The government has intensified measles vaccination efforts alongside routine immunisation programmes amid growing concern over shortages of health assistants and technicians involved in the nationwide campaign.
Health officials and public health experts warn that prolonged vacancies in frontline vaccination posts could eventually weaken Bangladesh's highly regarded Expanded Programme on Immunization (EPI), particularly as the country faces a measles outbreak and prepares for a future with reduced donor support.
The EPI remains one of the Bangladesh government's most successful public health initiatives. Ten vaccines are provided free of cost under the programme.
While vaccination activities are mainly conducted through government vaccination centres in rural areas, services in cities are provided through a combination of government centres, private primary healthcare facilities, private hospitals and NGOs.
Officials and public health experts said delays in recruiting health assistants and technicians could ultimately hamper national immunisation campaigns and make it difficult to achieve EPI targets
Divisional, district and upazila health officials told The Financial Express that they are continuing measles and routine EPI vaccination campaigns by redistributing manpower and seeking support from other government offices and local NGOs due to staff shortages.
The Civil Surgeon's Office in Kurigram has already submitted a written request for around 105 additional personnel linked to the national vaccination programme.
"We do not have a vaccine shortage right now. We are conducting immunisation activities in the district with manpower support from the family planning office, local NGOs and others due to shortages of staff," said Shwapon Kumar Biswas, Civil Surgeon of Kurigram.
Government health assistants mainly conduct vaccination activities.
He, however, claimed that the manpower shortage was not yet affecting vaccination campaigns significantly.
The Rajshahi Divisional Health Office is also facing manpower shortages in six out of its eight districts, although the government recently recruited health assistants in two districts.
"We need manpower to run vaccination activities smoothly. We have already filled vacant posts in two districts and are working on the remaining districts," said Habibur Rahman, Director of the divisional health office.
The division is also facing shortages of routine EPI vaccines. However, officials said supplies are being managed through coordination with neighbouring districts while new shipments are on the way.
Officials added that there is no shortage of syringes or other logistics.
The situation has improved in Satkhira Sadar Upazila following fresh recruitment against vacant posts.
According to research conducted by UNICEF and the Shastho Shurokkha Foundation in April last year, manpower shortages remain one of the major challenges facing EPI activities, alongside inadequate funding, unequal distribution of vaccination centres, vaccine shortages, insufficient worker training and transportation difficulties in remote and high-risk areas.
The situation could become more difficult after 2029, when support from the Gavi vaccination programme ends and Bangladesh will need to fund the programme independently.
Senior public health expert Nizam Uddin Ahmed told The Financial Express that manpower shortages linked to the national immunisation programme have been a longstanding problem.
"There is a shortage of Health Assistants of around 40 per cent and EPI technicians of around 50 per cent, while more than 53 per cent of posts at EPI headquarters remain vacant against sanctioned positions directly linked to EPI implementation," he said.
He added that these gaps need to be filled to strengthen routine EPI activities conducted through around 134,000 vaccine centres nationwide.
The government is considering recruiting 100,000 health assistants and technicians soon, the health minister said recently, although no specific deadline has yet been announced.
"The situation would improve significantly if the recruitment demand is met," said Dr Nizam, who is also Chair of the Gavi CSO Steering Committee.
NGOs currently support EPI vaccination activities in urban areas, including 12 city corporations and municipalities, where they provide nearly 95 per cent of vaccination services in partnership with local government bodies.
Experts said NGOs require continued funding to operate EPI services smoothly until the government recruits sufficient staff for urban vaccination programmes.
Dr Nizam suggested that the government should prioritise the issue and engage directly with city corporations to improve EPI services.
Md Zahid Raihan, Additional Director General of the Directorate General of Health Services (DGHS), acknowledged the manpower shortage and said the agency is working intensively to address the measles outbreak.
"The DGHS is managing the workload by bringing in doctors on deputation, while the same individuals are often handling multiple responsibilities," he told The Financial Express.
He said the DGHS is treating the ongoing measles outbreak as a top priority and will plan and act accordingly.
"This is not a small task. Financial issues and lengthy procedures are involved in such recruitment processes," he explained.
Regarding measles vaccination and routine EPI activities, he said there is currently no shortage of vaccines or logistics.
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