Butt Mahreen, Mohammed Raihan, Butt Eman, Butt Sundas, Xiang Jinpo
Institute for Global Health, University College London, London, UK.
Department of Medicine, University of Cambridge, Cambridge, UK.
Risk Manag Healthc Policy. 2020 Feb 12;13:111-124. doi: 10.2147/RMHP.S211170. eCollection 2020.
Immunization is one of the most successful public health initiatives in recent times. It is, therefore, worrying to learn the level of under-vaccination in Pakistan. Diseases that have been successfully eliminated through the aid of vaccination in other countries have not been eliminated in Pakistan. The reasons for this vary and show the uniqueness of the economic, healthcare and environmental landscape of Pakistan, through which public health programmes need to be implemented. The "Expanded Programme of Immunization" (EPI) is the main programme through which routine immunization is provided to the public. Within Pakistan, it has encountered many problems since its inception. This includes logistical obstacles, inefficient health worker attitudes, parental and female awareness, and education, the influence of religious community leaders and the complications that accompany conflict. When compared to globally standardised targets for immunization, Pakistan is trailing behind. Not achieving these targets is worrying from both a global perspective and within the national healthcare landscape of Pakistan. Research is necessary to bring together findings on the failings of routine immunization and polio campaigns; there are many intersecting factors that global health bodies and the Department of Health in Pakistan must address in order to relieve the burden of vaccine-preventable diseases (VPDs).
免疫接种是近年来最成功的公共卫生举措之一。因此，得知巴基斯坦的疫苗接种不足程度令人担忧。在其他国家借助疫苗接种已成功消除的疾病，在巴基斯坦并未消除。其原因多种多样，显示出巴基斯坦经济、医疗保健和环境状况的独特性，而公共卫生项目需要在此背景下实施。“扩大免疫规划”（EPI）是向公众提供常规免疫接种的主要项目。在巴基斯坦，该项目自启动以来遇到了许多问题。这包括后勤障碍、卫生工作者态度低效、家长和女性的认知与教育、宗教社区领袖的影响以及冲突带来的并发症。与全球标准化的免疫接种目标相比，巴基斯坦落后了。从全球角度以及在巴基斯坦国内医疗保健领域来看，未实现这些目标都令人担忧。有必要开展研究，汇总常规免疫接种和脊髓灰质炎防治运动失败情况的调查结果；全球卫生机构和巴基斯坦卫生部必须解决许多相互交织的因素，以减轻疫苗可预防疾病（VPDs）的负担。
