An overview of immunization practices in Pakistan

Wain, Zafeer Naeem; Masood, Rizwan; Ali, Rai Waqas; Bashir, Irfan

doi:10.3329/icpj.v5i11.29901

Cited by 4 publications

(4 citation statements)

References 6 publications

(10 reference statements)

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“…Competency of the staff, outreach capacity, service structure, attitudes towards clients, political interference in transfers and postings, and lack of accountability are all notable HR-related issues of EPI [ 20 , 21 ]. On the other hand, there are workers in the polio program who are willing to perform their duties while putting their lives at risk, and facing extremist sections of the society, amidst a grim law and order situation [ 22 ]. Introducing incentive structures among managers and health workers of EPI or contracting with non-governmental organizations (NGOs) can potentially improve the HR performance [ 23 ].…”

Section: Resultsmentioning

confidence: 99%

Health system barriers and levers in implementation of the Expanded Program on Immunization (EPI) in Pakistan: an evidence informed situation analysis

Shaikh

Haq²,

Tran

et al. 2018

Public Health Rev

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BackgroundIn Pakistan, immunization coverage has been quite low since the program’s inception, and the 2012–2013 population-based survey recorded it at 54%. Much has been written about the issues, challenges, and constraints in the implementation of Pakistan’s immunization program. However, there is a need to better understand the health system barriers as well as levers that influence progress. This review aims to bridge the information gaps on system-level barriers that currently impede the optimal delivery and uptake of immunization services to the children of Pakistan through the Expanded Program on Immunization (EPI).MethodsWe conducted a comprehensive literature review, using PubMed and Google Scholar to find peer-reviewed literature, and also reviewed EPI-related international and national reports. Additionally, we consulted government reports, surveys, and publications on the health system. Employing the basic tenets of WHO’s health systems framework for health system strengthening, and a socio-ecological model, this study cataloged the service delivery and the demand side perspective on various pillars of Pakistan’s immunization program.ResultsThemes generated from the literature review included financing, governance, service delivery, human resources, information systems, and supplies and vaccines. Findings suggest that certain areas in the larger health system need to be improved for a more coordinated implementation of EPI in Pakistan. Moreover, it is imperative to understand community behaviors and perceptions as well as demand side issues in order to achieve the desired results.ConclusionFor better immunization coverage and ultimately a reduction in child mortality due to preventable diseases, EPI operations and performance must be improved. Further systematic implementation research could help to develop an even finer understanding of the system-wide bottlenecks encumbering the coverage and efficiency of the program.

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Section: Resultsmentioning

confidence: 99%

Health system barriers and levers in implementation of the Expanded Program on Immunization (EPI) in Pakistan: an evidence informed situation analysis

Shaikh

Haq²,

Tran

et al. 2018

Public Health Rev

View full text Add to dashboard Cite

show abstract

“…Competency of the staff, outreach capacity, service structure, attitudes toward clients, political interference in transfers and postings, and lack of accountability are all notable HR related issues of EPI [20,21]. On the other hand, there are workers in the Polio program who are willing to perform their duties while putting their lives at risk, and facing extremist sections of the society, amidst a grim law and order situation [22]. Introducing incentive structures among managers and health workers of EPI or contracting with non-governmental organizations (NGOs) can potentially improve the HR performance [23].…”

Section: Human Resourcementioning

confidence: 99%

Implementation of the Expanded Program on Immunization (EPI): Understanding the Enablers and Barriers in a Health System

Shaikh¹

2018

Immunization - Vaccine Adjuvant Delivery System and Strategies

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Much has been written about the issues, challenges and constraints in the implementation of immunization program. However, there is a need to better understand the health system barriers as well as enablers that influence the progress. This chapter aims at bridging the information gaps about system-level factors that currently are impeding the optimal delivery and uptake of immunization services to the children through the Expanded Program on Immunization (EPI). This chapter draws its thematic content from a critical review of the EPI-related international and national reports. In addition to this, this chapter consulted government reports, surveys, and publications on health system. Themes generated from the literature review included financing, governance, service delivery, human resources, information system, and supplies and vaccines. Findings suggest that certain areas in the larger health system are to be improved for a more coordinated implementation of EPI. It is imperative to understand community's behaviors and perceptions as well as demand side issues in order to achieve the desired results. For a better immunization coverage, EPI operations and performance must be improved. Implementation research could definitely help in developing an even finer understanding of the system-wide factors influencing the efficiency of the program.

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“…Immunization is an effective tool for preventing and controlling morbidity and mortality associated with vaccine-preventable diseases (VPDs) [ 1 ]. Globally, immunization has prevented more than two million deaths among children under five years of age [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

A Survey Exploring Reasons behind Immunization Refusal among the Parents and Caregivers of Children under Two Years Living in Urban Slums of Karachi, Pakistan

Khaliq

Elahi

Zahid

et al. 2022

IJERPH

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This study assesses the experiences of parents/caregivers regarding the refusal to childhood immunization. A cross-sectional study was conducted among the parents/caregivers of children under two years old from January 2019 to June 2019 who were residents of either Pathan Colony or Orangi Town, Karachi. In this study, the data collectors targeted parents/caregivers of 440 households who showed a refusal mark “R” in the Expanded Program of Immunization (EPI) H-chalking system. These households were approached using a 30 × 7 multistage-stratified-cluster random sampling technique and were interviewed using a structured questionnaire. The study sample produced two different types of refusals: true refusal (absence) and potential refusal (presence), based on the absence and presence of a vaccination card at the time of the survey. Multivariate logistic regression was used to analyze the data using Jamovi (V-1.6.13). A total of 230 households consented to participate in this study, of which 141 (61.3%) represented true refusals, while 89 (38.7%) represented potential refusals. More than half of the participants from both groups complained about fever and pain at the injection site following immunization. The use of alternative medicines and a history of adverse events following immunization (AEFI) were associated with increasing the odds of immunization refusals by four-to-five fold. However, advanced paternal age, a long distance to the clinic, a lack of trust in government, and the influence of community/religious leaders were associated with lower immunization refusal odds. Thus, an unawareness about self-limiting vaccine-related adverse events, the use of alternative medicines, and an increased concern about the safety and efficacy of vaccines were found to be barriers to immunization, which can be improved by increasing public awareness through media campaigns and policy reform.

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An overview of immunization practices in Pakistan

Cited by 4 publications

References 6 publications

Health system barriers and levers in implementation of the Expanded Program on Immunization (EPI) in Pakistan: an evidence informed situation analysis

Health system barriers and levers in implementation of the Expanded Program on Immunization (EPI) in Pakistan: an evidence informed situation analysis

Implementation of the Expanded Program on Immunization (EPI): Understanding the Enablers and Barriers in a Health System

A Survey Exploring Reasons behind Immunization Refusal among the Parents and Caregivers of Children under Two Years Living in Urban Slums of Karachi, Pakistan

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