A helping hand for childhood immunisation

ChildrenEducationFamilyHealthcareInfectious Diseases

Many people have difficulty remembering the schedule for childhood immunisation. This means that children often miss some or all of a series of immunisations that can protect them against polio, hepatitis B, diphtheria, tetanus, and other preventable diseases.

Baby on mother's back. Photo: Clive Mear/Tearfund
Every year, immunisation averts 2 to 3 million deaths from diphtheria, tetanus, pertussis (whooping cough), and measles. Photo: Clive Mear/Tearfund

The schedule recommended by the World Health Organisation includes at least six different vaccines, which are given over the course of five visits, taking place at birth and then at six weeks, ten weeks, 14 weeks, and nine months of age. Parents who can’t read don’t benefit from written reminder cards or health cards issued at their child’s birth. How can we help them remember when to take their infants to be immunised? 

Song, mime, theatre and games are all good ways of sharing health information with people who cannot read. Trainers, teachers, and facilitators can use them to illustrate health messages, stimulate discussion, teach participants new skills, and create simple memory aids. 

The ‘Use your hands’ activity (see below) can be used in a workshop or during community education sessions. Trainers teach health workers, school children and parents to recite the poem and count off the necessary visits on a hand. The poem can be translated, adapted, and presented as a song, chant or rap. This is particularly effective if the words can be sung to the tune of a well-known local song. 

Use your hands 

People can learn to remember messages using their bodies. In Benin, an Integrated Family Health Project developed a learning activity called the ‘Immunisation hand’ which encourages people to use their fingers and a poem to remember the schedule. 

Step 1 Discuss with participants the advantages of immunisation and the dangers of not using it to protect a baby against childhood illness. 

Step 2 Ask participants to hold up their hand, separating the thumb and little finger while holding the three middle fingers together. 

Step 3 Show how each finger can demonstrate an immunisation visit, and the vaccines which may be used. (Different countries may follow a slightly different schedule, depending on the national immunisation programme.) 

Child with fingers demonstrating immunisation

LITTLE FINGER - FIRST VISIT - AT BIRTH
BCG (tuberculosis), polio 

RING FINGER - SECOND VISIT - AT 6 WEEKS
Diphtheria-tetanus-pertussis (DPT), OPV, Haemophilus influenzae type b (Hib) and hepatitis B (HepB) 

MIDDLE FINGER - THIRD VISIT - AT 10 WEEKS
Diphtheria-tetanus-pertussis (DPT), OPV, Haemophilus influenzae type b (Hib) and hepatitis B (HepB) 

INDEX FINGER - FOURTH VISIT - AT 14 WEEKS
Diphtheria-tetanus-pertussis (DPT), OPV, Haemophilus influenzae type b (Hib) and hepatitis B (HepB) 

THUMB - FIFTH VISIT - AT NINE MONTHS
Measles and yellow fever 

Step 4 Ask several participants, and then everyone, to repeat the schedule using their hands to remind them. 

Step 5 Explain that the three middle fingers are held together to represent three visits for the same immunisations. For them to be fully effective, the child needs to make three visits just a month apart. The bigger space between the thumb and the middle fingers represents the long wait until the child is nine months old for the fifth immunisation. 

Step 6 Ask participants to use this exercise to teach their friends and family members. 

Immunisation hand poem 

‘I need five immunisation sessions against terrible childhood sicknesses. 

Immediately at my birth, give me my first immunisation. 

When I’m six weeks old, give me my second. 

At two and a half months, give me my third immunisation. 

At three and a half months, give me my fourth. 

And then when I’m nine months old, give me my fifth immunisation. 

Bravo! I have completed them all before my first birthday!’ 

For more information on immunisation visit the World Immunisation Week (24-30 April, 2017) page on the World Health Organisation website. 

This article appears in issue 65 of Footsteps magazine, which is on the topic of adding value to food. You can read Footsteps online, sign up to receive Footsteps regularly or contact us to order printed copies. 

Siri Wood
Siri Wood is Senior Programme Officer for PATH’s Reproductive Health Global Programme in Seattle, USA