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An in-depth profiling of slums/underserved areas located within the five largest cities of Punjab province in Pakistan i.e. Faisalabad, Rawalpindi, Lahore, Multan and Gujranwala
Executive Summary
An in-depth profiling of slums/underserved areas located within the five largest cities of Punjab province in Pakistan i.e. Faisalabad, Rawalpindi, Lahore, Multan and Gujranwala has been undertaken between 2018-2019, with the following objectives i.e. to collect the socio-demographic information of the residents of slums and underserved areas, to assess the fixed EPI centers, to compile the data of health and EPI recourses at the union councils level and to determine the childhood immunization coverage rates in the slums and underserved areas.
There are 25 towns and 453 union councils in these five cities. Slums/underserved areas (2164) are found in 100 percent towns of 77 percent union councils (351 out of 453).
Almost 19 percent of the total slums are without any legal evidence of their registration status. The five cities have a total population of 20.39 million; the proportion of population living in slums/underserved areas is 46 percent (9.35 million out of 20.39).
Vaccination card retention is found among only 61 percent of the children (55 percent boys vs 45 percent girls). Overall, 63 percent children are fully immunized and 20 percent are partially vaccinated (records and recall). Almost 17 percent children are zero dose.
Almost 35 percent union councils do not have public healthcare facilities and 32 percent UCs do not have fixed EPI centers. Similarly, 32 percent UCs where no fixed EPI centers. Almost 61 percent of slums/underserved areas report that LHWs do not visit their areas. Almost half of the houses (47 percent) in slums and 13 percent in underserved areas are Kacha-Pacca (mixed). Assessment of water and sanitation conditions indicates that access of slums/underserved areas to government water supply is weak (70 percent). The most prevalent source of water is ground water. In terms of sanitation, 1 percent slums/underserved areas do not have toilet facilities and therefore practice open defecation. The houses, which have toilet facilities, little less than half of them, are open pit/traditional toilets (47 percent).
Further analysis on the status of drainage system shows that majority of the areas have either filthy or choked drains (46 percent), or drains are absent altogether (33 percent).
This report finds that living conditions of slum dwellers and underserved areas are not only poor, but major disparities also exist in terms of their accessibility to health and EPI centers.
It is important to improve the access and demand of health and EPI services so that children and women can be protected from vaccine preventable diseases.