A 40-year-old resident of a suburban area in the provincial capital, Hassan Ali, is overwhelmed by grief whenever he recounts how he lost a child to measles because his family forgot to vaccinate the child timely.

Hassan, a mason by profession, says the body of his daughter, almost one year old, developed red marks initially and when they took him to a doctor, they were told the baby was suffering from measles.

"At the doctor’s clinic, my family realised that the baby had really missed a dose of the anti-measles vaccine that is usually administered to children after birth till a specific age. Within a few days, her condition worsened," he says.

After the tragedy, however, he says he never misses any vaccination of his children now. There have been many children who became victims of the disease due to negligence of their parents who fail to vaccinate the child timely.

Another Peshawarite, Abdullah, has also learnt the same lesson once in his life when his child became victim of measles. The 30-year-old man says he had to suffer sleepless nights but at the end, his baby recovered. He had administered one measles vaccines but his family forgot the second vaccine.

"This taught me a lesson that I never forget now: I regularly see my children’s vaccination cards to ensure that they don’t miss any dose," he added.

After birth, a child has to be vaccinated against several diseases over the next several months of life. However, medical experts say there is no guarantee that the vaccine would have 100 per cent efficacy.

Asma, a lady health visitor in a dispensary of the city, said that they had even witnessed cases in which a child caught the disease despite being vaccinated against the disease.

"Lack of breastfeeding is also said to be a cause of measles among children," she added.

However, she added that if a vaccinated child catches the ailment, chances of his recovery are high, compared to those children who are not vaccinated.

According to the Health Department, 1,55,848 children under the age of 12 months were administered anti-measles vaccines all over the province during the first quarter of 2017. Swat district tops all the 25 districts of the province in terms of this vaccination, ie 17,918 children were vaccinated against measles there, while Kohistan district reported vaccination of 678 children, lowest figure of all other districts.

Similarly, the District Health Information System (DHIS) says that 144,338 children were fully immunised in all districts of the province during the first quarter of the current year. Full immunisation means that children under two years of age are administered all doses of BCG vaccines, three doses of polio and pentavalent vaccines and two doses of measles vaccine in a given year. Swat tops the list with 1,66,47 children immunised during the period while Kohistan is at the bottom with 393 immunised children.

The Maternal, Newborn and Child Health (MNCH) project coordinator for Khyber Pakhtunkhwa, Dr Sahib Gul, says that neonatal mortality rate is 35 per cent in Pakistan. The time from birth till the age of 12 days is called neonatal period.

"Most of the deaths occur due to low birth weight in infants," he added.

The MNCH programme was initiated by the provincial government. According to Dr Sahib Gul, the programme has increased the number of skilled birth attendants. He added that they also raised the number of midwives and awareness among people through media campaigns and social mobilisation to encourage expectant mothers to use hospital services.

"Our province Khyber Pakhtunkhwa has the lone MNCH programme in the entire Pakistan. Under this programme, Rs300 plus free medicine are given to expectant mothers at hospitals during their four antenatal visits, while a mother is given Rs1000 on birth of a baby and Rs700 in each post-natal visit," Dr Sahib Gul added.

According to the figures for first quarter of 2017, 1384 children have died of measles and other ailments across the province. Haripur tops the list and it has reported 173 infant deaths while Hangu, Kohistan and Torghar have not reported any infant death during the period.

Of other districts, 138 infant deaths were reported in Abbottabad, 113 in Swabi, 52 in Kohat, 147 in Mansehra, 41 in Buner, 25 in Tank, 32 in Karak, 18 in Lakki Marwat, 42 in DI Khan, 17 in Shangla, 110 in Mardan, 124 in Swat, 72 in Charsadda, 58 in Nowshera, 35 in Bannu, 119 in Peshawar, 24 in Chitral, 8 each in Upper Dir and Lower Dir, 24 in Malakand and 4 in Battagram.

Deputy Director of the Expanded Programme on Immunisation (EPI) Dr Abdul Hamid Afridi told TNS that under the PC-1 for a period of five years, the incumbent provincial government has approved around Rs6 billion for vaccination of children. Similarly, he added that Rs17.5 billion have been approved by international donors, i.e. the Global Alliance for Vaccines and Immunisation (GAVI).

He added that the authorities have also planned to replace the cold chains for vaccines across the province within the next two years.

"Also, solar ice lined refrigerators would be provided to health facilities in the areas that face eight hours loadshedding or more, with an aim to keep vaccines safe," he added.

He also mentioned a mobile android application that monitors working and performance of the vaccination staff.

"Right from our offices, we can monitor the performance and attendance of vaccination staff. This mobile App has improved our vaccinators’ attendance by almost 80 per cent," he added.

A report of World Health Organisation says that globally, the infant mortality rate has declined from an estimated rate of 63 deaths per 1000 live births in 1990 to 32 deaths per 1000 live births in 2015. Annual infant deaths have decreased from 8.9 million in 1990 to 4.5 million in 2015.