PAKISTAN ARMED FORCES
MEDICAL JOURNAL (Category Y)

A Journal of Army Medical & Dental Corps

Being published since 1956

ISSN (online) 2411-8842
ISSN (print) 0030-9648

VOL 68, No. 2, APRIL 2018

ESTIMATING ORAL POLIO VACCINE COVERAGE DROPOUTS FOR EQUITABILITY: EVIDENCE FROM PAKISTAN

Aneel Salman, Muhammad Iftikhar Ul Husnain, Tahir Ul Mulk Kahlon*

Abstract

Objective: To analyze the effectiveness of expanded program on immunization (EPI) in Pakistan by finding proportion of children who have received at least one dose of oral polio vaccine (OPV) to prevent poliomyelitis but failed to receive 2nd & 3rd dose before the end of their 1st year of life.
Study Design: Retrospective study.
Place and Duration of Study: The study was carried out at Sustainable Development Institute, COMSATS Institute of Information Technology and National Defense University Islamabad, from Jan 2015 to Mar 2016.
Material and Methods: Method of multivariate regression and odds ratio were used on Pakistan demographic and house hold survey micro-datasets to analyze the effectiveness of expanded program on immunization (EPI) in Pakistan by finding the proportion of children who have received at least one dose of oral polio vaccine (OPV) to prevent poliomyelitis. Drop-out (DO) rate was calculated in order to assess effectiveness of coverage-breadth.
Results: Gaps in service delivery, ineffective communication with mothers and entwined poverty dimensions are contributors to low coverage statistics and Drop-out (DO) rate of children in context of polio vaccination. Female children do not benefit to the same extent from polio vaccination efforts as male counterparts. Empowered mothers with good health seeking behavior care better for their children. Education is another key factor with major impact on health system service utilization and acceptability.
Conclusion: Gaps in service delivery, ineffective communication with mothers and entwined  poverty dimensions are contributors to low coverage statistics. Education is the key factor with major impact on health system service utilization and acceptability. Due to cultural norms in society gender discrimination is observed in all provinces which shows that girls are more likely to be vulnerable as compare to their male counterparts.

Keywords : Equitable delivery, Polio, Program evaluation, Systems research.



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