Reporting immunization coverage inequalities in Pakistan

Background: Immunization coverage in Pakistan is unequally distributed. Understanding the current status of reporting of immunization coverage inequalities in Pakistan can help to identify gaps and opportunities for strengthened monitoring and reporting. Aims: To assess the published literature on immunization coverage inequality measurement and reporting in Pakistan. Methods: We performed a literature search in PubMed in April 2019 to obtain articles reporting inequalities in immunization coverage in Pakistan. A data extraction rubric was applied to collate information about data sources, immunization indicators and dimensions of inequality. Results: We included 42 studies in our analysis. Most studies reported data from household surveys or research studies. Dimensions of inequality reflected geography (primarily provinces/territories), economic status, place of residence, education level, sex and occupation. District-level comparisons were featured in 5 studies that were subnational in scope. Conclusions: Expanded monitoring at district level is warranted as a major way forward in characterizing immunization inequalities in Pakistan.