Islamabad : Having ignored the children’s vulnerability to the debilitating soil-transmitted helminth infections when healthcare was a federal subject, the government has planned to embark on a mass deworming programme for Islamabad Capital Territory in the post-devolution regime. Under the initiative, the brainchild of the Planning Commission and the first of its kind to be introduced in the country, the ICT administration will reach out to the local minors, both school-age (5-15 years) and those aged under five, as well as women of reproductive age once a year to protect them from intestinal parasitic worms, which can lead to anaemia, malnutrition, impaired mental and physical development, besides threatening the children’s education and productivity.
They all will be given mebendazole, a medication for treating parasitic worm infestations, free of charge.
The World Health Organisation will donate these tablets for the programme’s school-based deworming part on request, while procurement for the non-school-based deworming component will be ensured by the health department using government funds.
A steering committee consisting of the representatives of the planning and development, national health services, professional education and training, religious affairs, and capital administration and development division ministries, and Federal Directorate of Education will handle the programme’s matters on coordination, implementation and monitoring, while three private organisations, including Interactive Research and Development, Indus Health Network and Evidence Action, will also be part of the exercise.
As a survey done by these organisations in 2016 together with Institute of Development and Economic Alternatives and WHO, put the average incidence of STH infections among school-age children at over 20 per cent in ICT and at over 50 per cent in a very limited area, the deworming programme’s strategy is to regularly treat at least 75 per cent of the at-risk population in at-risk areas.
According to the Planning Commission officials, around 570,000 children in the 5-15 age bracket, who are at risk of STH infections, will benefit from the mass deworming programme, no matter whether they study in government or private schools and seminaries, or are not enrolled in educational institutions.
As for the children under five years and women of reproductive age, the programme will be implemented by the ICT health department through its fixed facilities, including 14 basic health units and three rural health centres, outreach community-based workers, including lady health workers, community midwives and other such workers, health service delivery outlets of the Capital Development Authority-Municipal Corporation of Islamabad’s Health Services Directorate, and tertiary care hospitals overseen by the Capital Administration and Development Division.
The school-age children will be targeted under the school-based deworming initiative through the existing education infrastructure and teachers with the support of the health system, an approach, which is highly cost-effective, is well accepted by the community and efficiently targets the population groups at the greatest risk for STH infections: school-age children. The Multi-Stakeholders Steering and Coordination Committee will be the central decision-making body for the deworming programme, while there will be separate ‘implementation committees’ for the school-based and non-school-based components of the programme with representation from all relevant departments to develop and execute their respective operational micro plans.
While the programme will supply schools and communities with public awareness material, the technical assistance partners will help the ICT tailor locally-appropriate campaigns for deworming awareness.
A deworming day will be marked to target all school-age children and it will be followed by a mop-up day within a week to cover all those missing deworming medication, while a monitoring plan will be executed with the participation of all stakeholders to ensure deworming is actually happening, key processes are being followed, and difficulties, if any, are highlighted.
Dr Wasim Khawaja, senior gastroenterologist of the Pakistan Institute of Medical Sciences, the capital’s premier government hospital, welcomed the initiative strongly feeling that targeting children through school-based deworming was one of the best buys for development due to its impact on educational and economic outcomes coupled with the relative low cost of delivery.
He told ‘The News’ that chronic worm infections resulted from poor sanitation and hygiene conditions, tended to have highest prevalence in children of school-going age, and had both widespread and debilitating consequences.
“The STH infections exact a clear toll on human capital, hindering economic development, yet not all at-risk children are currently treated. Periodic administration of deworming medication to the at-risk population will help contain morbidity associated with STH infections,” he said.
Declaring active involvement of all stakeholders the key determinant of the programme’s overall success, the gastroenterologist kept his fingers crossed that the initiative would bring home the bacon.