Gender and immunisation

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All children have the right to health. Gavi, the Vaccine Alliance is committed to helping both girls and boys be healthy and fulfil their potential

Gender and immunisation

Credit: Gavi/2012/Sala Lewis.

Vaccines provide the same benefits for all children. Yet some societies privilege boys over girls, including in the provision of immunisation and other health services. In other instances, the opposite is true and girls have greater access than boys. Gavi is working to ensure that all children get equal access to life-saving vaccines.

WOMEN AND MEN DO NOT HAVE THE SAME ACCESS TO HEALTHCARE

In many societies women and men do not have the same opportunity to access or use health services. Gender-related barriers can prevent children from getting vaccinated if, for example, their mothers are not able to take them to health clinics.

In some cases, they may be working when the clinic is open; in others, they may not be allowed to leave the home without a male chaperone. The WHO study also showed that when women are empowered, immunisation coverage increases. Countries with a high level of gender equity, as measured through the Gender Development Index, have higher immunisation coverage.

The children of mothers who are educated are also more likely to be vaccinated and enjoy better overall health. Gavi is working with governments to reduce barriers to immunisation for women and others who take care of children to improve access.

Geneva Gender Champion

In 2015, Gavi was officially recognised as a 'Geneva Gender Champion', joining 65 other missions and international organisations based in the Swiss city who are committed to gender equity. Learn more 

A Gavi-funded study carried out by the World Health Organization (WHO) found that globally there are no significant differences in the level of immunisation coverage between girls and boys. However the same study found that gender differences persist in some countries and socio-economic groups. It also found that in some countries, women face a lack of information about and access to healthcare, which in turn reduces the chances of their children being vaccinated.

GAVI’S APPROACH TO ENSURING GENDER EQUITY

Gender equity is an overarching principle for all of Gavi’s work. In 2013, the Gavi Board approved a revised gender policy, which aims to increase immunisation coverage by supporting countries to overcome gender-related barriers to accessing immunisation services and to promote equity of access for all girls and boys, women and men.

Gavi works together with countries to overcome gender inequities. Gavi-supported countries are encouraged to break down data based on sex, income and geographic location to help identify reasons for low immunisation coverage.

They are also encouraged to apply for health system strengthening funding, which can include addressing gender-related barriers to immunisation.

Countries are given support to train more health workers and ensure that female health workers are available to provide immunisation services to women and their children where appropriate.

Increasing the number of female health workers has been shown to be an effective way to increase immunisation coverage. Female health workers are perceived as better able to understand the needs of mothers, and in some societies women are unwilling or unable to see a male vaccinator or health worker.

UNICEF takes the lead in helping to increase equity in these countries. This includes analysing current inequities in wealth and gender, and working with governments to develop plans to address them.

TARGETING IMPROVEMENTS IN WOMEN’S HEALTH

As well as working to reduce gender-related barriers, Gavi also supports two vaccines that are specifically targeted at women, protecting against rubella and HPV (human papillomavirus), which causes cervical cancer. Over 85% of deaths from cervical cancer occur in developing countries, where women often lack access to screening and treatment.

Vaccinating girls and young women before they are exposed to the virus can prevent more than two-thirds of all cervical cancer deaths. Rubella can cause serious malformations and disabilities in babies (including deafness, blindness and heart defects) as a result of infection in their mothers in the first three months of pregnancy.

Gavi is supporting the introduction of HPV vaccine in eligible countries. Demonstration projects began in 2013, and more than 20 countries have now been approved for support. Once countries demonstrate that they can deliver this vaccine to adolescent girls, they can receive support to introduce the vaccine nationally. In 2013, Kenya was the first country to introduce a Gavi-supported HPV demonstration project. Over 8,000 10-year-old girls began receiving the first dose of the vaccine. By 2020, Gavi expects more than 30 million girls in more than 40 of the world’s poorest countries to have been immunised with the HPV vaccine.

Gavi also supports countries to protect women against rubella by introducing the combined measles-rubella vaccine. Initially, countries receive support to protect girls aged from 9 months to 14 years. The combined vaccine is then gradually introduced into the national immunisation programme to protect women and their babies from congenital rubella syndrome.

AN ENLIGHTENED FATHER: CHANGING HEARTS AND MINDS IN NIGERIA

Yusuf Ibrahim is a father and a Muslim living in northern Nigeria. He is also a convert: not in his religious faith, but in his beliefs about immunisation. Rumours that vaccinations are the product of a Western plot to “control the Muslim population” abound in Nigeria, although no one is entirely sure of their origins.

Growing up in a tiny farming village an hour from Minna, Yusuf was told this as fact. It took a near tragedy to change his heart and mind.

His first-born daughter Saratu, then two years old, nearly died of pneumonia. He began to talk his beliefs through with physicians at the hospital where she was treated. They gradually convinced him that they were there simply to preserve life, and that had his child been given the right vaccination she would have been spared this ordeal.

A decade later and now the father of four, Yusuf is an advocate. He goes door to door through the streets and orange-dusted back alleys of Unguwar Daji, explaining to families why immunisation is so important.

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