Pakistan might have come a long way in reducing child morbidity and mortality over the past 30 years, nevertheless, cases of vaccine preventable diseases (VPDs) remain high, with the benchmark still a distant sight, the World Bank said in a progress report on Child Immunisation.
By Khushi Malhotra
The government of Pakistan has done much to vaccinate infants and children against preventable diseases. But, a lot more remains to be done.
A World Bank policy note on child immunization in Pakistan, assessing the country’s progress says that over the last three decades, the country saw an increment of 117 per cent in the number of fully immunized children (aged 12 to 23 months). More than 76 per cent infants got vaccinated in 2020.
This is in contrast to the situation in 1990 when only 35 per cent of Pakistani children were immunized. The burden of life threatening vaccine preventable diseases (VPDs) also reduced by promising numbers. For example, diphtheria reduced by 94 per cent and measles by 88 per cent.
Jugglery of numbers?
The mammoth task of immunizing little babies was made a priority by the government of Pakistan in 2016. The government initiated the National Immunization Support Project (NISP) with a five-year deadline, closing in 2022 to ensure universal coverage in immunization. The plan incentivized the government’s EPI (Expanded Program of Immunization) that was designed to reduce the worrisome rate of child morbidity and child mortality.
There was a tremendous amount of growth in the rate of immunization coverage within three years of implementing NISP. But the disparities between the provinces did not improve despite this acceleration.
Evidently, most of the government’s attention went into the provinces of Punjab, where about 90 per cent of the children (aged 12 to 23 months) were fully immunised in 2020. The absolute numbers were good enough to heighten the impression of the country’s overall performance, but individual provinces proved to be laggards.
For instance, during the same year, the figures for the north western province of Khyber Pakhtunkhwa was 68.4 per cent. Sindh had vaccinated just above 60 per cent of its children in the same age group and only 37.6 per cent of the children were vaccinated against preventable diseases in Balochistan.
Low immunization coverage
When compared to other eastern and SouthAsia regions with similar income levels, immunization coverage in Pakistan was found to be considerably low. With a GDP of over 4.9 per cent, the rate of immunization for DTP3 was only 75 per cent in the country. The only SouthAsian country with a gap lower than Pakistan is Afghanistan which has a much lower GDP.
Perhaps, due to the holes in the coverage strategy, Pakistan was also found to be one of the two SouthAsian countries where poliomyelitis is still an epidemic. Even in 2020, Pakistan had the second highest cases of Diptheria after India and Polio after Afghanistan and fourth highest cases of Measles amongst the SouthAsian countries, the World Bank study observed. Sri Lanka had the least number of all the VPDs amongst all.
While wrapping up the report, World Bank has advised Pakistan’s government to proactively invest in EPI and enhance their healthcare system by increasing the number of vaccination sites, providing the required assistance to the areas with high instances of VPDs and ensuring sustainable means for financing for EPI to improve conditions of underperforming provinces. The country needs to adopt new and innovative designs and strategies to get the benchmark immunity coverage, the study says.