Local Polio Eradication Programs in Key Endemic Regions in Pakistan: A Scoping Review

This scoping review aims to identify and map the existing programs deployed in Pakistan to improve polio vaccination rates and understand the factors contributing to the persistent challenges in eradicating the disease. The review followed the Joanna Briggs Institute (JBI) methodology for scoping reviews. A comprehensive search of PubMed was conducted, limited to publications within the last 6 years (2019-2025), yielding 96 publications. Data extraction and synthesis focused on program descriptions, target populations, implementation timeframes, geographic regions, and reported successes or shortcomings. The review provides a landscape of polio eradication efforts in Pakistan, highlighting gaps and opportunities for future interventions. The review identifies that complete eradication of polio in Pakistan is inhibited by a lack local strategies to target specific context. Such contexts can have barriers that are circumstantial or systemic. Circumstantial problems refer to unavoidable environments that deter vaccination efforts, such as the incidence of natural disasters that destroy sanitation systems or the prevalence of terrorism in a region, deeming it unsafe for healthcare workers to enter. Systemic problems are structural issues that lead to the spread of vaccine hesitancy, which is often rooted in significant mistrust for the healthcare sector. This may reflect both a lack of trust in healthcare stemming from limited access to basic medical facilities and misinformation fueled by conspiracy theories embedded within religious, social, or political narratives. In either case, the most effective response is one that is context-specific, drawing on community resources to rebuild trust and strengthen healthcare systems.