High infant immunisation rates reported

It's late in the afternoon and six-month-old Maya wails after receiving an injection that will protect her from mumps, tetanus and polio, administered at a small clinic outside the Turkmen capital, Ashgabat. As the screaming dies down and her mother bundles her out, another baby is laid on the vaccination table. The nurse administering the vaccine has been at it for six hours nonstop "Almost 50 done today," she announces as she prepares another syringe. Turkmenistan has one of the highest infant vaccination coverage rates in the region, IRIN learnt on Monday. "Vaccination rates among under-twos currently run at around 95 percent," Aliyeva Sofiya, head of the epidemiology department of the Turkmen health ministry, told IRIN in Ashgabat. Sofiya explained that the comprehensive vaccination programme was developed during Soviet times, and that the government had recognised the importance of retaining it. "Of course it's expensive, but it's cheaper than treating these diseases when they occur in our children," she noted. The UN Children's Fund (UNICEF) has been instrumental in helping the Turkmen government maintain such impressive levels of child immunisation. "The country has a very good cold chain system [to preserve vaccine]. On top of this, UNICEF helps the government train the people who provide vaccinations," Mahboob Shareef, the UNICEF country representative in Turkmenistan, told IRIN. This had helped Turkmenistan achieve polio eradication status last year, since not one case of acute poliomyelitis had been registered since 1997, he added. The government's vaccination programme has also been assisted by a very good surveillance system to detect, identify and assess the prevalence among children of diseases like measles, diptheria, polio and tetanus. The health ministry reported an infant mortality rate of 24.2 per 1,000 live births in 2001, down from 42 per 1,000 in 1996. World Health Organisation (WHO) statistics are less optimistic, due in part to a different definition of "live birth". According to WHO figures, Turkmenistan leads the Central Asian republics in terms of infant vaccination coverage. In other countries nearby, economic recession coupled with conflict have prevented comprehensive vaccination programmes from getting off the ground. "In neighbouring Tajikistan, coverage is somewhere in the region of 50 percent," Shareef added. In Tajikistan, blighted by a bloody civil war, state purchases and international donations combined do not cover its needs. Within the country, there is little coordination on procurement and distribution of vaccines. In some regions, conditions for storing vaccines do not meet international standards. Refrigerators are unreliable, vaccines are transported in wooden boxes instead of thermoses, and expired vaccines are not eliminated. Turkmenistan's high immunisation rate is also a product of the well developed family doctor programme that prioritises education and information. "Local practitioners really try to get people to see the importance of vaccination through education and other campaigns. Numbers are high because mothers understand why they must come forward with their kids for immunisation," Dilara Ayazova, a UNICEF project assistant, told IRIN.