TEST Ben: Alright. Anna: Alright. [Clearing throat] So can you tell me which children who have missed vaccinations are located approximately here in East New Britain or Kokopo/Vunamami LLG? Maybe you can name the villages or the woods? Anastasia: Alright. Thank you for this time. Thank you for having me to answer some of the questions contributing to our zero-dose receipts. I may be able to help and I may be able to answer the questions. Alright. In regard to the question that you were asking, Anna. Um, yes. Kokopo/Vunamami is, it looks after the urban and the remote areas of Kokopo/Vunamami. And because it is the urban LLG, under what we say referred to as Kokopo City. Uh, we have the remote areas to which you'll see most of them are linked with road but the roads are not good enough for mothers to have places like Gunanba. Gunanba's a big area, is one of them, that it is scattered in a very big area that mothers find in because we have syndrome patients for MCs to be conducted. So, Gunanba is one of them under Kokopo/Vunamami. We have also Tinganavudu, Tinganavudu, Malfoy. Malfoy is a boundary to a Rabaul East government in Kokopo/Vunamami, uh, under Kokopo district. That's why a lot of them are inland, far, going further inside. We have also the Sonoma, a Sonoma area which is quite right in boundary to Sikut Talvat. We have the Marambu and all those places at the back of Sonoma. So, those are some of the places in the Kokopo/Vunamami that we see the catchment immunization for children under 5 is a little bit long. Anna: Thank you. And can you tell me what you think is the best way to identify the children who may have missed their routine immunizations? What is the best way to identify them? Anastasia: Yes, we have the village health recorders under all the local level government and under all the wards. Information to transfer-, transfer to the ward recorders is not coming up good enough. We believe if all our ward members, they, uh, identify all our ward mem-, our recorders, we could get them in. And that is one of the best way, because every mon-, every year-, when every month and every year, they keeps the record of every newborns and they have a very good record and if you go through them, they will help us. Yes, they will help us, the health workers, especially the [inaudible] to identify all the children. And, maybe give us the request so that we can have them record all under our MCH program. Ben: So, the village health recorders, um, are they within like a health governance or are they like a community governance? Anastasia: Uh, they-, they live within the communities but, uh, they're the ones that keep the record of all the newborns and it-, the whole, the population of each, uh, ward. So at the moment, the provincial government, the Eastern region prompted administration is using them, catching them coming in, giving them training, and going back to keep the records of all their wards properly. Ben: Right, and so i-if-, as a health ward manager, are you able to access those documents very easily or do you have to talk to the government... Anastasia: Yes. Ben: ...the provincial government. Anastasia: Yes. So we have the ward members, but when there is a ward council meeting, the ward recorders do not attend because the meetings are for all the ward members only. And so, uh, Prom Chugaman [?] is trying his bets-, best to get separate training for the ward recorders so that-, because they're the ones that keep the data and apart from children population, and all that. Ben: Mm-hmm. Okay, thank you. Anastasia: Yeah. Anna: We were just around that question. You know the ward recorders have a book that they keep the population data in, where does it end up? Anastasia: Uh, in the... Anna: Once they finish recording data? Anastasia: ...in the local level government. Anna: Okay, and from the LLG, where does it go to? Anastasia: When it comes to census, population count and all that, they everything-, they uh, contribute to the data population count. Anna: But are those for different LLGs kept in the LLG office? Anastasia: Yes and they-, they also have helped the environmentalist offices when we go to conduct our surveys on the population and all that. And from there, when S.I.C/O.I.Cs ask for it, they bring it to as well. It hasn't happened many times, but, uh, that is one of the ways that we are now looking at having the ward recorders to help us identify all those children within so that we had them recorded, especially for the immunization. [Clearing throat] We-we've tried that one out already. Kokopo/Vunamami and Bitapaka, we tried it. Ben: And is it-, is it working? Anastasia: Yes. Ben: It's working, yeah? Anastasia: When we-, when-, during the past, uh, nursing officer Anna-, Anna, she's on a study leave now. She had a record in there when the Giroros came in. You remember, Anna, I was talking to you at the time when you came in the beginning, when you came in to introduce the research to us and I said we will-, we really supported it. We really want to find out why Madison not coming, why we not catch-catching the, the eligibility, the eligibility, the-the children within the immunizable state. Women, we tend not to drop out. We are asking why we're not getting that. So, I went ahead, out of all the districts, I got all the S.I.Cs/O.I.Cs, they got all the records. And we should have-, we have very poor records. So I said, let's do it the other way. Get all the assistant-in-charges for all the [inaudible] to come in and we get it in for 1 week. They brought all their green cards. We got green and red cards and yellow cards. They brought all of them in, 0 to 6 months, that 0 to 12 months, and 1 to 5 years. Those green cards and red cards, and their yellow cards, represent those. So, we found out that many, many children still missed out in our records. And, when we recruit new people, especially to concentrate on MCH alone, then we sorted all our records, good info because we involved ward recorders. Ben: Okay. Anna: [Clear throat] We'll move on to our next question. Anastasia: Thank you. Anna: Uh, do you think immunization services here in East New Britain or Kokopo/Vunamami LLG are easy for families to access and use? Why or why not? Anastasia: Uh, sure-, do you-, can you repeat the question there... Anna: The immunization services here in East New Britain, do you think they're easy for families here to access and use? Anastasia: Immunization activities... Anna: ...and services, yes. Are they easy for families to access and use or if not, why or why not? Anastasia: I can see under Kokopo/Vunamami they are good. Many families, really pr-, prioritize immunization programs, and yes. They-, they still-, I mean they think that immunization services are good. Ben: Are they able to um-, like transport-, is transport an issue at all? Anastasia: Yes. Anna: Is it affordable? Anastasia: Uh, especially for the ones in the-, in the rural. Sonoma is-, is still is one of the Kokopo/Vunamami as well. Sonoma is further in. Uh, yes, we still see a lot of children coming. Sonoma doesn't come to Kokopo Butuwin, they go to Vunapope but we still see them at the outpatient. And, Tinganavudu and Malfoy, they come, too. Ben: And that-, that is by bus or? Anastasia: Bus. Ben: Yeah, yeah. [Muffled crowd talking] Anna: [Clearing throat] And, I think we've identified the areas where they-, the children there may have zero or some... Anastasia: ...and difficulties. Anna: ... form of immunization. And so, what do you think is the best way for us to deliver routine vaccines to the hub[?] to reach children? Anastasia: Okay. Uh, having them being in the remote, uh, the necessary, uh, monthly programs. And, when they conduct the monthly immunization during the month, they start from the easy and then they go out to the pretty hard to reach areas last. Now, uh, if they see that the. uh, the, uh, the rich or the percentage is low in that area, they do what you call a mope up, and they do it. That is why I was telling you that they finished yesterday. There was one week mope up, especially to go to, those areas. Uh, one of the difficulties is they still find it hard to reach those women because women are mobile. They move from one place to another. Anna: That's in Kokopo/Vunamami. [END]