Strengthening Routine Immunization Services in Pakistan

Country: Pakistan

Client(s): Gavi, the Vaccine Alliance

Services: Applied Technology, Technical Assistance, Capacity Development

Technical Expertise: Health Systems Strengthening, Immunization, Applied Technology


In Sindh province, overall immunization coverage is 29% while coverage in districts varies from 10% to 68.5% in Kashmore and Jamshoro districts, respectively (Sindh Bureau of Statistics and UNICEF 2015, 228). Sindh houses some of Pakistan's largest slums with Karachi city having the highest number of unvaccinated children in the world, followed by Lahore, before other major cities in the world (WHO and UNICEF, 2016). As reported in the 2017 draft joint appraisal (JA) report, Karachi has an estimated 400,000 unimmunized children though this is difficult to fully quantity, making the need for a Karachi-specific approach a top priority. There are also several hard-to-reach districts in Sindh requiring additional technical and financial support to reach children who are being missed by RI services (CMYP 2014-2018).

To address these concerns, technical assistance will be focused on the following three main objectives:

  1. Develop a Karachi-specific road map for improving routine immunization.
  2. Develop programme management capacity of the EPI team in Sindh to plan, manage, implement, and monitor the immunization program at the district and Union Council levels.
  3. Help effectively transition the successful package of interventions from Maternal and Child Health Integrated Program (MCHIP) USAID to the government EPI program in Sindh.