March 26, 2008	Wednesday	Rabi-ul-Awwal 17, 1429

KARACHI, March 25: The Expanded Programme on Immunisation (EPI), Sindh, has decided to refocus the routine immunisation efforts to realise the goal of making Sindh a polio free province.

Talking to Dawn on Tuesday, the Project Director of EPI, Sindh, Dr Salma Ali, claimed that efforts were being intensified to contain the polio virus in the province. There have been three reported cases of polio in Hyderabad, Nawabshah and Shikarpur districts during the last two months.

She believed that polio would be eradicated from Sindh and it would happen as soon as the routine immunisation coverage was enhanced. “The ideal is achieving 100 per cent routine immunisation coverage, but it will be satisfying if we get around 80 per cent coverage overall in all districts and union councils of the province,” she observed.

She said that the routine immunisation of children was part of a well-established four-pronged strategy of polio eradication, including supplementary immunisation activity, acute flaccid polio surveillance and mop-up immunisation.

She said the district governments and city district government Karachi had also been asked to furnish plans aimed at the enhancement of routine immunisation. “In order to ensure implementation of the plans the EPI would provide funds to the districts and city district government Karachi, but a third party evaluation would also be made after three months to find out the outcome,” she added.

According to Dr Ali, as an incentive, 40 town surveillance officers and district surveillance officers meant for surveillance of vaccine preventable diseases are also being provided with a special amount of Rs4,500 per month to spend additionally on their mobility and transportation.

She said the importation of the polio virus from other provinces and from neighbouring countries has also been a source of concern for anti-polio workers in the province.

Vaccination centres

To contain the importation, she said, the Sindh EPI has now released an amount to the tune of Rs800,000 for its 26 oral polio vaccine administration posts established for inter-city and inter-province child travellers at entry and exit points in the province to make them round-the-clock vaccination facilities.

She said the EPI had decided to run these centres round-the-clock from mid-January, but things could not go in the right direction due to the paucity of funds.

“Now we have allocated and released the funds to the centres for a period of three months under an ad-hoc arrangement so that the salary component required for arrangement of staff for additional shifts at the centres could be met,” she said.

“These centres – known as permanent centres – are at present run in one shift of six to eight hours, where paramedical or other health staff belonging to the district government concerned is supposed to vaccinate every child visiting the cities of Sindh by trains, planes or ships,” she added.Experts are of the opinion that the routine immunisation coverage factor had been failing to get enough and sustained attention in Sindh as well as other provinces of the country. “There is a need to strengthen the routine immunisation for long-term success,” said an observer.

According to a source privy to the immunisation programme, a cluster evaluation survey regarding immunisation carried out about two years ago in the province had shown that only a couple of districts – including Karachi and Hyderabad – had the routine immunisation coverage of between 75 to 85 per cent, while other districts had coverage ranging from 55 to 65 per cent.

On occasions, the government officials stressed the introduction of a national health immunisation card or linking the routine immunisation with admissions in primary schools, but nothing could be seen on the ground, the source added.