From their own perspective - constraints in the Polio Eradication Initiative: perceptions of health workers and managers in a district of Pakistan's Punjab province

BMC International Health and Human Rights

Research Article

Mushtaq Ahmad Shad¹  Javed Akram²  Muhammad Umair Mushtaq²  Ubeera Shahid²  Muhammad Ashraf Majrooh²  Arif Mahmood Siddiqui² 

[1] Department of Health, Government of Punjab, Lahore, Pakistan;Research Society, Allama Iqbal Medical College, Lahore, Pakistan;

关键词: Primary Health Center;    Oral Polio Vaccine;    Polio Eradication;    Union Council;    Communicable Disease Control;   

DOI  :  10.1186/1472-698X-10-22

 received in 2009-07-31, accepted in 2010-08-23,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundThe success of the Global Polio Eradication Initiative was remarkable, but four countries - Afghanistan, Pakistan, India and Nigeria - never interrupted polio transmission. Pakistan reportedly achieved all milestones except interrupting virus transmission. This paper describes the perceptions of health workers and managers regarding constraints in the Polio Eradication Initiative (PEI) to ultimately provide evidence for designing future interventions.MethodsA qualitative cross-sectional study using focus group discussions and in-depth interviews was conducted in the Nankana Sahib District of Pakistan's Punjab province. Study subjects included staff at all levels in the PEI at district headquarters, in all 4 tehsils (sub-districts) and at 20 randomly selected primary health centers. In total, 4 FGD and 7 interview sessions were conducted and individual session summary notes were prepared and later synthesized, consolidated and subjected to conceptual analysis.ResultsThe main constraints identified in the study were the poor condition of the cold chain in all aspects, poor skills and a lack of authority in resource allocation and human resource management, limited advocacy and communication resources, a lack of skills and training among staff at all levels in the PEI/EPI in almost all aspects of the program, a deficiency of public health professionals, poor health services structure, administrative issues (including ineffective means of performance evaluation, bureaucratic and political influences, problems in vaccination areas and field programs, no birth records at health facilities, and poor linkage between different preventive programs), unreliable reporting and poor monitoring and supervision systems, limited use of local data for interventions, and unclear roles and responsibilities after decentralization.ConclusionThe study highlights various shortcomings and bottlenecks in the PEI, and the barriers identified should be considered in prioritizing future strategies.

【 授权许可】

CC BY   
© Mushtaq et al; licensee BioMed Central Ltd. 2010