Number of vaccination refusal cases go up as coordination crumbles

In 2012, the number of refusal cases was under 74,000 while in 2013 the number nearly doubled.

PESHAWAR: Despite the increasing number of polio cases in the country, many parents across the province refused to vaccinate their children against the virus in 2013.

In 2012, the number of refusal cases was under 74,000 while in 2013 the number had nearly doubled to 154,918.

Last Sunday, 15-month-old Adil from North Waziristan was one of five children diagnosed with polio on the same day. These cases pushed the total number of reported polio cases to 91, including 10 from Khyber-Pakhtunkhwa and nine from Sindh.

One of the reasons behind this could be the lack of coordination between the provincial health department and United Nations Children’s Fund (UNICEF). This communication breakdown has failed to create a demand for vaccination against the poliovirus in the province and tribal areas.



UNICEF’s polio programme coordination is dealt with via the Communication Network (COMNet). They oversee the implementation of an integrated communication strategy for polio eradication in high-risk areas in Pakistan.

The Fund supports the government in polio eradication in the country and started COMNet by recruiting 1,072 communication officers at the district and union council levels in 2012. However, due to poor coordination with the Expanded Programme on Immunisation (EPI), things did not go according to plan.

While talking to The Express Tribune, EPI’s deputy director Janbaz Afridi said the link between the EPI and COMNet was weak. He said COMNet officials usually did not inform the EPI when they were visiting an area or on field. He added that since they were not government employees, they were not answerable to anyone.

According to Afridi, the EPI was not happy with COMNet’s work as they had not seen an improvement in the number of refusal cases reported from K-P. He claims that in the original arrangement, they were supposed to work with the health department to raise awareness about the vaccination but did not and started working on their own.

Afridi added they had also issued government employee cards to around 98 COMNet officials but stopped as they were not, and did not work with, employees of the health department.

According to an official from the health department, 204 COMNet staff members were recruited in K-P, 144 in the Federally Administered Tribal Areas (Fata) and another 210 will be hired from Bannu, Swabi, DI Khan, Hangu, Mardan and Nowshera.

He said COMNet’s main job was to raise awareness among those people who were against polio immunisation and improve coordination. He added that since the COMNet staff did not come under supervision of the health department, they had no space to accommodate them in their programmes, especially after the deteriorating security situation.

The official claimed that COMNet officials had been provided with all sorts of facilities and good salary packages. He said he did not understand why the staff did not report for duty or coordinate with the health department or district health officers.

UNICEF strikes back

Responding to the statements made by the EPI, UNICEF’s media officer for polio, Shadad, said the total strength of the COMNet staff in Fata was 187 and 320 in K-P. She said Afridi was involved in the entire process and COMNet staff did in fact report to the district health communications support officer, who is supposed to share the updates with others.

According to the media officer, COMNet was there to raise public awareness about polio, routine immunisation and create a demand for the vaccination.

She said their performance was monitored by the government and international partners on a regular basis.

Responding to a question about government employee cards in Fata, she said the government had issued the cards but they were held back due to some technical errors.

Published in The Express Tribune, January 17^th, 2014.