Immunisation coverage: Pakistan losing immunity to health disasters

Coverage rates down in Sindh, Balochistan as frequency of epidemics shows worrying trend.

ISLAMABAD:

Pakistan’s health sector continues to be one of the most ignored areas as the routine immunisation coverage has seen a dismal increase of 6.5 per cent from 2006 to 2012. The population’s immunisation coverage, according to the World Health Organisation (WHO), should be at least 80 per cent.

According to a preliminary report titled ‘Comparison between findings in Pakistan Demographic and Health Survey (PDHS) 2006-07 and 2012-13’ conducted by the National Institute of Population Studies (NIPS), reveals a sorry state of affairs of overall immunisation coverage which has  increased from 47.3 per cent in 2006-07 to a mere 53.8 per cent in 2012-13.



According to the report, Punjab and Khyber-Pakhtunkhwa (K-P) showed a slight improvement in their routine immunisation coverage in the time period but there has been an alarming decline in Sindh and Balochsitan.

In Punjab, the percentage of completely immunised children has increased from 52.6 per cent to 65.6 per cent, while in K-P the figure has increased from 46.9 per cent to 52.7 per cent. In Sindh, it has dropped from 37 per cent to 29.1 per cent and in Balochistan, from 35.2 per cent to 16.4 per cent, according to the report.

The total number of children without any vaccination has declined from 6 per cent to 5.4 per cent in the last seven years. In Sindh, it has increased from 6.3 per cent to 8.5 per cent, in K-P from 7.5 per cent to 12 per cent and has declined in Punjab from 3.8 per cent to 1.5 per cent and in Balochistan from 28.9 per cent to 20.8 per cent, reveals the report.

According to the study, the overall measles immunisation coverage in Pakistan has increased from 59.9 per cent to 61.4 per cent. The coverage in Punjab increased from 65.1 per to 70 per and in K-P from 56.6 per to 57.8 per, however, it declined in Sindh from 50.7 per to 44.6 per cent and in Balochistan from 54.0 per cent to 37.3 per cent.

This coincides with a deadly measles outbreak across Sindh in 2012-13 which claimed over 200 lives.



Talking to The Express Tribune, Dr Qamarul Hassan of the WHO said that even though according to the PDHS 2012-13 there has been an improvement in routine immunisation coverage in Pakistan as compared to 2006-07, it is still worrisome.

“The major reason behind the low coverage is that the government does not seriously care about vaccinating children,” he said.

He said the concerned government officials do not question their staff in districts and union councils about their poor performance.

“There are also issues such as poor accountability, management and shortage of human resources as higher-ups are not competent  and lower staff numbers are not enough to cater the need of the target population,” said Hassan.

He said that between five and six million children are born in Pakistan every year and need to be secured against vaccine preventable disease under the Expanded Program on Immunisation (EPI) in their first years. He added that with 7,000 vaccinators in total, there is only one vaccinator for 30,000 people in one union council.

Another reason for the low coverage figures is the lack of interest and information among parents in urban and rural areas regarding the importance of immunisation of children, he said.



Talking to The Express Tribune, Ministry of National Health Services, Regulation and Coordination Secretary Imtiaz Inayat Elahi said the government is aware of the loopholes and shortcomings behind the low immunisation coverage and is taking necessary measures to bridge the gap.

The ministry, in collaboration with an international donor agency, will be initiating a project under which software will be installed to keep a record of cold chain and supply of vaccines from the federal government stores to their desired destinations, he said.

According to Elahi, the EPI will be given the same priority as the Prime Minister’s special cell on polio and the vaccinators’ stipend will also be increased.

Published in The Express Tribune, August 29^th, 2013.