Provincial differences in levels, trends, and determinants of childhood immunization in Pakistan

Abstract

Although some strategies to increase immunization coverage are relevant nationwide, programme managers need to seek solutions specific to provincial trends and predictors. This analysis demonstrates that viewing childhood immunization in Pakistan through a provincial lens can help achieve a deeper understanding of the challenges and potential strategies to boost coverage.

<p>Why Have Immunization Efforts in Pakistan Failed to Achieve Global Standards of Vaccination Uptake and Infectious Disease Control?</p>

“…22 There are over 10,000 vaccine personnel including Lady Health Workers and paramedics who provide vaccines to patients. However, as a system, 23 The main three goals of the EPI in the contemporary context are the elimination of polio, measles and neonatal tetanus. 10 Although these figures may seem impressive, there are other convening factors that relate to actual vaccination uptake.…”

Spatiotemporal clustering analysis of Expanded Program on Immunization (EPI) vaccination coverage in Pakistan

“…According to Pakistan Labour Force Survey 2014-2015, rural to urban migration accounted for 22.5% of the total flow of migrants within and between districts and out of these migrations, 43.8% in Balochistan, 25.1% in Punjab, 21.1% in KPK and 13.9% in Sindh 46 . These migration trends may explain the low vaccination coverage due to more missed children in Balochistan and higher vaccination trends in Sindh 23,47 . Also, the heterogeneities in coverage of different districts and provinces is a key factor in non-achievement of desired periodical targets and eventually of herd immunity at the subnational and national levels.…”

“…Statistics from different sources in Pakistan have reported varying percentages of vaccination coverage, ranging from 40 to 80% with wide variations between provinces as well as between male and female children 22 . The higher percentages for vaccination coverage are generally reported by the government while some researchers and non-governmental agencies have reported low vaccination coverages across Pakistan over the time [23][24][25] . This variation may be attributed to the methodology adopted in collection of data (recall/record base data, estimation of the numerators/denominators), over/miss-reporting of the collected data, training/skill of the field teams and some other socio-geographical factors (parents' knowledge, religious beliefs and accessibility to health facility).…”

Viral infections in Pakistan: prevalence, factors affecting spread, and recommendations for control

“…Punjab has the highest rates of childhood immunization while Balochistan has the lowest [125]. In recent years, although the immunization rates in Punjab and Khyber Pakthunkhwa have improved, Sindh and Balochistan have witnessed a decline in their rates of childhood immunization [126]. Furthermore, it has been noted that the vaccination rates among adults are significantly lower than even those of children, despite a majority of adults considering adulthood vaccination to be important.…”