|Immunization in Practice: Learning (3 modules) Activities Manual, Trainer's - Guide, Modules 1-11 (WHO - OMS, 1998, 34 p.)|
What are the five essential messages about immunization?
The new outreach site
Maria, the energetic new director of the Modu Health Centre, has agreed with the district supervisor to raise immunization coverage by 20 % in her first six months in the job. One of the things she plans to do is to increase the number of outreach sites. She makes a big calendar to put on the wall of the health centre, showing the days and locations of the outreach sessions.
One week before the first outreach session in Tuding, Maria visits the place for the first time. She sees the community leaders and tells them about the immunization programme. She says that a team will come the following Tuesday at 8.00 to give immunizations and she asks the community leaders to notify people and arrange a site.
When the team arrives the next Tuesday there are no tables, chairs or water, and no clients.
The team members are disappointed and the community leaders wonder what has gone wrong.
1. What do you think has happened and how could Maria have prevented it?
2. What can the team do while in Tuding?
Crossing the road
Abu-Bakar holds immunization sessions once a week in his health centre. His supervisor, Nash, visits him on an immunization day and observes that there are no clients.
The people here dont like to have their children immunized, says Abu-Bakar. They come only when someone is sick.
I wonder why, says Nash. Lets try to find out by asking the woman who is standing across the road.
Mrs Banda is surprised when the health workers cross over to see her. She tells them that her older children have had whooping cough and measles but have survived. None of her children have been immunized.
Abu-Bakar and Nash sit down with Mrs Banda on the front porch and start talking about immunizations.
1. Why do you think no one comes to be immunized?
Kassim has recently been appointed district supervisor. During his first few months in the job he visits every health centre. One, located in a remote area, has a large population but few clients. Kassim wants to know why.
First, he talks with community leaders. They tell him that the health centre is too far away for most people to walk to and that there is no transport.
Then he goes to the health centre and talks with Claudia, the community nurse. He asks her about her work and her family and how she is getting along. She is glad to have the opportunity to sit down and talk to someone about her problems.
While Kassim is at the health centre he also sits with clients and asks them about their work, families and health, and whether they have difficulty in getting to the health centre.
Claudia is amazed at how relaxed and friendly the clients are with Kassim/and she thinks about how she treats them. She usually feels too tired to bother with the niceties and just rushes the clients through and sends them away.
She decides to try working in Kassims way. She offers clients a chair, asks them how they and their children are, and enquires whether the health centre is meeting their needs.
The next time Kassim visits he finds many clients at the health centre. The atmosphere is warm and friendly, and Claudia spends at least a few minutes talking with every client. No one has any complaints about the centre being too far away.
Discussion point: is the health centre really too far away or is there another problem?