Role of District Administration in Polio Campaigns and Supplementary Immunization Activities (SIA) in Karachi, Sindh, Pakistan: A QualitativeStudy

Objective: The present study was conducted for exploring the role and district administration impact during polio campaign and supplementary immunization activities.Methods: A qualitative study through two focus group discussions was conducted in the division of Karachi from January 2023 till December 2023. Each focus group consisted of ten participants with one Ministry of Health official and one each high level WHO and UNICEF official along with one district administration staff as well as one each district level WHO and UNICEF staff, two polio workers (one each from polio affected community and polio immunized community) and two community members (one each from polio affected community and polio immunized community). The probes (i.e. district administration dynamics and power structure, logistic, polio eradication program evaluation and technical, physical and human resources necessary for successful implementation of Polio campaign for universal coverage) were used in assisting the discussions. Thematic analysis was performed using Microsoft Excel. All the participants’ prior inclusion in this research gave writteninformed consent. The research is approved by the Institutional Review Board (IRB) of Karachi MetropolitanCorporation (KMC).Results: The qualitative research highlighted improved supervision, enhanced accountability, higher level of motivation, increased access to marginalized population and funding for polio campaigns has increased as a result of district administration given the role to supervise polio campaign. However, the district administration supervision has shown little improvement in the polio surveillance and cold chain maintenance.Conclusion: Pakistan has documented the reduction in polio cases and district administration has played a significant role in polio eradication efforts and improved efficiency as well as effectiveness of polio campaign.