Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada.
Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan.
Expert Rev Vaccines. 2021 Jun;20(6):661-678. doi: 10.1080/14760584.2021.1915139. Epub 2021 May 10.
: Established in 1994, Pakistan's polio program demonstrated early success. However, despite over 120 supplementary immunization activities in the last decade, polio eradication efforts in Pakistan have been unable to achieve their objective of halting polio transmission. Variable governance, and inconsistent leadership and accountability have hindered the success of the polio program and the quality of the campaigns. Insecurity and terrorism has interrupted polio activities, and community fears and misbeliefs about polio vaccinations continue to persist.: The article consists of a systematic review of the barriers and facilitators associated with the delivery of polio eradication activities in Pakistan. We also provide a comprehensive review of the policy and programmatic decisions made by the Pakistan Polio Programme since 1994. Searches were conducted on Embase and Medline databases and 25 gray literature sources.: Polio eradication efforts must be integrated with other preventive health services, particularly immunization services. Addressing the underlying causes of polio refusals including underdevelopment and social exclusion will help counteract resistance to polio vaccination. Achieving polio eradication will require building health systems that provide comprehensive community-centered care, and improving governance and systems of accountability.
1994 年成立的巴基斯坦脊髓灰质炎计划取得了早期成功。然而，尽管在过去十年中开展了 120 多次补充免疫活动，但巴基斯坦的根除脊髓灰质炎努力仍未能实现阻止脊髓灰质炎传播的目标。多变的治理以及不一致的领导和问责制，阻碍了脊髓灰质炎计划的成功和运动的质量。不安全和恐怖主义中断了脊髓灰质炎活动，社区对脊髓灰质炎疫苗接种的恐惧和误解仍然存在。本文对与在巴基斯坦开展根除脊髓灰质炎活动相关的障碍和促进因素进行了系统回顾。我们还全面审查了自 1994 年以来巴基斯坦脊髓灰质炎方案作出的政策和方案决定。在 Embase 和 Medline 数据库以及 25 个灰色文献来源中进行了搜索。根除脊髓灰质炎的努力必须与其他预防保健服务，特别是免疫服务相结合。解决脊髓灰质炎拒绝接种的根本原因，包括欠发达和社会排斥，将有助于抵制脊髓灰质炎疫苗接种的抵制。实现根除脊髓灰质炎需要建立提供全面以社区为中心的护理的卫生系统，并改善治理和问责制度。
