Immunisation is the most cost-effective health intervention against preventable diseases affecting the poorest of poor sections of society. These views were expressed at a meeting on “Poverty and Social Impact of Expanded Programme for Immunisation in Pakistan”, organised by the Sustainable Development Policy Institute (SDPI) on Wednesday.
They called for a comprehensive inquiry in to exploring linkages between health and poverty and also the factors that negatively influenced health sector outcomes. They said Pakistan had the second highest poverty level and the highest infant mortality rate in South Asia.
The poorest of the poor segments of society have inadequate health service utilisation and unhealthy sanitary and dietary practices, which subsequently causes them to have poor health status. This poor health status leads to diminished incomes making them further vulnerable to terminal diseases. Speakers talked about very low percentage of birth registration and vaccination card recall in Pakistan. They demanded to make vaccination cards mandatory for admission in schools at kindergartens’ level and proposed to link polio campaign with incentives for the people. The consultation was attended by representatives from Ministry of Finance, Planning Commission, World Health Organisation (WHO), UNICEF, UNDP, World Bank, Extended Programme on Immunisation Unit at the National Institute of Health, National Health Services Academy, Pakistan Institute for Development Economics, civil society organisations and members from medical community.
Joint Secretary and National Project Manager Poverty Reduction Strategy Monitoring Sajjad Shaikh said Pakistan demonstrated well in polio immunisation until 2004, but it was a matter of concern that the country was still one of the polio-endemic countries with a rise in polio cases in recent years. Stressing the need of Poverty and Social Impact Analysis (PSIA) of immunisation programme to gauge impacts of public policies, he urged researchers to identify gaps with empirical evidences and recommendations for policymakers to improve health situation in the country.
Dr Sofia Ahmed of Pakistan Institute of Development Economics (PIDE) highlighted the current crisis in immunisation and shared the methodology of proposed study to analyze impacts of immunisation programme in Pakistan. She called for a conceptual framework to link institutions that influence health sector outcomes. During discussion, participants deliberated on the relevance, objectives, ground realities, cost-effectiveness and sustainability of any baseline study on the subject. Participants also observed that people in Pakistan mostly relied on private sector for health services whereas immunisation was provided only by public sector, which could be another reason of deduced coverage. They also cited education, gender, age, religion, culture, family and community background, law and order, environment, climate and disasters as other factors.