COVERAGE AND CAUSES OF MISSED ORAL POLIO VACCINE IN URBAN AND RURAL AREAS OF PESHAWAR
AbstractBackground: Poliomyelitis mainly affects children under five years of age. Pakistan is one of the fewcountries where wild polio is still endemic. The purpose of this study was to find out the coverage rateand factors associated with the failure of OPV in urban and rural areas of Peshawar. Methods: Thiscross-sectional study was conducted in Peshawar. Data was collected through random sampling inPeshawar University, Peshawar Saddar, Hashtnagri, Naway Kalay and Pawaka from 9th to 19th June2010. A questionnaire was used to interview parents of 548 children, aged four years and below, aboutdemographics, OPV vaccination status, reasons for missed vaccination and views on immunization andEPI staff. Forty workers from immunization staff were also interviewed through a separatequestionnaire to find out factors associated with low OPV coverage. Chi-square test was used forstatistical testing and p<0.05 was considered significant. Results: Only 64.2% children werecompletely vaccinated, 13.3 % not vaccinated at all, and 22.4% were incompletely vaccinated. Thereasons for not vaccinating were lack of awareness (23.8%), family problem/mother busy (20.8%),centre too far (21.3%), wrong ideas (10.2%), fear of reaction (7.6%), child ill (5.6%) and miscellaneouscauses (10.6%). The problems faced by the EPI staff were lack of awareness among people (32.5%),load shedding (20.0%), poor transport facilities (10.0%), unavailability of vaccines (10.0%) andinsecurity (10.0%). Conclusion: Low vaccination coverage in Peshawar is mainly due to lowawareness among people, poor economic conditions and poor salaries, insecurity and transportproblems faced by the immunization staff.Keywords: OPV, Immunization, EPI, Polio
WHO Fact sheet No. 114 November 2010. Retrieved from:
Mastny, Lisa (January 25, 1999). Eradicating Polio: A Model for
International Cooperation. Worldwatch Institute.
http://uk.ask.com/wiki/Sabin_polio_vaccine. Retrieved 7-01-2011.
Salisbury D, Ramsay R, Noakes K. Joint Committee on
Vaccination and Immunisation. Immunisation Against Infectious
Disease. Edinburgh: TSO Stationery Office; 2006. p. 313–29.
Nishtar S. Pakistan Poilitics and Polio. Bull World Health Organ
Global Polio Eradication Campaign .December 14, 2010 from
Data and Monitoring. http://www.polioeradication.org/
Nuwaha F, Kabwongyera E, Mulindwa G, Barenzi E. National
immunisation days for polio eradication in Uganda: did
immunisation cards increase coverage? East Afr Med J
Desai VP, Kowli SS, Chaturvedi RM, Sunder SS, Kumar RR,
Bhalerao VR. Effectiveness of polio vaccination coverage in
reducing the incidence of paralytic poliomyelitis in a highly
endemic area of Bombay city. J Postgrad Med 1984;30(1):1–4.
Tarin E, Khalil M, Mustafa T, Alvi ZM, Sy ITS, Thomson SJ, et
al. Impact of community-based intervention on immunization
coverage against vaccine preventable diseases in Pakistan. Pak J
Siddiqi N, Khan A, Nisar N, Siddiqi AE. Assessment of EPI
(expanded program of immunization) vaccine coverage in a periurban area. J Pak Med Assoc 2007;57(8):391–5.
Shaikh S, Shaikh S.. Immunization status and reasons for low
vaccination in children, attending OPD at Liaquat University
Hospital. Pak Paed J 2003; 27: 81–6.
Bhattacharjee J, Gupta RS, Jain DC, Devadethan, Datta KK.
Evaluation of pulse polio and routine immunisation coverage:
Alwar District, Rajasthan. Indian J Pediatr 1997;64:65–72.
UNICEF information by country: Pakistan Accessed on 6
January, 2011. Availabel from: http://www.unicef.org/
J Ayub Med Coll Abbottabad 2011;23(4)
Prislin R, Dyer JA, Blakely CH, Johnson CD. Immunization status
and sociodemographic characteristics: the mediating role of
beliefs, attitudes and perceived control. Am J Public Health
Kimbro RT. On-the-job moms: work and breastfeeding initiation
and duration for a sample of low-income women. Matern Child
Health J 2006;10(1):19–26.
Childhood immunizations in four districts in rural Pakistan: A
comparison of immunization uptake across study years (1994 and
and an analysis of correlates. Department of Community
Health and Epidemiology, University of Saskatchewan, Saskatoon.
Sultana A, Jahan S, Ahmad I. Knowledge, Attitude and Practice of
Immunization in an Urban Population. Pak Armed Forces Med J
Jamil K, Bhuiya A, Streatfield K, Chakrabarty N. The
immunization programme in Bangladesh: impressive gains in
coverage, but gaps remain. Health Policy Plan 1999;14(1): 49–58.
Mansuri FA, Baig LA. Assessment of immunization services in
perspective of both the recipients and the providers: A reflection
from focus group discussions. J Ayub Med Coll Abbotabad
UNICEF Information By Country: IRAQ. Available at: