Public-private partnership to boost immunization in high-risk Karachi UCs

By Abdul Qadir Qureshi 

(Pakistan News & Features Services)

Efforts to integrate private providers for boosting routine childhood vaccination in Karachi’s low-income areas are set to receive a much-needed shot in the arm as a memorandum of understanding, signed by the Sindh Department of Health and the Aga Khan University goes into effect. 

The agreement entails integrating local private healthcare providers at the neighbourhood level to plug the gap in the government’s immunization infrastructure and develop sustainable community networks for increasing immunization coverage. 

The project, funded by the Bill and Melinda Gates Foundation, targets hot spots of immunization refusals in eight union councils of Karachi to increase zero dose vaccination provided at birth as well as Penta-3 vaccination in under six-month children which is a marker of complete vaccination in under six-month children. Through the project, immunization services and basic preventive care will be offered at 18 Expanded Programme of Immunization (EPI) centres set up within neighbourhood private provider clinics, NGO clinics and maternity homes. 

Community members in the districts where the project is to be implemented report that private clinics located in the local neighbourhood are the mainstay for their daily illnesses but do not offer immunization services, and while polio teams go from door to door to administer polio drops, the same facility is not available for other childhood vaccines for which families must visit government hospitals located at a considerable distance. 

According to AKU’s senior lead for the project, Professor Shehla Zaidi, AKU with EPI Sindh and other government stakeholders will co-design novel action learning strategies for co-opting private providers for quality assured services including pay for performance, quality accreditation scores and positive behaviour recognition, supported digital communication and community networks. The project will build sustainable links with the Sindh Health Department’s Action Plan for Strengthening Public Private Partnerships 2021-26 and regulatory frameworks towards urban primary health centres. 

Elaborating on the unique challenges of immunization delivery in megacities, Dr Irshad Memon, head of the EPI in Sindh, asserted that immunization rates in Karachi are far lower than in the province’s rural districts. “So far we have struggled to put in place a system to ensure that private providers report immunization volumes, provide free services and deliver quality-assured services. Hence this project fills a key need for technical assistance for effective private engagement for the urban poor. We need sustainable health systems as we don’t want to see super high-risk union councils in five years,” he explained.