19 May 2004	Wednesday	28 Rabi-ul-Awwal 1425

KARACHI, May 18: The routine immunization is considerably poor though 20,000 outreach teams are working in the province. This was stated by the director-general of provincial health department, Hussein Bukhsh Memon , while addressing the EPI Review Meeting, which was chaired by Sindh Health Secretary Ashiq Hussein Memon.

He said that the community response was said to be not encouraging which reflected poor communication skills and need of proper training to staff and volunteers. Out of 11 confirmed cases of polio reported in the country during the current year, he said, the share of Sindh came to five.

While last year, the total number of confirmed polio cases across the country was 99, he added. One each of these cases were registered at Karachi, Jacobabad and Nawabshah while two cases were registered in Ghotki district this year. Punjab and the NWFP each reported three cases during the same period.

While suggesting the need for technical inputs to be developed by the WHO for better results, he explicitly highlighted the shortcomings noticed during the National Immunization Days in April 2004 Round in different districts of Sindh.

The participants of the meeting came forward with various recommendations. Lacunae identified during the exercise, in different parts of the province, included not up to the mark training of personnel involved.

Weak door-to-door marking, poor adherence to micro-plan on part of certain teams, unsatisfactory involvement of nazims and councilors, weak social mobilization - particularly in remote villages were the other reasons.

Low number of female teams was also identified as a problem in certain areas. It was also noticed that the micro-planning in certain areas lacked the list of centres.

It was highlighted that maps carried by teams were mostly not prepared by themselves and the teams were often found unable to describe the areas and boundaries.

EPI-Sindh Project Director, Dr Imtiaz Mughal, in his presentation reiterating that children need to be immunized against all diseases preventable through timely vaccination mentioned that the province could attain 27 per cent coverage rate against BCG, 22 per cent against DPT-3 and 21 per cent against measles respectively during the first four months of the current year.

This, he said, had to be brought to a minimum level of 28 per cent in context of each of the diseases as then only the province could attain the set target of at least 80 per cent annual coverage rate.

Ironically, it was not only in remote areas that the reported routine vaccination coverage rate was observed not very satisfactory but even in Karachi, towns like Lyari were found to have a mere 15 per cent coverage for DPT-3 and 20 per cent for measles compared to 33 per cent for BCG. In Landhi Town, it came to 21 per cent for BCG, 19 per cent for DPT-3 and 21 per cent for measles.

Even in Gulshan-e-Iqbal, it was 17 per cent for BCG, 19 per cent for DPT-3 and 16 per cent for measles. In Saddar Town, the routine coverage from January to April this year for BCG was 42 per cent, yet for DPT-3 it came as low as 22 per cent and for measles 25 per cent.

The data presented regarding routine coverage across the province reflected concerted efforts to improve the same in both rural and urban areas. Among others, Rana Syed of UNICEF-Sindh, Dr Ghulam Nabi Kazi and Dr Yahya Mostafa of WHO and EDOs from various districts were of consensus opinion that the efforts to eradicate diseases through NIDS and SNIDS could not sustain without efficient routine programme. -APP