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Empowering communities and strengthening vaccination in urban slums of Karachi, Pakistan

posted Apr 24, 2018, 2:12 AM by GAVI CSO   [ updated Apr 24, 2018, 2:20 AM ]
By Amna Tanweer Yazdani and Yasir Shafiq 


According to a recent WHO report on the global measles and rubella surveillance data, Pakistan is facing a grave and colossal challenge, with more than double the number of reported measles cases in 2017 than in 2016. Moreover, Pakistan held the lion’s share of reported measles cases in the Eastern Mediterranean region in 2017. 

While these worrisome figures have spurred plans for a nationwide anti-measles campaign in 2018, preemptive measures and vaccine provision by CSOs can additionally be highly effective and are important to prevent ongoing outbreaks. This is especially critical in the urban slum areas and informal settlements where national health services don’t always reach. In these areas, there is a high risk of outbreaks due to low adherence to routine immunization. Further, lack of immunisation is as widespread as malnutrition in children which is a particular concern in measles outbreak - the frequency and severity of measles in malnourished children is higher and the resulting complications are more serious, leading to higher mortality rates. 

Due to their on-ground presence and long-standing relations of trust in their communities of operation, CSOs are pivotal in Pakistan’s endeavor to stop the measles outbreaks and achieving 95 percent vaccination coverage. Their role in mobilizing and counseling vaccination-resistant communities is what can make the difference between a fully immunized child and a child who is not immunized and suffering uneccesarily from vaccine preventable diseases. 

VITAL Pakistan Trust (VPT) is a CSO operating in several slum areas along Karachi’s coastal region. VPT uses community mobilization techniques to increase vaccination uptake and adherence, coupled with effective service delivery through liaison with vaccination providers and partners. VPT employs mobilizers, and works with community health workers from within the community, to facilitate counseling sessions, outreach visits, to improve awareness and knowledge about the importance of immunisation as well as facilitating meetings with community influencers and local government officials to improve vaccination coverage. They are key vaccine ambassadors in the local community working directly with families and exisiting health services. 

Additionally, VPT is working with its partners to identify and resolve program-side barriers. These include working to addres challenges to documentation and follow-up of vaccination refusals/defaulters, as well as the need for catch up campaigns for the large numbers of un-immunized children who are at risk for measles. Two key achievements from VPT’s community activities is the engagement with local communities to create a demand for vaccination, while also helping to embedd micro-level data on vaccination status of under-five children in the surveillance area in which they work. 

VPT community mobilizers Marvi and Nusrat counsel a group of mothers in Rehri Goth on the importance of routine immunization.
Photograph: Danish Ali, VITAL Pakistan Trust 
  
VPT community mobilizers introduce educational handouts on routine immunization during a counselling session.
Photograph: Danish Ali, VITAL Pakistan Trust

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