Debilitating blow: Parent refusals cripple polio programme

UNICEF document says trust deficit is to blame for an all-time low parent conversion rate.

ISLAMABAD:

The nation’s largest health initiative is in tatters.

Inefficient awareness building strategies, coupled with targeted attacks on polio teams and distrust among the populace, have led to a sharp increase in the number of families that refuse the oral polio vaccine.

According to official, unreleased documents prepared by Unicef Pakistan, available with The Express Tribune, the all-time low conversion rate of parents refusing the polio vaccine has completely crippled the country’s largest public sector health initiative.

Suspicions abound, trust goes missing

High-ranking officials within the polio programme claim that the ‘dirty’ role played by Dr Shakeel Afridi and some international donor agencies has significantly contributed to an upsurge in refusals.

“The leaked Abbotabad Commission Report has confirmed that international donor agencies have other motives that are clearly beyond their mandate,” says an intelligence officer, requesting anonymity.

According to Sona Bari, the spokesperson for the Global Polio Eradication initiative at the WHO headquarters in Geneva, country representative Dr Ni’ma Abid addressed this issue publicly in March. “WHO has always strongly stated that public health interventions should not be used for any purpose other than the improvement of health,” Bari adds firmly.



Restoring faith

Millions of dollars have been spent by international donor agencies to restore the dented credibility of the programme. And yet, nothing seems to be working.

“Unicef appointed cricket star Shahid Afridi without even realizing that people that follow celebrities like Shahid Afridi do not refuse the polio vaccine in the first place,” mocked Maulana Tahir Ashrafi, a notable religious cleric of the Ulema Council.

The documents also mention the hundreds of highly paid Unicef communications and social mobilisation staffers, known as COMNet, that have been paralysed after the targeted attacks on polio teams.

“The role of social mobilisation is to build the right kind of linkages with communities, and opening doors to the right influencers and households is critical. But the security context will also need to facilitate COMNet presence in these areas,” the papers state.



A nosedive

The documents clearly illustrate that the number of parent refusals after the fatal attacks on polio teams has grown this year. “The high-risk districts of K-P, for example, have recently shown a rise in refusals,” the papers state.

Last year, however, the number of refusals saw a constant decrease, whereas the number of parents ‘converted’ climbed upwards.

“During 2012, refusals were brought down from 60,000 to only 47,000 by the end of the year,” said an Extended Program on Immunisation (EPI) official as he interpreted a slide, a part of the documents, for The Express Tribune.

Last week, a high ranking official of the polio programme while making a presentation to parliamentarians, created serious confusion amongst the media and international donor agencies by claiming that 172,622 refusals had been reported throughout the country. With this, he put the authenticity of the polio programme’s data under suspicion, as WHO had claimed during a presentation in April that the country had reported 70,000 refusals, whereas the PM Polio Cell had claimed last year that the country had reported 47,000 refusals.

An EPI official, vocal about the failings of the programme, said the poor communication strategies are to blame for discrepant data.

“Almost two decades down the road, and the polio programme is still unaware about the different reasons as to why parents actually refuse polio drops,” said the official.

Published in The Express Tribune, July 26^th, 2013.