandmother for a meeting. I keep records of new couples. In the Anganwadi, I provide a box of essential items for the newborn, including diapers, mosquito nets, blankets, caps, nail clippers, toys, thermometer, and a cotton cloth for the mothers to cover her ears. We also provide nutrition to lactating mothers and children, including folic acid and deworming tablets,” she explained. Such initiatives build trust among the people, and they appreciate the vaccination services with enthusiasm.
Surekha Jagtap