New Journal Article on Inequity in Pakistan’s Immunization Services

A new article in the World Journal of Vaccines highlights the process the Sindh Government took to develop strategies and interventions to mitigate inequity in immunization services to achieve universal immunization coverage.

With a population of over 16 million, Karachi is the largest city in Pakistan, with nearly half of the population living in one of its 988 slum areas. It also has the highest density of unvaccinated and under-vaccinated children, due to a health care system that lacks governance and accountability and offers weak and inequitable immunization services. The urban poor, in particular, do not trust and therefore do not seek immunization services, which has led to frequent outbreaks of measles, poliovirus, and more recently, COVID-19.

JSI authors collaborated with the federal and state Expanded Programme on Immunization and Gavi to highlight the Sindh Government’s experience. This included a situation analysis, and multi-layer stakeholder and partner input to close gaps in governance, leadership and accountability, service delivery, and demand for and trust in immunization services. The strategy consisted of multiple initiatives including hiring more vaccinators, refurbishing vaccination centers, offering immunization in the evening for working families, and involving the private sector and community and religious leaders.

Initiatives such as these can be adapted for other countries experiencing similar challenges with their health systems.