Improving Childhood Immunization – Kiribati
The WHO CC UTS acknowledges use of key language from The WHO Global Strategic Directions for Nursing and Midwifery (2021–2025).
Communicable diseases continue to add to the burden of disease, disability and disadvantage in many countries and areas of the Pacific [1]. While major progress has been made in tackling the burden of some diseases, more is left to be done. Addressing the unfinished agenda of the Millennium Development Goals such as reducing the morbidity and mortality due to HIV/AIDS, TB and malaria as well as concerns regarding high infant and maternal mortalities remains a priority [2].
The Republic of Kiribati consists of 32 atolls and one raised coral island spread over vast areas of central-western Pacific Ocean [3]. Healthcare is provided free of cost, but access can be a challenge, especially on the sparsely populated islets that don’t have their own clinic. Immunization services along with other primary health care services are delivered by health centres and dispensaries.
Baaua Etei is based in South Tarawa where she works as a Deputy Director of Nursing. One of her key responsibilities has been the implementation, management and evaluation of the measles and rubella vaccination program across the country.
One of the main Public health programs carried out by nurses in the field is the routine immunization program. In July 2019, there was a one-week campaign on Integrated Measles and Rubella (MR) Supplementary Immunization Activity (SIA) that was carried out throughout the whole of Kiribati in which Baaua was joining the supervising team to the outer islands.
She adds, “the coordination of the vaccination campaign in the remote islands, isles and atolls was challenging. While there are delays in carrying out the campaign, due to flights and weather inconveniences on some of the outer islands, most managed to carry it out successfully.”
She underlines the pivotal role nurses and midwives played in implementing and carrying out the MR campaign.
Baaua highlights that getting the mayor and community members on each of the outer islands involved from the very beginning was important. She would have a briefing with each island mayor, sharing with them the purpose of the visit, the relevant age group and requesting their assistance in making the campaign run efficiently. “It’s a real collaborative effort between the health worker, local island councils, teachers, communities and most importantly the service recipients – juniors.”
As in many island countries, radio broadcasts in Kiribati provide vital source of information for public health issues, especially on the outer islands. The Ministry of Health used the radio programmes to communicate and inform the public about the importance of the vaccination programme. She adds, “VHF radios are the main communication devices. The internet’s good for some islands but not all. The maintenance of good network should be provided to islands with poor internet connections. With quality data better decisions are expected.”
1. World Health Organization, For the future – delivering better health in the Western Pacific Region. A White Paper on WHO work in the Western Pacific Region. Manila: WHO Regional Office for the Western Pacific. 2019.
2. United Nations, Sustainable development goals: knowledge platform. 2019(s).
3. Commonwealth of Australia, Australia's International Development Assistance Program 2012-13: Country and Regional Programs. 2012.
