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Health system barriers and levers in implementation of the Expanded Program on Immunization (EPI) in Pakistan: an evidence informed situation analysis

Overview of attention for article published in Public Health Reviews, September 2018
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • Good Attention Score compared to outputs of the same age (76th percentile)

Mentioned by

blogs
1 blog
twitter
1 tweeter

Citations

dimensions_citation
1 Dimensions

Readers on

mendeley
20 Mendeley
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Title
Health system barriers and levers in implementation of the Expanded Program on Immunization (EPI) in Pakistan: an evidence informed situation analysis
Published in
Public Health Reviews, September 2018
DOI 10.1186/s40985-018-0103-x
Pubmed ID
Authors

Babar Tasneem Shaikh, Zaeem ul Haq, Nhan Tran, Assad Hafeez

Abstract

In Pakistan, immunization coverage has been quite low since the program's inception, and the 2012-2013 population-based survey recorded it at 54%. Much has been written about the issues, challenges, and constraints in the implementation of Pakistan's immunization program. However, there is a need to better understand the health system barriers as well as levers that influence progress. This review aims to bridge the information gaps on system-level barriers that currently impede the optimal delivery and uptake of immunization services to the children of Pakistan through the Expanded Program on Immunization (EPI). We conducted a comprehensive literature review, using PubMed and Google Scholar to find peer-reviewed literature, and also reviewed EPI-related international and national reports. Additionally, we consulted government reports, surveys, and publications on the health system. Employing the basic tenets of WHO's health systems framework for health system strengthening, and a socio-ecological model, this study cataloged the service delivery and the demand side perspective on various pillars of Pakistan's immunization program. Themes generated from the literature review included financing, governance, service delivery, human resources, information systems, and supplies and vaccines. Findings suggest that certain areas in the larger health system need to be improved for a more coordinated implementation of EPI in Pakistan. Moreover, it is imperative to understand community behaviors and perceptions as well as demand side issues in order to achieve the desired results. For better immunization coverage and ultimately a reduction in child mortality due to preventable diseases, EPI operations and performance must be improved. Further systematic implementation research could help to develop an even finer understanding of the system-wide bottlenecks encumbering the coverage and efficiency of the program.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 20 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 20 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 6 30%
Researcher 4 20%
Student > Bachelor 3 15%
Unspecified 3 15%
Student > Postgraduate 2 10%
Other 2 10%
Readers by discipline Count As %
Nursing and Health Professions 6 30%
Medicine and Dentistry 5 25%
Unspecified 4 20%
Social Sciences 4 20%
Environmental Science 1 5%
Other 0 0%

Attention Score in Context

This research output has an Altmetric Attention Score of 8. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 September 2018.
All research outputs
#2,095,305
of 13,526,707 outputs
Outputs from Public Health Reviews
#66
of 141 outputs
Outputs of similar age
#62,030
of 266,699 outputs
Outputs of similar age from Public Health Reviews
#2
of 2 outputs
Altmetric has tracked 13,526,707 research outputs across all sources so far. Compared to these this one has done well and is in the 84th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 141 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 15.4. This one has gotten more attention than average, scoring higher than 53% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 266,699 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 76% of its contemporaries.
We're also able to compare this research output to 2 others from the same source and published within six weeks on either side of this one.