COMPARATIVE STUDY OF ROUTINE VACCINATION COVERAGE OF CHILDREN LESS THAN 2 YEARS OF AGE IN LADY HEALTH WORKERS COVERED AND UNCOVERED AREAS IN SOUTH PUNJAB, PAKISTAN

The EPI structure of Pakistan is administratively union council base. Vaccinator is responsible for vaccination services in each union council. LHWs are supposed to support vaccinators in their own registered communities for vaccination activities in the field. Lady health workers have several important duties to perform but vaccinating infants against childhood communicable diseases is one of the most cost-effective public health interventions. Each union council is partially covered with LHWs. There are some areas in South Punjab where routine EPI coverage is below benchmark. The main aim of the study is to measure the performance and effectiveness of LHWs in their own communities for the vaccination of under 2 years old children. Vaccine-preventable diseases incidences are high in South Punjab. Socioeconomic status and literacy rate of population is poor in South Punjab as compared to North and Central Punjab. South Punjab is highly polio-endemic region. The incidence of measles and NNT cases are high in South Punjab. Poliovirus circulation was detected in human in District Lodhran and environmental samples in District Multan. The mortality rate is high due to poor vaccination for measles. The benchmark coverage is 80% for all the antigen of RI vaccination. Overall in Multan Division, fully immunized coverage (12-23 month that is BCG-Measles 1) is 84% in lady health worker covered areas and 76% in lady health worker uncovered areas. Statistical analysis portrays that standard deviation of fully immunized children is quite low in LHWs uncovered areas. Measles 1 and measles 2 coverage are suboptimal in LHWs uncovered areas. Community AEFI awareness is relatively better in LHWs uncovered areas as compared LHWs covered areas. Routine immunization coverage and quality are better in LHWs covered areas. Community AEFI awareness is not up to the mark in LHWs covered areas. Community participation is suboptimal in LHWs covered areas. Their role is well visible to boost up routine immunization at union council levels in each District. There is a need to extend LHWs support in uncovered areas