According to the latest statistics of National Health Survey, IMR has significantly dropped in Nepal’s context.[break] “While the country’s IMR was 64 per 1,000 live births in 2001, it had decreased to 48 per 1,000 children in 2006,” Dr Aryal said. The health survey is conducted every five years.
“Among all the health sectors of government, child sector is the most effective one,” says Dr Aryal adding, “Our target is to achieve Millennium Development Goal 4 by 2015, which is to reduce child mortality rate and immunization is one of the important factors to accomplish this goal.”
Under the country’s National Program, Bacillus Calmette-Guérin (BCG), Polio, Pentavalent vaccinations are provided free of cost throughout the country through different hospitals (with delivery system) and health and sub-health posts.
Immediately after the birth, the baby should be immunized with BCG. The vaccination provides protection against tuberculosis. “Usually the shot should be given after the first or second day of delivery but if the hospital cannot do so, the baby needs to be vaccinated within a year’s time frame,” informs Dr Aryal.
Dr Kiran Bajracharya of Nursing Campus at Maharajgunj advises mothers not to massage children’s body part where they are injected.
After 45 days of birth, the baby should be immunized with Polio vaccine and Pentavalent, also known as combined vaccination. Dr Bajracharya suggests not breastfeeding the children for half an hour after polio drops are given.
“Pentavalent is used to immunize children below one year of age against Tetanus, Diphtheria, Pertussis, Hepatitis B and Haemophilus Influenza. Three doses of Polio and Pentavalent should be provided at the interval of one month each,” says Dr Aryal.
A child might get feverish for a couple of days after the Pentavalent shot. “But there is no need to worry as it is common, says gynecologist Bajracharya. After the completion of nine months, measles vaccination is administered to children.
Apart from these routine childhood vaccinations, the trend of providing other optional vaccines like MMR (Measles, Mums and Rubella), chicken pox, Japanese Encephalitis, typhoid is also found. Pneumococcal and Hepatitis A are the new optional vaccines that have hit the market. Among these various optional immunizations, Dr Aryal recommends MMR vaccine and he opines that MMR should be made compulsory.
“The government has included the optional vaccinations under National Program time and again depending upon the country’s health scene. But these days, they are just optional,” the doctor adds, “If the parents are interested they can easily get the vaccines.”
Children should be immunized with MMR when they are 15 months old. “The price of MMR ranges from Rs 200-300,” adds the pediatrician. Second dose of MMR can be provided after a few months of the first one or within the age of five.
“Mainly, a woman must get MMR or simple Rubella vaccination before getting married,” suggests the doctor. According to him, German measles or Rubella is a mild disease but when a pregnant contracts rubella it affects fetus, which leads to the birth of abnormal child.
“If people are interested and can afford Rs 2,000-3,000, one can also provide pneumococcal vaccine to the children. The vaccination does not only protect against pneumonia caused by microbes other than pneumococcus bacteria, it also protects against pneumococcal bacteria strains not included in the vaccine.”
Some vaccinations like those of measles and typhoid should be taken repeatedly. “The vaccine’s effect starts decreasing after a year. It has to be taken in two years interval,” informs the doctor.
The doctor also stresses on providing children with booster dose of the vaccinations like DPT, though they don’t come under National Program. “The boosters increase the protection rate and effectiveness of the vaccinations,” inform Dr Aryal. Booster doses of DPT are to be provided when they reach 18 months and five years.
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