Ms. Manju Joshi is an Auxiliary Nursing Midwife working at the Vaghrol Public Health Centre (PHC). The PHC is the cornerstone of the rural healthcare system in India and it relies on the dedication and expertise of trained paramedics like Manju.
By Sonia Sarkar
DABHIPUR, India, 1 November 2011- In November of 2010, the Government of India, supported by UNICEF and WHO, launched the measles ‘catch-up’ campaign with the aim of reaching 134 million children in 14 high risk Indian states, to prevent an estimated 60,000 to 100,000 child deaths annually.
Recently, the second dose of the measles vaccine was administered to children at outreach sites all across the country, and for those who missed out on their first scheduled dose at nine months, they were given a chance to ‘catch up’ with those children who have already received it.
Measles is a highly contagious respiratory illness and a leading cause of death among young children worldwide, despite the fact that a safe and effective vaccine has been available for 40 years. In the first few weeks after contracting measles, a child’s immune system weakens and this can lead to severe health complications, such as pneumonia, diarrhoea and encephalitis.
Mr. Kapurji Rupaji, principal at Dabhipur School in the western Indian state of Gujarat, is well aware of the severity of the disease. He has received special orders to ensure that each student is informed about the measles catch-up campaign.
“During such a school session, we make sure that all children under 10 receive the measles vaccine,” he said.
Challenges and setbacks
However, not all schools readily receive the campaign vaccinators and this can cause problems. When this happens, proactive direct engagement with the parents must take place.
“Some parents wrote back to us that they do not want their children to be vaccinated,” explained Dr. Tapasvini R. Acharya, Health Supervisor at the Primary Health Centre in Dabhipur. “We will tried to convince them so that they willingly brought their children for vaccination.”
Ms. Manju Joshi is an Auxiliary Nursing Midwife working at the Vaghrol Public Health Centre (PHC). The PHC is the cornerstone of the rural healthcare system in India and it relies on the dedication and expertise of trained paramedics like Manju to coordinate with other frontline health workers to mobilise women and children to the center for vaccination.
“We got the message from the PHC about the forthcoming measles campaign,” said Ms. Joshi. “We prepared a list of villages and schools and mapped the total number of children anticipated, syringes and needles needed and the number of booths.”
Ensuring vaccine safety
The measles campaign lasted three weeks. While school children between the ages of five and 10 years of age were targeted in the first week, non-school going children were reached in the second and third weeks at the outreach sessions.
Cold chain management is an integral part of the routine immunization program. During Village Health and Nutrition Days, the vaccine vials are transported from vaccine storage units in the state capital of Ahmedabad and carefully preserved in specially designed carriers that are kept at the optimum temperature.
“On the back of the tally sheet, we write the mixing time and the batch number of the vial, the name of the manufacturer, the expiry date, and the names of the children who have received the vaccine from that vial,” explained Dr. Acharya.
Severe reactions following measles immunisation are rare. Minor reactions such as fever and rashes follow within 6-12 days and usually subside naturally. However, most adverse events following immunisation that occur are the result of programme or human errors. This is why training of vaccinators for safe injection practices is an essential aspect of the second dose of measles campaign.