#ReachEveryChild: Vaccines work and can change the healthcare equation

Starting from Edward Jenner’s small pox vaccine in 1796 to the latest vaccines on rotavirus and shingles, vaccination has come a long way. Be it the triumph of small pox eradication in 1980 to the recent polio eradication, continuous dedicated directional healthcare efforts have been pivotal in these health treats. Every child born has a right to be vaccinated against the preventable infectious diseases to attain the optimal health status. For vaccination to eradicate a given infection almost 90% of the population should be vaccinated.

How to improve vaccination coverage?

1. Increase community demand for vaccination
   1. Client reminder/recall: target the children at birth and regular follow up with providing education on the importance of vaccination
   2. Compulsory vaccination schedule to be produced at the time of admission in schools, colleges and offices targeting all age groups
   3. Increase awareness at community level by regular articles and write-ups in newspapers and social media
2. Enhance access to vaccination services
   1. Make the vaccines affordable
   2. Expand the access of health care by reaching out more and more population: conducting camps in villages, towns, school, market places etc
   3. Encourage home visits for healthcare and vaccinating professionals to target individuals who cannot reach the clinics and hospitals: elderly, children and women
3. Interventions at the level of the provider
   1. Provider reminder/recall
   2. Collect feedback from the providers which can target difficulties and problems encountered
   3. Educate the provider with the importance of vaccination and its role in the cost effectiveness and improved health outcomes

#ReachEveryChild is an endeavor of Gavi.org with a global presence. The estimated birth cohort of 2014 for India was 25,519,497 with an under-five child mortality rate of 53 per 1000 live births. About 70% of childhood deaths are due to due to conditions that are preventable or treatable with affordable interventions.

Advantages of vaccination are multifold

1. Disease control benefits
   1. Eradication of disease
   2. Elimination of disease
   3. Control of mortality, morbidity and complications
2. Reduced severity of disease in vaccinated individuals
3. Protects unvaccinated population due to herd immunity
4. Prevents related diseases and cancer like liver cancer due to hepatitis B infection, acute otitis media prevention by HIB vaccination etc
5. Benefits to the society:
   1. Healthcare savings
   2. Prevents development of antibiotics resistance by reducing the usage of antibiotics
   3. Extends life expectancy
   4. Safe travel to endemic regions
   5. Empowerment of women by improving the health status of children and women
   6. Protect against bioterrorism

So to conclude vaccination is beneficial way beyond the prevention of specific diseases and makes very good economic sense.

Reduction of global child mortality by vaccination is a moral obligation for the international community as it is a human right for every individual to have the opportunity to live a healthier and fuller life. We cannot achieve the Millennium Development Goal 4 (two-thirds reduction in 1990 under-5 child mortality by 2015) without this basic health care intervention.

Read more at:http://www.gavi.org/, http://www.who.int/bulletin/volumes/86/2/07-040089/en/

Spread a Word: Protect yourselves from Cervical Cancer

January is Cervical Health Awareness Month which is chance to raise awareness about how women can protect themselves from HPV (human papillomavirus) and cervical cancer. Cervical cancer is the most common cancer and also the leading cause of cancer mortality in women, both in India and abroad. It occurs in the lower part of the uterus, which is called as cervix. Overgrowth of abnormal cells in the cervix leads to cervical cancer. It is caused by a virus known as Human Papilloma Virus (HPV). Not all HPV infections cause cervical cancer, some cause genital warts while some others show no symptoms at all. Most HPV infections resolve on their own, but sometimes they cause genital warts or lead to cervical cancer.

How do you know you can have Cervical Cancer-

• Abnormal bleeding from vagina between menstrual periods or after sexual intercourse or after menopause
• Pain during sexual intercourse
• Abnormal vaginal discharge
• Pain in pelvis/lower belly.

Chance increase if you are

• Into an early marriage
• a smoker
• Using hormonal contraceptives
• Having high number of pregnancies

 

Cervical cancer screening tests-

• Physical exam and history : An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
• Pelvic exam : An exam of the vagina, cervix, uterus, fallopian tubes, ovaries, and rectum.
• Pap test: A procedure to collect cells from the surface of the cervix and vagina. A piece of cotton, a brush, or a small wooden stick is used to gently scrape cells from the cervix and vagina. The cells are viewed under a microscope to find out if they are abnormal.
• Human papillomavirus (HPV) test : A laboratory test used to check DNA or RNA for certain types of HPV infection. Cells are collected from the cervix and DNA or RNA from the cells is checked to find out if an infection is caused by a type of HPV that is linked to cervical cancer. This test may be done using the sample of cells removed during a Pap test. This test may also be done if the results of a Pap test show certain abnormal cervical cells.
• Endocervical curettage : A procedure to collect cells or tissue from the cervical canal using a curette (spoon-shaped instrument). Tissue samples may be taken and checked under a microscope for signs of cancer. This procedure is sometimes done at the same time as a colposcopy.
• Colposcopy : A procedure in which a colposcope (a lighted, magnifying instrument) is used to check the vagina and cervix for abnormal areas. Tissue samples may be taken using a curette (spoon-shaped instrument) and checked under a microscope for signs of disease.
• Biopsy : If abnormal cells are found in a Pap test, the doctor may do a biopsy. A sample of tissue is cut from the cervix and viewed under a microscope by a pathologist to check for signs of cancer. A biopsy that removes only a small amount of tissue is usually done in the doctor’s office. A woman may need to go to a hospital for a cervical cone biopsy (removal of a larger, cone-shaped sample of cervical tissue).

If you fall under 21-30 yrs age group, you should have PAP tests once in every 3 years

• If you fall under 30-65 yrs age group, you should have a combination of HPV and PAP test once in every 5 years
• If you are above 65 yrs, you do not need any PAP tests if you had 2 HPV+ PAP tests with normal results in a row

Screening tests are highly recommended for women who-

• Are above 35 years of age
• Have HPV infection
• Are married for more than 8 years
• Have an abnormal PAP smear

Cervical Cancer Treatment-

Treatment of cervical cancer varies according to the stage the individual is in. The affected person may need to undergo one or more treatments or a combination of the following treatments.

• Surgery- This involves surgical removal of uterus (hysterectomy) and removal of pelvic lymph nodes with or without removing ovaries and fallopian tubes. This can be avoided if cancer is found early.
• Chemotherapy - This involves using medications to kill cancerous cells. It is used to treat advanced stages of cervix cancer.
• Radiation therapy - This involves exposure to high dose X-rays or implants in vaginal cavity to kill cancerous cells. It is mostly used in combination with surgery.
• Chemoradiation - This involves the use of both chemotherapy and radiation to treat both early as well aslate stages of cervical cancer.

It is very important for women to get themselves checked regularly for the presence of cervical cancer. Getting tested in the above recommended time intervals can help to detect the disease at an early stage and thereby prevent cervical cancer. HPV vaccination is also highly recommended to avoid HPV infections, which can cause cervical cancer. Lets pledge on this Cervical Awareness month to increase public understanding of the disease, including its prevalence, approaches to screening and prevention, treatment options, and resources that offer updated cervical cancer information throughout the year.