Immunisation programme fails to achieve targets in Balochistan and FATA

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Despite the government’s tall claim, Pakistan is yet to achieve the expected benchmark of the immunisation indicators, as 26 districts of Balochistan and FATA as a whole have poorly performed in routine Expanded Programme on Immunisation (EPI).

According to the document available with Pakistan Today, out of 147 districts of Pakistan, 59 districts are performing quite poorly in the routine EPI coverage.

The recent years’ administrative coverage reports received by respective provinces projected bleak future for children of Pakistan especially Balochistan and FATA; however situation in Punjab is satisfactory.

The documents show that a total of 26 districts of Balochistan and almost all districts of FATA performed alarmingly low, while 10 districts of Khyber-Pahtunkhwa (KPK), three districts of Sindh and two districts of Punjab are included in low performance districts.

The EPI programme will be expanded to include older children, adolescents and adults and work in synergy with other public health program would be started in order to control disease and achieve better health for whole population.

Federally Administered Tribal Areas (FATA) is the least developed regions of Pakistan as per human development indicators, and the primary healthcare programs in FATA are severely compromised due to the prevailing precarious security situation; therefore vaccination coverage is extremely poor in all agencies and FR areas.

Like FATA, Balochistan is also an underdeveloped and security-compromised region with poor health indicators and less-developed population, which is evident from the fact that 26 of its districts show very less EPI coverage.

Similarly, the documents show that situation in KP is quite unsatisfactory as 10 of its districts have low coverage of routine EPI, while three districts of Sindh i.e., Kambar, Jacob Abad and Karachi also performed poorly in this regard.

The situation in Punjab is comparatively satisfactory, as only two districts out of 36 i.e., D.G Khan and Rajanpur have poor EPI coverage.

Gilgit-Baltistan’s districts Hunza Nagar, Diamer and Ghizer are among the low coverage districts of the country for routine EPI especially due to poor infrastructure and hard to reach areas.

Official in ministry of health said that an integrated approach is needed across the country especially Balochistan, FATA and KPK for improving the routine immunisation so the eligible children and women could be provided with vaccination against Vaccine Preventable Diseases (VPDs).

He said that the key challenges compromising the achievement of desired vaccination coverage in least develop districts and areas are weak EPI infrastructure, HR deficiency, inaccessibility, illiteracy, inadequately monitoring and supervisory systems, insufficient cold and storage capacity among other things.

However, he said that these should not be used as an excuse and expressed optimism that the set target would be achieved soon, as efforts afoot to deal with these challenges are underway.

The data available on Ministry of National Health Services Regulations and Coordination (MNHSR&C) website shows that the routine reporting from provinces and areas indicates an overall coverage of about 80 per cent; however Pakistan Demographic Household Survey (PDHS) depicted overall national full child vaccination coverage of only 53.8 per cent.

The WHO created the EPI in 1974 as a means to continue the great success that had been achieved earlier with the eradication of smallpox. At that time, less than 5 per cent of the children in the developing world were receiving immunisations. At present EPI protected the children against nine vaccine preventable diseases which include poliomyelitis, neonatal tetanus, measles, diphtheria, whooping cough, hepatitis-B, Hib pneumonia, meningitis and childhood tuberculosis.

The diseases are preventable and can be eradicated like smallpox, as very safe and effective vaccines are available.27 per cent of deaths in children of 5 years age group are caused by vaccine preventable diseases.

Immunisation is one of the most successful and cost effective health interventions.