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Reaching zero-dose children in PNG not a 'one-size-fits all' approach

  • 04 Dec 2023

Burnet staff working in PNG by gathering data.

PNG Burnet staff members, Sister-in-Charge, Samantha (left) from Molot Health Centre in Duke of York, East New Britain, and project coordinator Hannah Athaliah James (right).

Immunisation is a life-saving public health intervention, but routine immunisation coverage varies substantially across Papua New Guinea (PNG).

A project by Burnet Institute, together with East New Britain Provincial Health Authority and Papua New Guinea Institute of Medical Research, aims to better understand the challenges around children accessing routine immunisation, and to better plan and develop context-specific strategies to address these barriers.

In the first year of the project, researchers found most parents in East New Britain want to immunise their children, but find it difficult.

"Generally, communities understand the importance of being vaccinated against diseases [such as diphtheria, tetanus, pertussis, measles, and rubella], and they do want their children to be immunised," Dr Stefanie Vaccher, Burnet Senior Research Fellow – Immunisation and Health Systems Strengthening, told ABC’s Pacific Beat radio program.

She said some of the barriers are physical, like not having access to transportation, or expenses for fuel or bus fares.

But community aid posts are also increasingly shutting down, which means people now have to travel further to reach clinics. 

"Sometimes healthcare workers are unavailable at the facilities, and we're also seeing vaccine’s stock out,” Dr Vaccher said.

"So when parents or caregivers finally make it to the clinic, and then there's no vaccine there, it means they have to come back another time, or their child isn't vaccinated." 

This project works closely with communities in PNG’s East New Britain province to strengthen health delivery services and increase widespread vaccine coverage in under-immunised areas.

Data was collected through hundreds of interviews with residents, healthcare workers, and community and religious leaders, as well as analysing available resources at health facilities.

"It's not a one-size-fits-all approach. It’s about spending the time to work with communities to understand why they can’t specifically access vaccines," Dr Vaccher said.

"Often in communities, there's inadequate knowledge, understanding and awareness of immunisation. So, without that information, communities don't feel empowered to be able to make healthcare decisions." 

Dr Vaccher said outreach, the main means of reaching people, requires careful planning.

"Instead of expecting the communities to get to the clinic, the clinics, the healthcare workers can go to the communities," she said.

"But outreach is also expensive and needs to be well planned out.

"Sometimes it means if there's only one healthcare worker at a clinic, that clinic has to shut down for the day for the healthcare worker to go out to a community and vaccinate. But it is an important way of reaching communities and does tend to increase immunisation rates."

The team will return to the communities to communicate their findings, answer any additional questions, and ensure that planned strategies are sustainable.

The information they gather will also be used for advocacy, for instance, to highlight government barriers beyond community control — such as the availability of vaccines — and for sharing up-to-date health information.

"People were really hungry to have to have this information, to have their questions answered and I think it's up to us to provide that in an accessible manner," Dr Vaccher said.

"[We’re] making sure we're advocating to remove those other barriers, making sure there are adequate vaccine stocks, that aid posts are functioning, that healthcare workers are being compensated for their work."

Listen to Dr Stefanie’s Vaccher interview on the ABC’s Pacific Beat radio program here.

Read Year 1 Formative Data Collection Summary Results of the Reaching Zero-Dose and Under-Immunised Children in East New Britain, Papua New Guinea here.