Breaking barriers
How local partnership is extending vaccination access for children and women in Kalay, northwest Myanmar
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In the face of escalating conflict and insecurity across Myanmar, access to critical health services - including vaccinations for vulnerable children and women - has become increasingly challenging. The growing number of children missing out consecutively on vaccination programmes continues to raise concerns around their future wellbeing and susceptibility to vaccine-preventable diseases. The situation is particularly dire for underserved communities where immunization services were discontinued, and where displaced families could not afford transportation fares to reach their nearest health facilities for basic vaccinations.
To prevent and mitigate potential impacts and consequences for children missing out on immunization in a challenging context, UNICEF consistently explores various options and initiatives. This includes forging partnerships with local organizations possessing community networks to incrementally extend the reach to vulnerable children, even in the most remote and hard-to-reach areas.
Kalay city, in Myanmar’s conflict-affected Northwest region, is one of the locations where UNICEF’s investment in localization and partnership with local/community-based organizations is making significant progress in navigating the challenging operating context to reach some of the most vulnerable and underserved communities. Kalay, like other major towns in the Northwest, is hosting thousands of internally displaced persons (IDPs) fleeing violence in their communities of origin.
In April 2023, UNICEF’s Expanded Programme on Immunization (EPI) partnered with Servants of Vulnerable People (SVP), a local NGO with large presence in Kalay, to negotiate with various actors and facilitate transportation for under-five displaced children and lactating women to be vaccinated at a local health facility, more than 15 kilometers away from the camps.
To further close the vaccination gaps, UNICEF partnered with SVP to launch a pilot routine vaccination programme targeting some of the most remote and hard-to-reach areas in Kalay, using community-based mechanisms and approaches. Between September and October, the pilot programme, with funding support from the Canadian Government’s CanVax programme, delivered lifesaving immunization to some 300 women and under-5 children, many for the first time since their birth.
“It is a critical lifeline for me, knowing that my children now have a better chance to grow healthy despite our displacement,” said Daw Ni Ni, whose two under-5 children were vaccinated, the younger one for the first time since birth. For Daw Kan Kaung, a pregnant woman due for delivery in three months, the shutdown of the rural health facility in her community had resulted in missing scheduled vaccinations. “With the rural health facility gone, I cannot afford the cost of vaccination at private clinics or transport cost to the urban health centers. This support has restored hopes for me and my unborn child, as I already missed some important vaccinations.”
For Nan Wai Tin, who usually had to trek 6 kilometers to reach the nearest urban health care facility to get vaccinations for her one-year-old daughter, the transportation support is making a significant difference. “It was usually very tough having to trek for hours in scorching sun and with my baby strapped to my back, sometimes developing fever. Having to go through several checkpoints along the route made it worse”. Nan Wai's husband, a casual laborer, struggles to make ends meet, leaving little room for additional expenses. The financial burden of transportation was simply beyond their means, as Nan Wai recollected, "we just couldn't afford the cost of transportation as we barely have enough to eat”. The support provided is not just about convenience; it's a lifeline for vulnerable families like Nan Wai's, ensuring essential immunization is accessible without undue hardships. “Now I look forward to my child’s next vaccination appointment with excitement as we no longer have to endure the agony of trekking hours in harsh weather,” Nan Wai added.
UNICEF, in conjunction with SVP, will roll out another phase of the pilot in November and December 2023 to incrementally extend vaccination programmes for the most vulnerable populations in underserved and conflict-affected communities, using the established local networks.
Routine vaccination coverage has dropped significantly across Myanmar since 2020 due to the combined impact of the COVID-19 pandemic and the ongoing conflict, leaving many, especially children, with their future wellbeing at risk. With unabating conflict and insecurity hindering access in many areas, local partnerships such as this will be critical to sustaining and incrementally expanding life-saving assistance such as vaccination programmes, ensuring that every child, no matter where they are, get a chance to reach their future potential.
Donor support, including flexible funding such as the multi-stream CanVax facility from the Canadian government, which is also providing solarization for rural health centers and cold chain storage facilities, will continue to strengthen localized and community-driven approaches that are becoming the last resort for delivery in some of the most-affected areas.
