The legal framework
Pakistan carries a heavy burden of viral hepatitis. Vaccination is part of the expanded programme on immunisation, but the birth dose is frequently missed, particularly with home deliveries. Reuse of syringes and unsterilised equipment in informal healthcare settings is a documented and continuing driver of transmission, for hepatitis B as for hepatitis C.
Pakistan has hepatitis B in its routine immunisation programme from six weeks of age, but a universal birth dose is not part of the standard schedule, which leaves the mother-to-child route open. Prevalence is intermediate to high, and unsafe injections and reused equipment remain significant transmission routes alongside perinatal infection.
Key points
| Prevalence | High, with a large number of chronic carriers |
|---|---|
| Vaccination | Part of the expanded programme on immunisation |
| Birth dose | Frequently missed, especially with home deliveries |
| Unsafe injections | A documented driver of ongoing transmission |
| Antenatal screening | Not universally applied |
| Treatment | Available through hepatitis control programmes, with variable access |
| Blood safety | Screening of donated blood is mandatory |
In practice
- Insist on a new syringe taken from a sealed packet for every injection.
- Ask for the birth dose within 24 hours of delivery.
- Provincial hepatitis control programmes provide free testing and treatment in many districts.
- Have household contacts of a carrier tested and vaccinated.
Cost and coverage
Provincial programmes provide free testing and treatment in many districts; private care is expensive.
Where to go
- Provincial hepatitis control programmes.
- Expanded programme on immunisation centres.
- Teaching hospital gastroenterology departments.
Worth knowing
Reused injection equipment remains a real risk in informal settings. Watching the syringe being unwrapped is the simplest protection available, and it costs nothing.
Frequently asked questions
How is hepatitis B transmitted most often in Pakistan?
Through unsafe injections and reused medical or dental equipment, alongside transmission from mother to child at birth. This is why the safe-injection campaigns matter as much as vaccination. Insist on a new syringe from a sealed pack for any injection.
Why does the birth dose matter so much?
Because transmission from mother to baby at birth is the route most likely to produce a lifelong chronic infection — an infant infected at birth has a very high chance of never clearing the virus, whereas an adult usually does. A vaccine dose within twenty-four hours of birth, with immunoglobulin where the mother is positive, prevents this in the great majority of cases.
Official sources and links
- Government of Pakistan — official government portal