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Does outsourcing improve immunisation coverage among children aged 12-24 months in Pakistan?
Shiraz Shaikh1, Kashif Shafique1
1School of Public Health, Dow University of Health Sciences Karachi, Pakistan.
Summary
Outsourcing Pakistan's vaccination program management in Sindh Province showed no significant overall coverage increase. However, a notable decrease in compliance at 9 months was observed in outsourced districts compared to non-outsourced ones.
Area of Science:
- Public Health
- Health Services Research
- Global Health
Background:
- In 2017, Pakistan initiated outsourcing of its vaccination program management to a non-governmental organization in two districts of Sindh Province.
- This initiative aimed to assess the effectiveness of private sector involvement in public health programs.
Purpose of the Study:
- To evaluate the impact of outsourcing vaccination program management on immunization coverage rates in selected districts of Sindh Province, Pakistan.
- To compare immunization status between children in outsourced and non-outsourced districts.
Main Methods:
- A comparative study involving 1600 children aged 12-24 months across four districts (two outsourced, two non-outsourced) in Sindh Province.
- Data collection included sociodemographic and immunization information, analyzed using STATA with chi-square, Man-Whitney U tests, and regression modeling to assess differences at 9 months.
Main Results:
- Overall full immunization coverage was marginally higher in outsourced districts (78.8%) versus non-outsourced districts (75.8%), with no statistical significance (P=0.067).
- A statistically significant difference was found at 9 months, with a 15.0% decrease in compliance in outsourced districts compared to a 19.7% decrease in non-outsourced districts (P=0.036).
Conclusions:
- Outsourcing vaccination program management yielded partial improvements, with better coverage observed in only one of the two outsourced districts.
- Further research is recommended to explore the reasons behind the observed differences in immunization coverage and to assess the cost-effectiveness of outsourcing vaccination programs.
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