Understanding Pakistan’s Immunization Problem – A Transactional Approach (II)
Dr. Sameen Mohsin Ali (LUMS) and
Dr. Samia Waheed (UNICEF)
This project builds upon the research conducted during the first round of funding under PHRG Cycle 1 (Understanding Pakistan’s Immunization Problem: A transactional Approach I}.
The earlier pilot study was aimed at mapping the ‘field’ and conducting a survey in Kasur on the demand and supply side of the immunization problem. And it hypothesized that health sector reforms are “stymied by a lack of understanding of the local context in which citizens access health services”, as a direct result of over-centralization of policy making. The preliminary results from original hypothesis that the EPI program is implemented as a top-down medical program while being looked upon by communities as a transaction between the state and its citizens with costs and benefits for all concerned, holds.
Drawing on the qualitative and quantitative fieldwork in Kasur, a custom designed intervention is proposed that provides families with readily available, properly contextualized health education regarding vaccinations through the medium of the elder women of the community, or those with credibility (grandmothers, for instance). This intervention takes a community specific, human centred approach by drawing on the respected position that older women hold within their families and communities and using their influence to enhance parents’ knowledge of immunization.
The aim is to implement this intervention in specific clusters within our pilot study district and evaluate the results by comparing household survey results on knowledge of vaccines and coverage estimates before and after the intervention. And the hypothesis is that this intervention will have a positive impact on the results of the vaccination program in the district. Based on results, an argument will be made for the intervention to be scaled up and incorporated into the EPI’s program design nationally.
This project has been published in the Journal of Behavioral Public Administration. You can read the report here.