A recent international publication of a comprehensive review of frontline immunisation services in Papua New Guinea (PNG) has identified a range of opportunities to improve the country’s rates of vaccination that currently fall well short of national global targets.
Conducted in East New Britain (ENB) Province, the assessment focused on ways to improve the existing system using available resources, as well as helping to inform a longer-term national strategy.
The review was performed under the Healthy Mothers Healthy Babies Program as a partnership including Burnet Institute, PNG Institute for Medical Research, ENB Provincial Government, World Health Organization PNG, and University of Melbourne.
The study formulated 10 recommendations to improve the coverage and quality of immunisation in rural PNG, including:
- Quarterly outreach that is properly resourced and implemented
- Counseling and education for families
- A system for tracking unvaccinated children
- Training for lay health workers to provide support and promote uptake
“We found many areas where, even with the resources they’ve got right now, you could tweak the way service delivery and outreach was planned to reach many more children,” lead author, Burnet Head of International Development, Dr Chris Morgan, said.
“This is critically important because when you only vaccinate half to two-thirds of the childhood population, the community becomes vulnerable to outbreaks of diseases like the mutated form of polio that broke out in 2018, the first polio that PNG had seen for 20 years.
“And it also risks serious outbreaks of measles which caused many infections and deaths in 2014, and is just starting to come back again in 2020, which is concerning.”
The latest World Health Organization (WHO) Global Vaccine Action Plan set a worldwide target of 95 percent coverage to protect against outbreaks of vaccine preventable diseases such as measles, diphtheria and tetanus.
Dr Morgan said PNG’s capacity to respond at national level was severely tested during the 2018 polio emergency, but its conclusion means the focus can now return to the longer-term rebuilding of routine immunisation, with one eye on new and emerging threats, including measles.
“Control of measles requires a high baseline routine immunisation coverage, and the fact that PNG has had several years of low routine coverage certainly makes it vulnerable,” Dr Morgan said.
“However, the measles and other vaccines were included in last year’s polio emergency response, so while you can’t rely on emergency campaigns in the long-term, in this instance that’s probably helped PNG to reduce its vulnerability right now.”
Dr Morgan said the Healthy Mothers Healthy Babies study, which was conducted in 2017, has been discussed from that time with provincial health managers in ENB who are committed to improving immunization coverage, as well as national immunization partners, and was presented to PNG’s 2017 national medical symposium.
The recent international publication, which appeared in the open access journal BMC Public Health in January 2020, reviews the evidence again, with discussion of how current investments in immunisation programs and emergency campaigns could strengthen PNG’s services in the future.
Professor James Beeson, Deputy Director at Burnet Institute said: “This important partnership project provides crucial new knowledge and practical steps to strengthen immunisation and prevent serious infectious diseases in PNG’s children.”