“Smile” for immunisation

Nur Awwalia and her Immunisation Wall of Fame. © UNICEF Indonesia/2015

The walls of the Tanah Merah Bangkalan Health Centre on Madura Island in East Java have all the usual posters expected in a health clinic. But one stands out. It’s a plain white board lined with photos of 25 smiling babies.

Each baby has completed their five stages of immunisation – five free immunisation sessions which mean they are safe from diseases including diphtheria, tuberculosis, hepatitis B, tetanus, polio and measles.

A midwife at the centre, Nur Awwalia, recently came up with the idea for the poster. “Every parent likes to show off their baby. So why not use this to promote immunisation!” she says.


Nur Awwalia – usually called Lia – says the idea came to her when she noticed how relatives and friends could get quite competitive in comparing their babies. She thought some friendly competition could help drive up immunisation rates.

Lia decided to put the Immunisation Wall of Fame next to posters of children suffering from polio and diphtheria – diseases that are prevented by simply giving the child their five immunisation sessions.

“I don’t think any mother or father would like to have their baby suffering. It is difficult to explain it, but very effective when showing the possible disease your baby can catch when not immunised,” she says.

Lia has been working at the centre since 2011. Her day typically begins at 5am and she accepts patients until 3pm. Aside from her work in the centre, Lia also visits patient’s homes and conducts advocacy meetings with parents.

Mothers gather at the Tanah Merah Bangkalan Health Centre. © UNICEF Indonesia/2015

Immunisation sessions are scheduled at the centre once a month. It’s challenging work for Lia and her colleagues – as the remote sub-district of Bangkalan has one of the lowest immunisation rates in Indonesia.

Lia says parents are reluctant to take their children for routine immunisation sessions for many reasons, ranging from a fear of side effects to cultural misunderstandings to family objections.

These are some of the challenges that Lia has fought against over a number of years. To help address these, she is receiving technical coaching from the local District Health Office with the support of UNICEF. As a result, she now engages more knowledgably and skillful in immunisation advocacy work at community gatherings, with both parents and with religious leaders.

Lia is very proud of her Immunisation Wall of Fame. She hopes it will continue to grow in the days, months and years ahead.