OPV III immunization in all provinces of Pakistan
Following the successful eradication of small pox, World Health Assembly (WHA) decided to target polio virus eradication. By the efforts of World Health Organization (WHO) program Global Eradication of paralytic poliomyelitis has been eradicated from America, Western Europe, and many other regions of the world. Expended program on immunization began in Pakistan in 1976 and expanded countrywide by 1978. Both regionally and worldwide EPI has a significant impact on poliomyelitis eradication performance. Pakistan is achieving immunization targets set globally and has made progress towards achieving Millennium Development Goal 4. But lack of parent knowledge, limited access to immunization services and poor managements are present as hard barriers in front of immunization progress. Every year vaccines for approximately 5.8 million children are procured by the program. More than 30 million children are immunized in every round of polio supplemental immunization activities. EPI is the exclusive provider of immunization in Pakistan and about 3% of immunization is provided by private sector. Each year Over 6000 permanent centers and more than one million outreach and mobile vaccination sessions provides immunization services. Over 10,000 vaccinators and approximately 6000 lady health visitors (LHVs) are assigned in these centers. About 100,000 lady health workers (LHWs) also aid in routine and supplementary immunization activities.
Materials and methods
Several Government documents, survey reports and unpublished program documents were studied and online searches were made to find literature on EPI Pakistan. World Health Organization (WHO), United Nations Children’s Fund (UNICEF) and other websites were also explored. The EPI program official database was also analyzed for this study. SPSS 16 and Microsoft Excel 7 were used for the statistical analysis, tabulation and compiling of collected data.
OPV III immunization in all provinces of Pakistan
A “fully immunized child” is one who has received at least 1 dose of Bacilli Calmette-Guérin (BCG) vaccine, 3 doses of oral polio vaccine (OPV), DPT3 and measles1 vaccine. EPI programs target is to immunize children of 0-11 months against seven EPI target diseases. According to EPI surveys 2001, Khyber Pakhtunkhwa was the best performing province with 89% immunization (OPV III) in fighting against polio. The lowest immunization results were in Baluchistan and Gilgit Baldistan with 52% and 34.6% immunization respectively. The EPI surveys are regularly conducted in Pakistan by the Ministry of the Health in collaboration with WHO and other organizations that are active in fight against polio. The main aim of the surveys is to get data about the immunization, to identify the regions that are at the risk so that the special consideration should be given to these areas in planning the programs, in future.
The vaccination campaigns conducted from 2002-2004 shows approximately the same results as in previous exercise in 2001. Azad Jammu and Kashmir (AJK) and KPK were the best performing provinces with 88% and 74% immunization and Baluchistan and Gilgit Baldistan having the lowest immunization 54%, 58% respectively. The main reason for the lowest immunization in Baluchistan and Gilgit Baldistan are the poor infrastructure, low education rate, lack of political well and highly diverse and inaccessible population. In 2005, over all reported immunization was 65%, the immunization campaign highly affected due to severe earthquake in the northern area of the Pakistan, due to which a huge population migrated to the other areas of the country. The surveys conducted during 2006 to 2010 in all the province of Pakistan shows that vaccine immunization has been greatly improved in door-to-door immunization campaigns.