The UTPS NGO clinic in Uttara, North Dhaka feels like home for Mahmuda. After working many years as a government appointed family welfare assistant, a service promoter and now as a paramedic, she knows quite a lot of people at the clinic, both co-workers and visitors. And even more mothers who come regularly to the clinic with their newborns for routine immunisation.
The NGO clinic provides all the routine vaccines, five days a week. BCG, Penta, PCV, OPV, MR. Mahmuda knows the schedule by heart and sums up the protection that vaccines offer for various childhood diseases. The clinic, run by the local NGO Unity Through Population Service (UTPS) , is working with the government as an immunisation service provider. As a paramedic Mahmuda is supporting the immunisation process. Awareness raising and monitoring are part of her job, a very important part. She contacts the parents of all newborns at the clinic after six weeks to remind them to receive the first dose of Penta, and bring their vaccination card along, which should be handed over to them after their newborn got the BCG shot.
Every week Mahmuda encounters a few ‘left-out’ children as she calls them. They are zero-dose children who have not received a single dose of Penta, or otherwise have no proof of being vaccinated. Most of the zero-dose children that Mahmuda identifies are from the nearby slums. Their parents are ignorant of the benefits of immunisation or do not pay proper attention to the schedule, losing track of the dates. Some parents visited the Uttara clinic only for delivery, but live further away in Tongi or Gazipur. They tend to take their child to nearby vaccination centres. Mahmuda has to check if children indeed received their vaccines at the UTPS clinic or elsewhere. That is easier said than done since many of the poor parents don’t have a mobile phone and need to be contacted at their homes via networks of health workers at the various localities which takes time.
Parents point out multiple hurdles to Mahmuda. Migrant workers move from place to place and their vaccination cards easily go missing. Mahmuda knows that parents are not the only ones to blame. Private clinics do not always provide birth certificates and vaccination cards; neither do they inform parents properly about the routine immunisation programme. Factory workers often have difficulty in getting time off to visit the vaccines centre during working days.
The UTPS clinic is trying to reach out to the parents. Recently the clinic started an evening immunisation session twice a week. This helps. But the vaccination service charge continues to be a hurdle for many poor families despite the clinic charging only a small fee of 50 taka or 50 dollar cents. Hence, Mahmuda does not ask for money at times.
Mahmuda takes her job seriously. She works long days at the UTPS clinic and at two other clinics in the area, building relationships with new mothers. And also with the local fieldworkers, because they are the ones that form the vital link in reaching new mothers through personal networking.