KARACHI, Feb 28: Sindh Manager (Operations), the World Health Organization, Dr Mohammad Azmoudeh, has called for a pragmatic administrative approach to help Pakistan attain the zero polio prevalence target by the end of current year.

He was speaking at the two-day meeting, held to review the strategy for the National Immunization Days, which concluded here on Saturday.

Dr Azmoudeh observed that rapid transfers of EDOs especially during campaign largely hindered its success and hence such transfers must be avoided as much as possible. He said that area supervisors, concentrating in specific areas of their jurisdiction without any unnecessary administrative interference, were the key to a campaign's success. He said that this point was also underlined by Dr Yahya Mustafa of the WHO.

Expressing his optimism about reaching zero level of polio prevalence by the end of current year, he said that everybody was putting maximum efforts to reach the goal, but the task was very difficult.

"Health department can't do the job alone," he commented adding that inter-sectoral collaboration is vital for success.

The EPI Consultant of WHO, Geneva, Mr Julian, said that the required resources and technical skills were available here and only proper utilization of the same was required to achieve the goal.

According to him, main problems are the "Hidden Children"- below six months old as majority of the confirmed polio cases seen are infants. Focus should be made on planning to cover these young children, he said and stressed need to encourage female participation.

In his presentation on "Progress in Pakistan", WHO Country Representative Dr Anthony Mounts observed that out of two only five cases were registered in the later part of the year 2003. He said the fact that peak season went without any polio case was a positive sign, which reflected that polio virus transmission could be stopped.

"We (people of Sindh) are very near to our goal. But, one must be cautious in celebrating the achievement, as the virus can attack again like it did in the case of Punjab," he said.

Dr Mounts said that no confirmed polio case in January 2004 was a record as this had never happened in the history of Sindh.

Referring to the risk factors for continued virus circulation, he said that these included inconsistent campaign coverage; repeated failure to reach 95 per cent population and excessive missing of the youngest age group. He maintained that one good round was not enough and a strategy should be ensured under which average coverage could be predictive.

He urged the need to do away with the inconsistent leadership, frequent changes of district leadership or uninvolved district leadership that could not be restricted to the EDO.

With regard to problems faced in Pakistan, the WHO country representative said that it was mainly the socially conservative population resistance to strangers coming into community and resistant to women involvement in the programme, besides high population of the country.

For the challenges conceived for 2004 and for which three National Immunization Rounds have been scheduled from January to April, he suggested that resources should be focussed and attention must be paid on high risk areas.

The WHO representative also submitted the need to increase the number of external consultants in high risk districts followed by increased engagement of local political leadership and civil administration.

Sindh Additional Secretary Dr Iqbal Dewan, who chaired the concluding session, said that Pakistan was fully cognizant of its responsibilities and each and every segment of the society was thus being activated to play its role in polio eradication.

The EPI-Sindh Project Director, Dr Imtiaz Mughal, presented some district-wise indicators, which were not found up to the mark in the National Immunization Days of January 2004 and which needed proper and timely planning for improvement prior to the National Immunization Days of March.

At the meeting, all the EDOs gave their feedback on the problems and constraints faced by them and assured the secretary of their commitment to the polio eradication initiative and promised to ensure that the coming March NIDs would yield the desirable results.

Earlier, Sindh Secretary Health Ashiq Hussain Memon observed that poor coordination amongst the people working in the field from various agencies could be the reason for the delay in attaining the objective. -APP