KARACHI, Nov 17: Senior health officials at an inter-provincial coordination meeting have called for induction of more staff and new vehicles besides increased and timely release of operational costs to meet the targets of routine and special polio immunisation programmes.

The coordination meeting for expanded programme of immunisation was organised by the Sindh health department on Monday. Federal Minister for Health Aijaz Hussain Jakhrani was the chief guest.

It was said that the objectives of the expanded programme on immunisation run at the national and provincial levels included reduction of mortality and morbidity from the seven preventable diseases in children by administrating good quality oral polio drops and routine vaccines in children under five.

According to the latest reports and surveys, the routine immunisation coverage is 47 per cent at present and polio immunisation coverage in the country ranges from 80 per cent to 95 per cent. Besides, health authorities have confirmed 101 polio cases across the country with the highest number of cases (ie 40) in the NWFP, followed by 29 in Punjab, 16 in Sindh, 10 in Balochistan, and five in Islamabad and other areas.

Sindh Health Director-General Dr Ghulam Nabi Memon said that there was a need for an institutionalised system of accountability to help improve the programme. He complained that the EDOs-health and town health officers and district governments did not own the programme. Also, frequent transfers and postings of high officials in the districts and posting of inexperienced officers also hampered the polio eradication and routine immunisation programmes in Sindh, he added.

Since the vehicles available with the immunisation programme were turning old there was a grave need to induct new vehicles, he said.

Laying emphasis on undertaking more special campaigns to cover nomadic population, particularly in the northern parts of the province, he attributed the transfer of the dreaded virus to frequent movement of people between different provinces.

Dr Pervez Kamal Khan from the NWFP attributed the highest number of polio cases reported in the Frontier province this year to persistent movements in villages on both sides of the borders with Afghanistan. He said special immunisation activities for polio eradication and routine immunisation remained an insurmountable task due to ongoing fight, low-literacy rate, conservative community and other factors.

A major hurdle was inaccessibility to the target population of children because many villagers had been displaced due to insecurity.

He suggested that a joint commission of health officials from Pakistan and Afghanistan should be established to strengthen supervision on all the selected points. Besides, he said, meetings of health officials on each side of the border alternatively should be conducted on a regular basis.

EPI Manager in Punjab Arshad Iqbal said the province faced a vast gap in demand and supply of vaccines like BCG, Combo, Measles and oral polio vaccines for routine programmes.

He said that the province received only 3.92 million vaccines last year against a requirement of 9.56 million vaccines, adding that the situation did not improve much this year as against a requirement of 11.81 vaccines the province only received 5.42 million vaccines.

Mr Iqbal suggested that shipments of vaccines should be made directly to the provincial immunisation headquarters instead of routing those through Islamabad. He demanded that the EPI Punjab be provided with additional 400 deep freezers and 39 single-cabin jeeps to strengthen the routine immunization programmes.

Balochistan Health Services Director-General Dr Amanullah Khan said that weak supervision and monitoring from district health management teams, non-reliability of data received from districts, poor micro-level planning, insufficient operational cost and inadequate community involvement were the major constraints in the success of immunisation programmes.

Dr Khalif-Bille, chief of the World Health Organisation’s Pakistan chapter, hailed the idea of inter-provincial meeting, citing that he personally felt that health problems were not restricted to one province and as such there was a need to formulate a comprehensive policy and make joint efforts towards achieving a collective goal.

While urging the provincial health ministers, health secretaries and officials to move for a redesigning of strategies, Dr Bille said the health officials and field workers should understand that the collective aim of local and international health organisations was to reach the 30 million children who were awaiting vaccinations against preventable diseases. This would ensure the accomplishment of universal coverage targets both in respect to routine and special polio eradication activities.

Dr Ibrahim El-ziq of Unicef Pakistan said the current polio-related situation called for critical reassessment of gaps in management, ownership, planning, service delivery, monitoring and supervision, surveillance, communications as well as routine immunization.

“Our challenges are no longer technical. They are all operational,” he observed, stressing that there was a need to understand the best way to implement a relevant strategy.

Dr Sagheer Ahmed, Ainullah Shams, Zahir Ali Shah and Mohammad Najeeb Naqi, the health ministers from Sindh, Balochistan, the NWFP and the Azad Jammu and Kashmir, also spoke. Besides, Excise Minister from Punjab Mujtaba Shuja Rehman also attended the meeting.

They maintained that their respective governments were fully committed to immunisation activities and ensuring a fool-proof monitoring and surveillance system to help achieve the health targets.