How Aliya Ejaz Is Strengthening Immunization through Integrated Service Delivery
In D.I. Khan and North Waziristan, District Coordinator Aliya Ejaz has been working to build trust and improve access to essential health services. People here have resisted vaccination in the past. Aliya set out to change that. Her efforts are already making a difference. She works with local health teams. Together, they have helped integrate 12 Basic Health Units (BHUs) into UNICEF's Integrated Service Delivery (ISD) initiative. The initiative has brought essential health services to 22 union councils across the target districts.
Integrated Service Delivery (ISD) was introduced by UNICEF with the National and Provincial Emergency Operations Centres (EOCs). It brings essential health services together in one place. Families can get the care they need more easily. This approach has improved access to services and strengthened trust in immunization. For Aliya, ISD has made it possible to address multiple community needs through a single, coordinated approach.
The impact is clear in UC Muryali. It is one of the 12 union councils under Aliya's responsibility. This area is home to over 55,000 people. Here, the uptake of immunization and polio vaccination has been remarkable.
When Aliya first started, outpatient visits to the BHUs were only 300–400 per month. Now, that number has risen to 1,600–1,700 monthly.
Additionally, the number of home births has also decreased. More women now choose skilled delivery care at the BHUs. The introduction of essential WASH infrastructure, including latrines, handwashing stations, and solar-powered water systems, has also built trust in the health facilities.
Before the launch of ISD, D.I. Khan had a high rate of polio vaccine refusal. About 300 families in UC Muryali alone had refused the vaccine in 2023. These refusals have dropped to just 10 during the Sub-National Immunization Days (SNIDs) held in June. Even these remaining refusals were due to temporary health issues affecting the children.
Aliya's success is not just in numbers but in the deep trust she has built within the community.
"I joined this project as a religious obligation," Aliya says. "Seeing malnourished children and struggling mothers drives me to do more for them."
Her commitment has not gone unnoticed. Local influencers, including religious scholars, now openly express their gratitude for the health services provided under her leadership. They are recognizing the positive change she has brought to their community.
“We are grateful for Aliya’s contributions to our community. We now have access to essential medicines and healthcare, which has greatly improved how we handle health issues. Our women feel secure seeking her help. We trust the facilities provided for all vaccinations, including polio,” says Muhammad Riaz, a religious influencer in UC Muryali, D.I. Khan.
The ISD initiative now includes comprehensive services. These provide pediatrics, nutrition, family planning, antenatal care, and birth registration. These services, coupled with off-site health camps linked to polio campaigns, have made a lasting impact on the community's health and well-being.
As Aliya reflects on her decade-long journey, she is filled with a sense of accomplishment.
"It is overwhelming to see the positive changes in people's behavior and attitudes," she says. "We have not only increased immunization rates but have also built a healthier, more resilient community."
Aliya's efforts have earned recognition from both her supervisor and colleagues.
“The area, which primarily consists of refugee families, had over 2,800 polio vaccine refusals in 2018, including many chronic cases that once seemed unmanageable, even by the district administration. However, with the help of ISD and the distribution of free medicines, the number of refusals has significantly decreased,” said Ali Raza, the Union Council Polio Support Person in D.I. Khan.
Aliya's work stands as a testament to the power of integrated health services in overcoming barriers and building trust in communities long resistant to change. Her story is a beacon of hope, illustrating how determined efforts can lead to lasting, meaningful improvements in public health.
