About 23 million children under the age of one did not receive essential immunisations in 2020 — the highest figure since 2009, according to global statistics. In India, about 4.6 million children missed their routine immunisation in 2020, of which almost 3 million children missed their first dose of measles and DPT vaccines.

Immunisation prevents 3.5-5 million deaths from diseases like diphtheria, tetanus, pertussis, influenza and measles every year. Elimination of polio in India, and most recently the gradual drop in Covid-19 deaths and cases ever since the get-go of immunisation drives is a long-standing proof to the efficacy of vaccines.

Even as we encourage more parents to get their children immunised, one factor seems to be at constant play, gender.

Impediments to immunisation

Gender roles and norms play a critical role in health outcomes. Gender-based immunisation barriers exist on numerous levels, from the individual to the family and the community.Across the world, gender-related barriers to immunisation are multifaceted: caregivers may be unaware of the benefits of immunisation due to a lack of knowledge; fathers’ involvement in childcare responsibilities, such as vaccination, may be impeded by the household’s division of labour; low socio-economic level status or women’s lack of access to household funds may limit their ability to afford indirect vaccination expenses; and due to safety and mobility issues, travelling long distances to health clinics may deter mothers, especially younger mothers.

The Global Polio Eradication Initiative (GPEI), a public-private partnership led by national governments with — Rotary, WHO, CDC, UNICEF, Gates Foundation and GAVI — identifies and addresses the gender-related barriers of immunisation, communication, and disease surveillance to ensure vaccination reaches every child.

Women frontline health workers

The GPEI has been engaging women as frontline health workers since the polio eradication programme. Collecting and analysing sex-disaggregated data further helps to gain an understanding of gender-related barriers that prevent reaching zero-dose children — those who have not received any vaccine. In turn, we can use this data to refine our approach for vaccinating these children.

Gender-related barriers must be addressed in the planning and roll out of vaccinations to reach everyone, especially the ones who are most marginalised.

(The writer is Chairman, Rotary International’s India National PolioPlus Committee. Views are personal)