The impact of polio eradication on routine immunization and primary health care: A mixed-methods study

Svea Closser, Kelly Cox, Thomas M. Parris, R. Matthew Landis, Judith Justice, Ranjani Gopinath, Kenneth Maes, Hailom Banteyerga Amaha, Ismaila Zango Mohammed, Aminu Mohammed Dukku, Patricia A. Omidian, Emma Varley, Pauley Tedoff, Adam Koon, Laetitia Nyirazinyoye, Matthew A. Luck, W. Frank Pont, Vanessa Neergheen, Anat Rosenthal, Peter NsubugaNaveen Thacker, Rashid Jooma, Elizabeth Nuttall

Research output: Contribution to journalArticle

Abstract

Background. After 2 decades of focused efforts to eradicate polio, the impact of eradication activities on health systems continues to be controversial. This study evaluated the impact of polio eradication activities on routine immunization (RI) and primary healthcare (PHC).

Methods: Quantitative analysis assessed the effects of polio eradication campaigns on RI and maternal healthcare coverage. A systematic qualitative analysis in 7 countries in South Asia and sub-Saharan Africa assessed impacts of polio eradication activities on key health system functions, using data from interviews, participant observation, and document review.

Results: Our quantitative analysis did not find compelling evidence of widespread and significant effects of polio eradication campaigns, either positive or negative, on measures of RI and maternal healthcare. Our qualitative analysis revealed context-specific positive impacts of polio eradication activities in many of our case studies, particularly disease surveillance and cold chain strengthening. These impacts were dependent on the initiative of policy makers. Negative impacts, including service interruption and public dissatisfaction, were observed primarily in districts with many campaigns per year.

Conclusions: Polio eradication activities can provide support for RI and PHC, but many opportunities to do so remain missed. Increased commitment to scaling up best practices could lead to significant positive impacts.

Original languageEnglish (US)
Pages (from-to)S504-S513
JournalJournal of Infectious Diseases
Volume210
DOIs
StatePublished - Nov 1 2014
Externally publishedYes

Fingerprint

Poliomyelitis
Immunization
Primary Health Care
Mothers
Delivery of Health Care
Refrigeration
Africa South of the Sahara
Health
Administrative Personnel
Practice Guidelines
Observation
Interviews

Keywords

  • eradication
  • health systems
  • poliomyelitis
  • routine immunization

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

Cite this

The impact of polio eradication on routine immunization and primary health care : A mixed-methods study. / Closser, Svea; Cox, Kelly; Parris, Thomas M.; Landis, R. Matthew; Justice, Judith; Gopinath, Ranjani; Maes, Kenneth; Amaha, Hailom Banteyerga; Mohammed, Ismaila Zango; Mohammed Dukku, Aminu; Omidian, Patricia A.; Varley, Emma; Tedoff, Pauley; Koon, Adam; Nyirazinyoye, Laetitia; Luck, Matthew A.; Pont, W. Frank; Neergheen, Vanessa; Rosenthal, Anat; Nsubuga, Peter; Thacker, Naveen; Jooma, Rashid; Nuttall, Elizabeth.

In: Journal of Infectious Diseases, Vol. 210, 01.11.2014, p. S504-S513.

Research output: Contribution to journalArticle

Closser, S, Cox, K, Parris, TM, Landis, RM, Justice, J, Gopinath, R, Maes, K, Amaha, HB, Mohammed, IZ, Mohammed Dukku, A, Omidian, PA, Varley, E, Tedoff, P, Koon, A, Nyirazinyoye, L, Luck, MA, Pont, WF, Neergheen, V, Rosenthal, A, Nsubuga, P, Thacker, N, Jooma, R & Nuttall, E 2014, 'The impact of polio eradication on routine immunization and primary health care: A mixed-methods study', Journal of Infectious Diseases, vol. 210, pp. S504-S513. https://doi.org/10.1093/infdis/jit232
Closser, Svea ; Cox, Kelly ; Parris, Thomas M. ; Landis, R. Matthew ; Justice, Judith ; Gopinath, Ranjani ; Maes, Kenneth ; Amaha, Hailom Banteyerga ; Mohammed, Ismaila Zango ; Mohammed Dukku, Aminu ; Omidian, Patricia A. ; Varley, Emma ; Tedoff, Pauley ; Koon, Adam ; Nyirazinyoye, Laetitia ; Luck, Matthew A. ; Pont, W. Frank ; Neergheen, Vanessa ; Rosenthal, Anat ; Nsubuga, Peter ; Thacker, Naveen ; Jooma, Rashid ; Nuttall, Elizabeth. / The impact of polio eradication on routine immunization and primary health care : A mixed-methods study. In: Journal of Infectious Diseases. 2014 ; Vol. 210. pp. S504-S513.
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AU - Landis, R. Matthew

AU - Justice, Judith

AU - Gopinath, Ranjani

AU - Maes, Kenneth

AU - Amaha, Hailom Banteyerga

AU - Mohammed, Ismaila Zango

AU - Mohammed Dukku, Aminu

AU - Omidian, Patricia A.

AU - Varley, Emma

AU - Tedoff, Pauley

AU - Koon, Adam

AU - Nyirazinyoye, Laetitia

AU - Luck, Matthew A.

AU - Pont, W. Frank

AU - Neergheen, Vanessa

AU - Rosenthal, Anat

AU - Nsubuga, Peter

AU - Thacker, Naveen

AU - Jooma, Rashid

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N2 - Background. After 2 decades of focused efforts to eradicate polio, the impact of eradication activities on health systems continues to be controversial. This study evaluated the impact of polio eradication activities on routine immunization (RI) and primary healthcare (PHC).Methods: Quantitative analysis assessed the effects of polio eradication campaigns on RI and maternal healthcare coverage. A systematic qualitative analysis in 7 countries in South Asia and sub-Saharan Africa assessed impacts of polio eradication activities on key health system functions, using data from interviews, participant observation, and document review.Results: Our quantitative analysis did not find compelling evidence of widespread and significant effects of polio eradication campaigns, either positive or negative, on measures of RI and maternal healthcare. Our qualitative analysis revealed context-specific positive impacts of polio eradication activities in many of our case studies, particularly disease surveillance and cold chain strengthening. These impacts were dependent on the initiative of policy makers. Negative impacts, including service interruption and public dissatisfaction, were observed primarily in districts with many campaigns per year.Conclusions: Polio eradication activities can provide support for RI and PHC, but many opportunities to do so remain missed. Increased commitment to scaling up best practices could lead to significant positive impacts.

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