The immunisation hand

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.

The schedule recommended by the World Health Organisation includes at least six different vaccines, which are given over the course of 5 visits, taking place at birth and then at 6 weeks, 10 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. To reinforce the message, a poster and radio item have been produced. 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, PROSAF staff (the 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.) 

1 LITTLE FINGER - FIRST VISIT - AT BIRTH
2 RING FINGER - SECOND VISIT - AT 6 WEEKS
3 MIDDLE FINGER - THIRD VISIT - AT 10 WEEKS
4 INDEX FINGER - FOURTH VISIT - AT 14 WEEKS
5 THUMB - FIFTH VISIT - AT NINE MONTHS

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!’

This article was written by the PROSAF Communications Team. For more information contact Siri Wood, PATH, 1455 NW Leary Way Seattle, Washington 98107-5136, USA.
E-mail: [email protected]