Women and children are back at immunization centres in Sri Lanka – following a rigorous appointment-only schedule put together by health workers. These services resumed only recently end of April – a month after they were completely suspended, while the country’s health system tried to come to terms with the COVID-19 pandemic amidst a nationwide lockdown.
By mid-May, the immunization backlog had been mostly cleared and it was business as usual.
“The resilience of Sri Lanka’s healthcare system has been tested several times in the past few decades, and it has proven to be strong, flexible, and resilient. This is largely due to both grassroots efforts and strategic planning. Very early on in the COVID-19 pandemic, the Government conducted an evaluation, taking stock of existing resources and identifying gaps,” said Dr Anil Jasinghe, Director General of Health Services.
A detailed assessment of the COVID-19 situation by the Epidemiology Unit of the Ministry of Health set the ground for re-starting the immunization programme by preparing guidelines on the resumption of services and conducting specialized trainings for health workers to ensure vaccines were administered, keeping in mind all COVID-19 related precautions and safety protocols.
“The Ministry of Health and Indigenous Medical Services drafted guidelines using international best practices and implemented additional prevention and control measures. As a result, we were able to keep Sri Lanka’s healthcare system operational throughout our response to COVID-19 and to resume essential services, such as immunization, very quickly,” added Dr Jaisinghe.
The government was aware that the fear of COVID-19 infection and restriction on movement due to the lockdown were keeping people away from health centers. To counter this, the Ministry of Health used mass media channels to allay fears, and inform people about the resumption of essential health services, including vaccination. The Ministry also urged the community to bring their children to the immunization clinics. Extensive communication campaigns through print and the electronic media announced the resumption of immunization services.
Photo credit: WHO Sri Lanka
Several virtual meetings were organized with regional epidemiologists and community physicians in provinces and districts to orient them on measures that had to be taken to prevent COVID-19 transmission in the clinics. All safety protocols were put in place and emphasized such as physical distancing, hand hygiene and wearing of masks.
Applauding the quick resumption of immunization services, Dr Razia Narayan Pendse, WHO Representative in the country said, “Sri Lanka has a long history of successful public health interventions, and thanks to decades of community engagement and consistent efforts to strengthen the health system, the country has near-universal immunization rates. Preventing and controlling the spread of COVID-19 is a top priority in Sri Lanka. However, it is important to ensure control measures are balanced with efforts to safeguard livelihoods and ensure well-being. Maintaining essential services, including routine healthcare procedures like immunization, is a crucial component of the government’s strategic preparedness and response plan”.
As immunization resumed, special care was taken to protect health workers. They were advised to wear appropriate personal protective gear, while providing essential health services. Appointments ensured no overcrowding in clinics, and for families where multiple women or children needed vaccination, health workers were advised to attend to all of them at one go.
Existing fixed immunization clinics which people were familiar with, were used to provide vaccinations as opposed to outreach and mobile clinics, to ensure quality of immunization services and also to effectively manage any adverse effects following immunization.
As immunization services for pregnant women and children steadily picked up amidst the pandemic, timings at immunization centres were extended and the frequency increased, with immunization sessions taking place even during weekends. Additionally, frequent review meetings were held with district and provincial health officers to assess the progress, identify challenges and define strategies to reach and vaccinate children who had been left behind.