Originally published on October 10, 2014.
To keep babies safe during their earliest months of life and to protect mothers against vaccine-preventable diseases, doctors recommend maternal immunization. In Pakistan’s Jacobabad district, vaccinations during pregnancy are taboo and women seek medical treatment only if health conditions become nearly life threatening. Women usually marry and give birth at relatively early ages. Additionally, women in this rural area must cope with some of the country’s worst health care conditions.
Nihalan, expecting her fifth child, is well aware of her and her baby’s health after vaccination.
Nihalan understands the risks associated with pregnancy. The 28-year-old mother of four, who is expecting a fifth, already lost one child during birth, and another was born physically impaired. For her, delivery is neither safe nor free from fear. She lives with 12 households in a single home. Her husband, Ramadan, works as a peasant, earning a daily wage of PKR 100-200 ($1-2). Poverty produces barriers to information about better health outcomes and exacerbates poor health and hygiene conditions. She had not previously sought maternal immunizations, because she believed doing so might further jeopardize her or her baby. Nihalan needed to know the vaccines brought help, not harm.
“No one told me it was good for me. I was always afraid of getting vaccinated,” said Nihalan. Fortunately, she came into contact with Arbeeli, the health worker at Jehanpur Basic Health Unit (BHU), within Jacobabad district. Arbeeli was working on a Land O’Lakes program for building awareness and improving health and hygiene conditions for pregnant and lactating women in the area.
Being a health worker, Arbeeli was well aware of the health conditions of women in the area. She went door-to-door, generating health awareness, and encouraging women that they and their children should get vaccinated. Land O’Lakes International Development’s 3-year Food for Education (FFE)
program funded by the U.S. Department of Agriculture (USDA) encouraged women to get vaccinated by giving them a four-liter bottle of cooking oil as an incentive. “Women used to work in the fields with their husbands for [their] livelihood; now Land O’Lakes’ oil has given the poor families strong financial support with health awareness, as oil is an expensive commodity,” said Arbeeli.
Before the oil distribution program, only 20-30 pregnant women were vaccinated in a month. Now it has increased to remarkably more than 300 in September 2013, keeping me occupied all the time.
Nihalan was initially approached by Arbeeli and encouraged by the other pregnant women from her community who had gotten vaccinated. She went to BHU when she was six months into her pregnancy. She did so because she now knew it was important to both her and her baby’s health. “I got the awareness late, but a little late is better than never,” she says. “I received the oil only once after my second vaccination, because the program started late in my village, but it provided help to me to run my kitchen.”
She was successfully vaccinated twice during her fifth pregnancy. She is happy to have access to better health information, which was only possible through the Land O’Lakes initiative. “I was not alone; there were other women like me who got vaccinated. Every one of them is aware of her health now. I will continue my vaccinations regardless of whether I receive the oil or not.”
It would not have been possible to build massive awareness without community mobilization, involving women from the region, women health workers and doctors from BHU. Dr. Mazhar from BHU Jahanpur says, “Before the oil distribution program, only 20-30 pregnant women were vaccinated in a month. Now, it has increased to remarkably more than 300 in September 2013, keeping me occupied all the time.”
In Pakistan alone, so far 20,000 pregnant and lactating women have been vaccinated and received the 4 liters of free oil as an incentive through the Pakistan FFE program. Nihalan is hopeful of delivering a healthy child this time. With the enhanced maternal care, she not only sees a healthier future for her and her family, but a better future for her community and the village.