Pakistan: Corruption in polio programme

In order to minimise corruption in the anti-polio campaign the World Health Organisation (WHO) has announced to directly pay the vaccinators in 10 districts of Khyber Pakhtunkhwa during the upcoming Sub-National Immunisation Days (SNIDs), officials said. The sources said that after a briefing about district level corruption in polio programme, Prime Minister Raja Pervaiz Ashraf had approved direct payment to the field workers and even suggested its privatisation to rid Pakistan of the crippling disease. “The so-called Direct Disbursement Mechanism (DDM) is part of the efforts to better reward and motivate the vaccinators and other field workers who face challenging circumstances to administer polio drops to every child,” a senior official of the Health Department told The News on Saturday. He said all field workers taking part in the anti-polio drive from September 10-12 would be paid directly and would not wait for months. This mechanism was started three years ago in Nigeria. The WHO pays Rs1,000 to every vaccinator for the three-day campaign in Pakistan. Pleading anonymity, a health manager said the DDM was set up to ensure that workers involved in polio immunisation have quick and easy access to their payments upon completion of vaccination rounds. The decision was made after vaccinators, area in-charges and union council medical workers expressed frustration over inordinate delays in receiving the payments. “It is very painful and shocking when you risk your life and visit each and every household to vaccinate kids and then wait for months to receive the payment. The donors’ main priority is to reward those who are really delivering,” an official from a donor agency said. Requesting anonymity, he said with the successful execution of DDM in the July campaign when more than 85 percent polio workers were paid on time, the WHO decided to expand the practice nationwide. In September, the official said, 8,966 vaccinators, 852 area in-charges and 204 union council medical officers from Vehari, Hyderabad, Charsadda, Kohat and Nowshera, Pishin and Qilla Abdullah and the Islamabad Capital Territory (ICT) would receive their payments directly. The donor agencies are also endeavouring to ensure that under-age people don’t take part in the anti-polio drive. “Besides direct payments to the polio workers, the DDM would allow the government and stakeholders to closely monitor the progress during the anti-polio campaigns, including full information about the age of the monitors, the number of trainings undertaken and the days of active participation in the campaign. This accountability is a key element of the emergency strategies currently in place to eradicate polio from Pakistan and rest of the world,” a Health Department official explained. He said the donors had also been informed about the ghost teams and under-age vaccinators. He said usually the Executive District Officers (Health) were involved in such practices. In Khyber Pakhtunkhwa, over 2.5 million children below the age of five are supposed to be vaccinated against polio in the 12 high-risk districts in the upcoming campaign. The vaccinators are facing tough time in Khyber Pakhtunkhwa as around 19,000 parents refused to get the children vaccinated during the recent three-day NIDs campaign. Dr Janbaz Afridi, deputy director EPI Khyber Pakhtunkhwa, said the anti-polio drive would be carried out in Peshawar, Charsadda, Nowshera, Mardan, Kohat, Hangu, Lakki Marwat, Bannu, Tank, Dera Ismail Khan, Upper Dir and Lower Dir by more than 7,500 teams.