Yes, Meghalaya has achieved many milestones in the health sector, but challenges remain, and vaccine hesitancy is one of those challenges that require aggressive interventions.
Though immunization coverage in Meghalaya has gone up from 58 percent in 2017 to 91 percent in 2021, the refusal of parents to get their child vaccinated continues to remain a challenge for state and national health officials, including the United Nations Children’s Fund (UNICEF).
Zero-Dose Children: Where does Meghalaya stand?
According to the State Surveillance Officer Dr Valarie Laloo, 6 percent of the child population in 7 districts of Meghalaya is unvaccinated or falls under the “zero-dose” children between the age group of 0-1 year.
Zero-dose children are defined as those who lack access to or are never reached by routine immunization services. They are operationally measured as those who did not receive their first dose of Penta-1 or pentavalent vaccine that protects children from five life-threatening diseases — diphtheria, pertussis, tetanus, hepatitis B, and Haemophilus influenzae type B (Hib).
Dr Laloo informed that in 2023-24, the number of zero-dose children in seven districts of Meghalaya covered under the Global Alliance for Vaccines and Immunization (GAVI) stands at 5007 against the child population of approximately 81,000.
While the state-wise rate is likely around 12,000 which includes both unvaccinated children and incomplete vaccination.
This was informed during a workshop organized by the Centre for Development and Peace Studies, Guwahati, in collaboration with UNICEF at the Shillong Club on January 20. The event was aimed at informing and empowering media professionals in Meghalaya on critical issues of child health and immunization in the state.
Reacting to the figures highlighted by the officials, Health Minister Dr. Mazel Ampareen Lyngdoh emphasized the need for a thorough study to be conducted on vaccine hesitancy and incomplete vaccination in urban centres.
She highlighted that there are many migrated families in urban centres and a few families who have lost track of the vaccination tracker due to their busy schedules.
Stating that officials often take it for granted, believing that most of the urban populace is educated and informed, the minister said, “We need aggressive interventions and campaigns even in the urban centres.”
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What is this 1000-day project for every child all about?
In her speech, the health minister observed that immunization and its complexities are rooted in birth spacing, a practice of waiting a certain amount of time between pregnancies.
She announced that the government of Meghalaya has come up with a 1000-day project for every child. This child-oriented project, which will be incentivized soon, aims to promote and inform parents that every child deserves 1000 days of attention.
“A mother should give a thousand days to every child and not be forced by circumstances to again attend to two more children before this 1000-day target is achieved; if this does not happen, then we are going to have a lot of these problems because there will be delayed action for every child that is born,” she said.
Mothers, irrespective of their strata in society or education, need to be held responsible for their child, she remarked adding, “Because there are no legally binding factors, there is a free for all interpretations of this responsibility.”
She informed that officials have been instructed to make parents aware of this 1000-day spacing, failing which birth certificates will not be given to the parents concerned. “We have received a lot of complaints. If the government has to be the bad guy, so be it because someone has to be ‘bell the cat’,” she added.
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Compliance with Interventions: Why religion is important?
Several interventions have been made in this regard to counter vaccine hesitancy, particularly in the rural areas.
Georgina Lamare from the Social Behaviour Communication, UNICEF informed that in the initial stage, UNICEF is focusing on two districts of Meghalaya – West Jaintia Hills and Ri Bhoi, districts with the lowest immunization rates in the state.
With 20 villages in Ri Bhoi and 10 villages in West Jaintia Hills under its radar, UNICEF has rolled out several interventions to bring down the high refusal rate of vaccination by countering problems as challenging as religious and social stigma.
Admitting that religion has a major role to play in increasing immunization coverage, Lamare said despite their efforts, they made little progress in convincing religious leaders to champion their cause.
“We are working with religious leaders to spread awareness; due to high hesitancy, we had to reach out to the Shillong All Faiths’ Forum to step in and advise their members accordingly,” she added.
UNICEF is also working closely with the village headmen and the Village Health Councils of the two districts to increase coverage. “We can say that compliance to these interventions in these two districts is around 50 percent,” she said.
It takes a village to raise a child. Similarly, Lamare said inter-personal intervention like the fathers’ intervention is the need of the hour, to make parents aware that raising a child requires the attention, love, and support of everyone concerned.
