Covid-19 vaccination drive In Nepal, challenges are huge

When the Humla District Health Office ordered local health offices to send a list of female community health care workers and volunteers working under them for the Covid-19 vaccination program, Hansa Mahatara, a health coordinator at the City Adanchuli rural district in the district followed the order .

But he wonders how it will be possible to carry out mass vaccination in the rural municipality, three days walk from the district office of Simikot. the drug regulator has granted emergency use approval for Covishield, a vaccine made in India, as well as has received assurances from the country that it will provide some doses of the vaccine by January.

 “Coronavirus vaccines will come soon, Dr. Jhalak Sharma, head of the Child Health Section at the Family Welfare Division under the Department of Health Services, told ata Post. In addition, Covid-19 vaccines for three percent of the population, which will be provided by the World Health Organization as part of the COVAX facility in the first phase, will be available by the end of April, according to the Ministry of Health. Healthcare workers be among the first to be vaccinated, according to the governments priority list, including those serving in remote parts of the country such as Adanchuli Rural Municipality, the most remote part of the district, which borders the districts of Mugu and Bajura. “Yes, we have a lot of challenges to roll out coronavirus vaccines to the population,” Sharma said.

“We will be doing microplanning at the district level. We have time for that. If Mahatara’s experience in vaccinating babies matters, the challenge is indeed great. Even after vaccines are shipped to the villages, 80 percent is lost due to a lack of refrigerated storage facilities in the rural Adanchuli community and lack of adequate vaccine doses for babies. According to Mahatara, there are often not even enough syringes available. Covishield, developed by Oxford University and pharmaceutical giant AstraZeneca, is Nepals preferred vaccine as Nepals infrastructure for storing and transporting vaccines supports it.

“Two years ago we provided a UNICEF refrigerator to store vaccines, but it got dusty because there was no electricity to support them, he said. The situation in the rural Adanchuli community reflects the challenges they face the country faces When vaccinating the population against Covid-19. Of the approximately 30 million inhabitants of Nepal, 72 percent have to be vaccinated as ch.Children under the age of 15 are not vaccinated because existing vaccines have not been tested for them.

The Ministry of Health is preparing in The first phase will involve immunizing 300,000 health workers and support workers, and the necessary preparations will be made accordingly, according to Sharma. Offices at the ministry says that since coronavirus vaccines will not be immediately available to everyone, no additional human resources or other mechanisms are needed so. “We have completed the first phase of preparation,” said Dr Roshan Pokhrel, chief specialist at the Ministry of Health. We took into account storage facilities, transport and cold chain maintenance, among others.

Other than the challenges faced in remote areas like the Rural Municipality of Adanchuli, there are other challenges that experts are wary of. “If there is an unwanted side effect after vaccination, a patient should be brought immediately to health facilities, Dr Bikash Lamichhane, former director of the Child Health Division of the Department of Health, told the Post. Health workers need to watch people after vaccination, and for that too we need health workers in place. In Nepal, people generally do not question the effects of free injections But there have also been incidents where people have been reluctant to take drugs distributed as part of mass drug administration programs such as lymphat ic filariasis.

Even after 12 cycles of programs, disease is not under control in some districts Doctors say coronavirus vaccine delivery is not like mass drug administration program and in the reader, the live virus will be inserted into the body No vaccine or drug is 100% safe and some unwanted effects may be seen after vaccination, because the coronavirus vaccine is new and a lot remains to be done. know, Dr Shyam Raj Upreti, coordinator of the Covid-19 vaccine advisory committee, told the Post.

Public health experts also point out that existing vaccine distribution systems that aim to immunize children will be used in a largescale adult immunization program, which will not be easy as expected. More than 16,000 vaccination camps operate across the country each month and thousands of trained health professionals on site.

Ministry of Health officials say these camps and health workers will be used in a coronavirus vaccination campaign. Coordination between the three tiers of governmentfederal, provincial and localwhich are independent in themselves, will be crucial to ensuring the success of nationwide immunization. But some experts fear that problems with the chain of command will be a big problem in a successful mass vaccination program. “A strong MS surveillance mechanism should be in place before the vaccine is introduced, said Dr. Krishna Kumar Aryal, public health expert.

There may be decisions to be made when unforeseen problems arise and there should be mechanisms to resolve them, according to Aryal. Floating populations can be another challenge in places like the Kathmandu Valley, which can make it difficult for authorities to locate people taking the vaccine as each person two doses of vaccine are required. Another challenge is that a new, more contagious variant of the coronavirus, first detected in the UK, has been detected in Nepal, which experts say could jeopardize the vaccine rollout plan. If the new variant of the virus enters society and infects many people at the same time, it will affect our mass vaccination,said Dr. Sher Bahadur Pun, Head of Clinical Research Unit at Sukraraj Tropical and Infectious Disease Hospital. the Post said, Our surveillance system should be strengthened to minimize the risks.

Officials also agree that surveillance is key to a successful drive. Poor surveillance and the lack of health workers in remote locations to take care of people In the case of vaccinations, side effects could prove to be a challenge for the campaign, said Upreti, Coordinator of the Vaccine Advisory Board. This is why training for health workers such as female health volunteers, whose role in raising awareness is crucial Data collection and monitoring has not yet started. “Adequate preparation is required for pre-immunization and also for the post-immunization scenario, Lamichhane, former director at Chi ld Health Division, told the Post, “They are aggressive Preparation required, e An implementation strategy should be made, public trust in the program should be increased and there should be a mechanism to combat the adverse effects of vaccines. ” A successful vaccination campaign would mean that Nepal becomes free of the coronavirus, the Covid -19 . caused. “The virus will stay in society if we don’t immunize all eligible citizens,” said Aryal, the public health expert. A strong control mechanism should be put in place before introducing the vaccine.

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