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Immunisation and nutrition: why the two sectors must no longer be considered in silos

CH1953992 Flocy three holding a bowl at her family garden in Balaka district Malawi

Malnutrition cannot be tackled alone. At The Power of Nutrition, we have always advocated for a multisectoral approach through partnerships to tackle global malnutrition. The 24th-30th April marks World Immunisation Week. To coincide with this, we are drawing attention to why it is so important to combine immunisation and nutrition when creating robust and sustainable programmes.

Immunisations build the body’s natural defenses and can be the best way to prevent disease, save lives and promote overall health. Currently immunisation prevents approximately 3.5-5 million deaths per year from diseases such as diphtheria, tetanus, whooping cough, influenza and measles. It is especially vital for children to receive proper vaccinations during their early years, to help strengthen developing immune systems. As of 2022 however, 14.3 million children were considered zero-dose children, this is where a child has received no vaccinations for any disease. This is an incredibly dangerous state for any child to be in.

For these children, getting access to vital immunisation is paramount, but it’s not the only issue at play. Limited access to general health services are enormous barriers for children receiving vital vaccinations; this is also true for access to adequate nutrition. In fact, it’s extremely likely that the 14.3 million zero-dose children also fall into the category of the currently 30 million children who are suffering from acute malnutrition. As well as these children falling into the same category, there’s also evidence to show that nutrition can alter the effectiveness of a vaccination.

Malnutrition significantly affects the effectiveness of immunisation and the overall immune response. Malnutrition also weakens the immune system and reduces the efficacy of immunisations. Undernourished children have a weaker immune system, less appetite and a harder time absorbing nutrients than well-nourished children. Therefore, both work together and both need to be addressed to ensure that more children are growing up healthy and free from easily preventable diseases.

Mother holds her child at a health centre in Rwanda

It’s also true that unvaccinated children and mothers are more likely to miss out on other forms of primary healthcare. Immunisation provides an opportunity for enhanced health service coverage by bringing communities into contact with the health system. It provides them with other essential services, including nutrition interventions and in particular, malnutrition screening. Integrating the delivery of nutrition and immunisation interventions is therefore a useful and cost-effective tool for countries to renew their efforts to identify and reach vulnerable communities.

Combining immunisation alongside nutrition services is mutually beneficial - the rationale is evident. However, at this stage, the only blocker is funding for more nutrition and immunisation integrated programmes to grow the evidence-base and learning to save more lives. The Power of Nutrition is keen to make this possible and we’ve been integrating the interventions in a number of our programmes. Our partnership with Gavi is a great example.

Our programme in Indonesia

The Power of Nutrition is a key partner, along with Group M, Gavi, Unilever and Lifebuoy, in an integrated immunisation-nutrition-WASH programme in Indonesia. With the aim of reaching one million children aged under five, the programme aims to highlight the combined benefits of immunisation, handwashing with soap and nutrition. It centres around social behaviour change communication activities to reinforce positive health choices around vaccination, handwashing with soap and infant and young child nutrition.

Our programme in Indonesia is a vital step in gathering more research and learnings to take these interventions to other parts of the world where it is needed most importantly save more lives. To help us take the next step, contact Zubeda:

Header image: (c) Sam Vox/Save the Children


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