Dear Neil and HIFA colleagues,
Good morning. In response to the Rebecca's Alban inquiry regarding CHW's involvement in vaccination program for Global Health I would like to comment as follow: to me who is being involved in initiating PHC program in Iran since 1971, the main and priority task of CHW is Child care. And the main component of child care is vaccination. Furthermore vaccination is a continuous care because of several doses. Therefore a local person like CHW is the most relevant person to do vaccination continuously. In Iran where the CHWs run PHC program coverage became country wide the first procedure of CHW's training program is Child care, and the first task of CHW for child care is Vaccination. Since 1971 till now more than 20,000 CHWs are performing vaccination as their first task and duty. That is why they could bring down the Infant Mortality Rate from 131 per thousand life birth in 1971( prior to recruiting CHW)to around 10 to date 2019.
Also I would like to comment on a review posted in HIFA, from several African countries including Nigeria, where the impact of CHW's services on reduction of Infant Mortality Rate (IMR), were not considerable. I assume that vaccination was not performed by CHWs in those countries. One of the best mean to reduce IMR is preventing death from Vaccines preventable diseases. To me CHW could be one of the best reasonable way to achieve Universal Coverage Of Immunization (over 90%) at Global levels.
Respectfully, Dr. M.A.Barzegar.
For kind information of Rebecca based on my experiences in Iran I have adapted similar CHW run PHC Program in Yemen, Somalia, and Pakistan after approval of the government concerned, during my assignment from 1983 to 2000 with WHO. I should mention that early days in Iran where there was no electricity for keeping vaccines safe we were using Crosin Refrigerator. But in Yemen and Somalia we have benefited from Cold Boxes.
HIFA profile: Mohammad Ali Barzegar is an initiator of Primary Health Care in Iran since 1971, and Representative of People's Health Movement (PHM) Iran. His interest include 45 years of national & international experiences on PHC, Sustainable Development and Public Health. barzgar89 AT yahoo.com