Madang’s innovative approach to immunizations

In Papua New Guinea, immunizing children represents a complex challenge.

A country with communities spread across vast areas of diverse terrain, its provincial health authorities (PHAs) struggle to reach families in remote locations to deliver essential services.

Health workers are forced to travel for days at a time across areas with fraying infrastructure and internal conflict, risking their safety to protect children from debilitating and vaccine preventable diseases.

Sitting on the northern coastline of PNG, the province of Madang has the highest immunisation dropout rate of 40% in the country, which means children are getting the first dose - but not the second or third doses - required to give them full protection.

Recognizing the critical importance of ensuring children receive their second and third doses of essential vaccines, health workers are using innovative techniques to deliver vaccines to urban and rural communities alike.

This program is supported through the Accelerated Immunization and Health System Strengthening Phase 2 [AIHSS 2] Program funded by the governments of Australia and New Zealand and Gavi, The Vaccine Alliance.

Community outreach and volunteer-led awareness programs are impacting urban and rural areas, while mobile clinics have been set up to bring services directly into neighbourhoods, markets, and other public places.

Although health facilities in Madang still rely on manual records and paper-based registers to track individual children and families, health workers are making dedicated efforts to reduce missed appointments and close the immunisation gap in urban and rural areas ensuring that no child is left behind.

The Officer in Charge of Madang town Urban Clinic, Sister Janet Sully, continues to see a high number of patients each month, half of whom are children.

“We see over one thousand patients each month, but for immunization, we conduct mobile and static clinics every Tuesday. We also see children every day on what we call an ‘opportunity basis’. These are babies from outside the Madang district. When their parents are in town for shopping, selling food items, banking and other services, they bring their kids to get immunized. So, in a month we immunize around 500 children,” she says.

''When we started mobile and static clinics, we saw an increase in mothers bringing their babies - as a result, pneumonia cases among children dropped.”

Accessibility continues to be an issue for those in rural areas; however, when given the chance, parents make sure their kids are vaccinated.

Georgina George and Georgina Pukini are both mothers who live on Krangket Island, a few minutes off Madang town, and access the services at Madang Urban Clinic, just like other mothers who gather at the Urban Clinic every now and then.

''I am a working mum from Bogia but live on Krangket Island and work here in Madang town. Today was my 9-month baby's measles and rubella shot. It's important to get our babies immunised and protect them from sickness. I feel that if we don't do our part, we will face health issues later on in life with our children,” says Georgina Pukini.

''I'm a mother of three and I believe by getting our children immunised, we are not only protecting our kids but also contributing to the health and well-being of our entire community especially here in Krangket,'' Georgina George.

For the two mothers of Krangket Island, it's a small step with a huge impact, ensuring that their children can grow up to be healthy, happy, and ready to embrace the future.

Jomba Clinic is also in Madang town and continues to see an increase in patients and the number of parents bringing their children to get immunized.

Nursing officer Denise Amol says they have been working with volunteers to carry out awareness programs within the surrounding areas and have found this approach effective.

“Word goes around quickly, and I believe information is key. Our volunteers have been actively working with us carrying out awareness campaigns, and community visits talking to parents about the importance of vaccination," says Denise Amol. "Now, with regular updates and community meetings, we're seeing more families show up on time."

Silas was one of the 9-month-old baby boys his grandmother brought in to get immunised because of the continued awareness by the volunteers.

''Raising a child is a shared responsibility,” says Grandmother Lino, a second-generation East Sepik woman and long-time resident of Jomba, a suburb of Madang town.

Grandmother Lino says it's supposed to be a family affair, and everyone should take responsibility in some way.

Meantime, Sister Janet Sully, OIC of Madang Urban Clinic, says “collaboration is a way forward to progress, and I'm thankful that partners like Australia, New Zealand, GAVI, WHO, and UNICEF are working with the PNG government and the health department to help us improve our health and well-being.”