AKU helped drive the number of polio cases in Pakistan to its lowest level ever by introducing an innovative and influential immunization strategy in conflict-ridden areas.
Working in high-risk communities of Karachi, Khyber Pakhtunkhwa, the Federally Administered Tribal Areas and the border area of northern Sindh and Balochistan, researchers increased polio vaccination rates through health camps where a range of services were offered, including immunizations. That represents a shift from door-to-door, vaccination only campaigns.
Taking its cue from the results, the government implemented the health-camp approach in numerous areas, helping to slash the number of cases of the crippling disease from 306 in 2014 to 20 in 2016, with declines continuing into 2017.
“Our results showed the government that it could increase community demand for vaccination among hard to-reach and insecure populations with vaccine hesitancy,” said Professor Zulfiqar Bhutta, Founding Director of the AKU Centre of Excellence in Women and Child Health. “It got the system moving.”
In total, more than 250,000 children were immunized against polio by the project, which brought together AKU, the Ministry of Health, the Trust for Vaccines & Immunization and Peshawar Medical College. The Bill & Melinda Gates Foundation funded the ongoing initiative, which is expanding its work in Balochistan, with
a US$ 7.7 million grant.
Polio is only one of many vaccine-preventable diseases that cause immense suffering in Pakistan. In fact, with nearly half of the country’s children going unvaccinated every year, tens of thousands die from diseases such as pneumonia and diarrhoea. But that can change, as shown by a pilot project led by Associate Professor Shehla Zaidi in rural Tando Muhammad Khan district in Sindh.
When the effort began, only 12 per cent of children were receiving the required three doses of pneumococcal conjugate vaccine and only 22 per cent were receiving the required three doses of pentavalent (five-in-one) vaccine. In one year, the project tripled the figure for the former and nearly doubled it for the latter.
Working with the Sindh Expanded Programme on Immunization and the district government, Dr Zaidi and her team have trained immunization managers and health facility staff, educated the public through radio bulletins and equipped vaccinators with a smartphone application developed by the Aga Khan Development Network’s eHealth Resource Centre. Vaccinators take photos of each child they immunize using the app, which also records date, time and location, enabling managers to monitor vaccinators and ensure that reported activity matches real activity.
The project’s success has captured the interest of the Government of Sindh's Health Department, which has signed a memorandum of understanding with the University, under which AKU will advise it on scaling up the initiative. If the results are anything like those of the pilot, numerous lives will be saved. “It shows what happens when you bring together evidence and innovation to improve the health system,” Dr Zaidi said.