Table 1 provides an overview of the current EPI schedule in Pakistan. Table 1 EPI schedule for vaccination in Pakistan selleck chem inhibitor According to the 2010 report of Pakistan Institute of Legislative Development and Transparency (PILDAT), presently 15% of deaths below the age 5 years make up 50% of overall mortality in Inhibitors,Modulators,Libraries Pakistan, showing children as the most neglected part of Pakistan��s society [4]. Although there has been a big improvement in EPI coverage in Pakistan in recent years, stronger measures are still required to achieve the desired results. The percentage of Pakistani children (age 12�C23 months) receiving all the vaccines is only 47%, and 6% of children remain non-vaccinated [4]. Complete EPI coverage from province to province also shows marked variation, being 35% in Baluchistan, 37% in Sindh, 53% in Punjab, 47% in Khyber Pakhtunkhwa (KPK) [4].
Routine EPI coverage as of 2007 was: BCG – 89%, Polio – 83%, DPT – 83%, Hepatitis B – 83% and Tetanus Toxoid – 46% [5]. These numbers showed improvements in 2012 to 95%, 89%, 89%, 89% and 68% respectively [5]. Despite Inhibitors,Modulators,Libraries the mentioned coverage, Pakistan is still among the 3 countries of the world where wild poliovirus remains endemic. The government of Pakistan provides only 20% of total immunization expenditure while, EPI with the help of UNICEF, WHO, GAVI-ALLIANCE shares the major burden of funding [6]. Despite the funding provided by EPI and routine immunization coverage, Pakistan has seen outbreaks of measles and diphtheria in 2012, and an increased in number of tuberculosis and tetanus cases due to weak implementation and the major focus of government being on the polio eradication [7].
About 1000 deaths of children less than 5 years of age will occur if the EPI program is discontinued, Inhibitors,Modulators,Libraries which signifies its importance [8]. However, despite the efforts of government and WHO, this program has not received the amount of success that was desired. This has been due to a multitude of reasons, majority of which can be broadly divided into two main categories, namely provider-associated and consumer-associated. The former, which includes entities such as lack of proper government policies, absenteeism of vaccination personnel, poor vaccine quality and inadequate coverage, has been widely covered in local as well as international media [9-12].
Inhibitors,Modulators,Libraries In contrast, the latter has rarely received the attention it requires, which is evident in the paucity of pertinent cross-sectional literature from this geographical area. Inhibitors,Modulators,Libraries Included GSK-3 in this category are factors such as lack of awareness, illiteracy, social/religious dilemmas and misconceptions, financial issues and accessibility problems. Various studies have been conducted in different parts of the world to derive the major factors associated with non-vaccination.