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[ISLAMABAD] Improving the socio-economic status of women could ensure better success of the oral polio vaccination (OPV) programme in Pakistan, one of the last refuges of the wild polio vaccine in the world besides Afghanistan and Nigeria, says a new study.

Pakistan represents more than 85 per cent of the global wild poliovirus cases because of unvaccinated pockets, dropouts from complete oral vaccination doses and persistence of positive environmental samples, according to the study to be published November in Public Health.

Made with ‘live’ but weakened polioviruses, OPV doses have been administered around the world for decades to replace the wild poliovirus in the environment and stop transmission of the disease and eventually eliminate it.

“We found that because urban mothers are better educated, aware of vaccination benefits and empowered to handle household economic affairs, they ensure that their children get vaccinated”

Waqas Imran, Idara-e-Taleem-O-Aagahi

Based on data in three nationally representative Pakistan Demographic and Health Surveys (PDHS), the study finds that children of socio-economically empowered and educated, female-headed households are more likely to receive OPV doses than male-headed households.

The study found rural versus urban residence, the mother's age at marriage, the child's birth place (home versus hospital), parental education and household wealth status are significant predictors or factors in acceptance of OPV or dropping out of mass vaccination programmes.  
“We found that because urban mothers are better educated, aware of vaccination benefits and empowered to handle household economic affairs, they ensure that their children get vaccinated,” Waqas Imran, a study author and researcher at the Idara-e-Taleem-O-Aagahi, (Centre of Education and Consciousness) Islamabad, tells SciDev.Net.
The percentage of children aged 12—23 months who dropped out of OPV was 76 per cent in the year 1990—1991, 21 per cent in 2006—2007 and 17.5 per cent in 2012—2013, according to the PDHS surveys. 

“Having analysed the three datasets, we discovered a 58 per cent decline in OPV dropout cases and almost 25 per cent drop in no OPV children over a study period of almost two decades,” says Faisal Abbas, corresponding study author and visiting associate professor in economics at the University of Göttingen, Goettingen, Germany.   

“But startlingly, OPV dropouts/no OPV still account for about a fifth of the vaccine-able children, mostly in rural areas,” says Abbas. Mandatory vaccination of children born at urban health facilities was found to be a major factor behind better vaccine compliance, says Imran. In the rural areas, women prefer unassisted delivery and tend to have a sceptical view of modern medicine and vaccination because of their religious beliefs, Imran says.
Executive director at the Karachi-based Health Foundation Laila Rizvi suggests that introducing income-generating programmes for women, improving women’s literacy and ability to make decisions for her own financial well-being as well as that of her family can positively impact the country’s polio eradication efforts.
This piece was produced by SciDev.Net’s Asia & Pacific desk.