Immunization is one of the most successful and cost-effective public health investments we can make for future generations. Yet, globally 18.7 million children- 1 in every 5- remain unvaccinated and over 2 million children die from vaccine-preventable diseases annually. Of the 19.5 million children globally who did not receive 3 doses of DTP vaccine in 2016, around 1.4 million (7%) lived in Pakistan, making under and un-immunization one of the leading causes of high infant mortality rate in the country
Inaccessibility and inefficiencies associated with the health system deter parents of young infants from utilizing government services. Among other factors, this situation is compounded with parent’s poor socioeconomic status, and feared loss of income due to time wasted at over-crowded public facilities a. While traditionally government efforts to improve immunization coverage have targeted the supply side, there is a need to simultaneously focus efforts towards generating demand for immunization among caregivers
Pakistan has launched a program to improve timely immunization coverage through the introduction of small mobile money-based Conditional Cash Transfers (mCCTs) for parents and Performance-based Incentives (PBIs) for vaccinators.
Building upon the Zindagi Mehfooz Immunization Registry platform, the program offers small incentives to parents and vaccinators for each child that gets immunized in order to increase uptake and completion rates of immunization. The CCTs are transferred through widely accessible mobile money to vaccinators as well as parents of immunized children.
The program pilots a solution that incentivizes behaviour change by employing existing resources and can easily be replicated across even the most remote and marginalized communities.
The program is currently being implemented in two towns/talukas (Shikarpur and Garhi Yasin) within the Shikarpur district, covering 28 Union Councils, 30 EPI Health Centers and 69 vaccinators. Over 46,000 children have been enrolled to date, and 20,000 eligible caregivers have been sent incentives. The Program has a pre-post evaluation design and full immunization coverage rates will be compared through a baseline and endline survey. Final Program results will be available by mid-2018.
NIPS , I.I., Pakistan Demographic and Health Survey 2012-13., 2013: Islamabad, Pakistan, and Calverton, Maryland, USA: NIPS and ICF International.
“Immunization 'game-Changers' should be the norm worldwide, says UN health agency.” UN News Center, United Nations, 21 Apr. 2016, www.un.org/apps/news/story.asp?NewsID=53746#.Wab7pih97IU. Accessed 28 Aug. 2017