Babar Tasneem Shaikh, Aamir Akram Alizai.
Head on with the challenges of routine immunization in pakistan: the need and importance of health systems research.
Pak J Public Health Jan ;2(3):4-9.

A functional and responsive routine immunization program is fundamental for reducing the under 5 mortality in developing countries including Pakistan. The immunization coverage indicators are getting better but at a very slow pace; and therefore one presumes that we will not be able to achieve the MDG4 targets for improving the immunization status and a reduction in child mortality. Within a multi-cultural milieu and a complex health system, the country presents an ideal case for embarking upon the health systems research to develop an empirical evidence base and to re-build the routine immunization program in the country to serve the people who are most in need. This critical review presents an inventory of factors responsible for the unsatisfactory state of affairs in terms of routine immunization in Pakistan. This paper will be helpful to the future research endeavors in the field of immunization as it provides the guide for studying the issue with a novel approach and not just keeping the designs focused on diseases, vaccines or factors related to EPI program management. Moreover, this paper pleads a case for conducting health systems research in order to have a new policy, better programmatic approach, responsive service delivery and a multi-stakeholder engagement for improving upon the situation.

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