Randa S Hamadeh*

Primary Health Care, MoPH, Antonine University in Lebanon, Lebanon

*Corresponding Author: Randa S Hamadeh, Primary Health Care, MoPH, Antonine University in Lebanon, Lebanon.

Received: June 24, 2020; Published: July 30, 2020

Citation: Randa S Hamadeh. “Immunization Amidst COVID-19: The Relentless Mission of the Primary Healthcare Network in Lebanon”. Acta Scientific Paediatrics 3.8 (2020):85-87.

Despite the COVID-19 pandemic, the provision of quality immunization service is continuously being delivered by the primary healthcare centres in Lebanon, reaching to vulnerable and marginalized children with life-saving vaccines.

Figure 1: A child receiving his polio vaccine at Makhzoumi Foundation PHCC in Beirut.

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Equitable healthcare services for all children

Every child has the right to quality healthcare services. Immunization constitutes an essential means to prevent the spread of communicable and potentially life-threatening diseases, keep children safe and healthy [1] and help achieving health-related sustainable development goals [2]. Despite the continuous unrest situations in the country including wars, conflicts and tensions, Lebanon contained outbreaks and remained Polio free for the past 16 years.

The Expanded Program on Immunization (EPI) launched by the Ministry of Public Health (MoPH) in Lebanon since 1987, and housed under the Primary Healthcare department is continuously committed to sustaining high quality free of charge immunization services, routinely delivered at more than 867 PHCCs and dispensaries.

To guarantee that all children in Lebanon are vaccinated and protected against dangerous diseases, and that no child is left behind, especially the most marginalized and vulnerable ones, the MoPH provides immunization for Lebanese and non-Lebanese children through primary healthcare centres, dispensaries, vaccination centres on borders, and at UNHCR registration sites across the country. Immunization is an indisputable human right. According to the MoPH’s 2019 data, 94.2% of children in the country were vaccinated with OPV 3, 93.5% with Penta 3 and 92.9% with MCV1.

Lebanon is hosting approximately 1.5 million Syrian displaced since the beginning of the Syrian crisis in 2011 [3]. The protracted nature of the Syrian crisis has raised a great need to design holistic response programs targeting host and displaced communities, and providing them with safe, healthy and supportive physical and social environments [4]. The PHCCs being well-resourced facilities with adequate expertise have been at the heart of the Syrian crisis response in Lebanon, where 40% of their beneficiaries are from the displaced Syrians, as well as host communities, immigrants and minorities. 236 Primary Healthcare Centers (PHCCs) covering the eight Lebanese governorates and led by 113 entities mostly nongovernmental organizations, governmental entities and academic institutions operate under the umbrella of the Primary Healthcare Network [5]. Immunizing children against vaccines preventable diseases especially polio, measles and rubella has always been a high priority on the PHC Network’s agenda.

Figure 2: A baby receiving immunization at Howard Karagheusian PHCC in Mount Lebanon.

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In early 2018, Lebanon has witnessed a national measles outbreak spread across all the country. Ever since, a range of accelerated immunization activities were launched as imminent response, and a national measles campaign was launched in 2019 and implemented by the MoPH in partnership with UNICEF and WHO to ensure measles control, and mobilize caregivers to vaccinate their children [6].

The MoPH builds on a strong partnership with the United Nation’s Children Funds (UNICEF) and the World Health Organization (WHO) to avail high quality vaccines at all immunization outlets. As such, all vaccines are prequalified by WHO and procured through the UNICEF Copenhagen Supply Division, which ensures the delivery of the best available vaccines. Besides, healthcare providers are trained on effective vaccine management to assure high quality immunization services are provided to all children residing in Lebanon.

Immunization during COVID-19 pandemic

The COVID-19 outbreak is strongly affecting the healthcare services globally including immunization [7]. It is a real evidence of the impact of an infectious disease when a protective shield of immunization is unavailable. This pandemic is a reminder of the importance of vaccination in saving millions of people’s lives around the globe.

In Lebanon, same as elsewhere, COVID-19 is causing a range of challenges hindering the provision of basic health services. The shortage in personal protective equipment supplies, the lockdown measures declared by the Lebanese Government delays the access of patients to non-critical health services [8]. Also, the high level of panic and misconceptions spread among community members are major contributing factors.

Notwithstanding, PHCCs never ceased to actively respond to the pandemic as key healthcare gateways in the community. Out of the 236 PHCCs operating under the PHC Network, 86% are continuing to accommodate patients during the pandemic, while taking utmost infection prevention and control measures to guarantee a safe environment for both patients and healthcare providers.

Furthermore, at the start of the COVID-19 outbreak, MoPH and partners combined efforts and jointly worked on equipping healthcare providers not only with personal protective equipment, but also with capacity building on how to deal with the pandemic. 243 healthcare providers received on site and online training sessions on “Preventive Measures at Primary Healthcare Centres during the COVID19 Pandemic”, to enhance their preparedness [9].

Figure 3: An Ethiopian little girl being screened before receiving her vaccination at Makhzoumi Foundation PHCC in Beirut.

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Despite the bottlenecks caused by the fast spread of COVID-19, the PHC Network in Lebanon has reported that since the start of the outbreak, with the first case of Corona virus identified on February 21^st, 2020, more than 51,000 children received immunization services in 630 vaccination sites including PHCCs and dispensaries. Children from all nationalities continued having access to immunization [10]. Among the vaccinated children, the majority are Lebanese and displaced Syrian, yet, Palestinians, Armenians, Iraqis, Ethiopians, Egyptians, Sudanese and Bangladeshis are also provided with immunization to ensure that no child is left behind. The PHCCs’ reach to all children from host and displaced communities, and minority groups is a clear evidence that caregivers’ trust in the quality of services provided by these centres has never diminished.

Bibliography

1. Andre FE., et al. “Vaccination greatly reduces disease, disability, death and inequity worldwide”. Bulletin of the World Health Organization 2 (2008): 140-146.
2. World Health Organization. “Vaccination Safety Communication” (2016).
3. The Government of Lebanon and the United Nations. “Lebanese Crisis Response Plan 2017-2020” (2019).
4. The Government of Lebanon and the United Nations. “Lebanese Crisis Response Plan 2017-2020” (2018).
5. Ministry of Public Health - Lebanon. “National PHC Network” (2020).
6. World Health Organization. “Measles – Lebanon” (2019).
7. United Nations Children’s Fund. “The impact of COVID-19 on routine vaccinations” (2020).
8. Think global Health. “Coronavirus in Lebanon” (2020).
9. Ministry of Public Health. “Training on the Preventive Measures at Primary Health care Centers during the COVID19 Pandemic” (2020).
10. United Nations Children’s Fund. “Lebanon renews its commitment to ensure free and accessible vaccines for children” (2020).

Copyright: © 2020 Randa S Hamadeh. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.