Understanding Pakistan’s Immunization Problem

Understanding Pakistan’s Immunization Problem: A Transactional Approach I

Associated Materials

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 Dr. Sameen Mohsin Ali  (LUMS)  and Dr. Samia Waheed  (UNICEF) 


Dr. Sameen and Dr. Samia’s work is targeted to look into the demand and supply side issues in the policy for providing vaccinations in Punjab region. They hypothesize that the government’s policy on vaccinations lacks understanding of the local context and how people access health services. 

This study explores two aspects of public health provision with regard to vaccinations:

(i) the processes of decision-making and policy implementation in the Punjab Department of Health, and;

(ii) the cultural, economic, and social context of Pakistan’s EPI, looking at it not as a top-down medical program but as a transaction with costs and benefits for all concerned—the providers and the consumers 

They hypothesize that the reforms that the Punjab government has introduced in the health sector in general, and in the EPI in particular, have been haphazard and piecemeal. They are stymied by a lack of understanding of the local context in which citizens access health services such as vaccinations and the circumstances in which staff provide them. It is argued that this lack of understanding is a direct result of overly centralized decision-making and a lack of local autonomy over health policy, resulting in policies and program designs that are unable to adapt to the needs of local populations. This work is an attempt to provide local context to inform policy-making, in the district of Kasur and beyond.