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Coordination as a best practice from the polio eradication initiative: Experiences from five member states in the African region of the World Health Organization

Tuesday, 4th of October 2016

Vaccine,Volume 34, Issue 43, 10 October 2016, Pages 5203–5207

Polio Eradication Initiative Best Practices in the WHO African Region

Coordination as a best practice from the polio eradication initiative: Experiences from five member states in the African region of the World Health Organization

Excerpts below; full text is at

http://www.sciencedirect.com/science/article/pii/S0264410X16303929

Highlights

•Structures were put in place to ensure coordinated mobilization of resources for PEI.

•With the recorded successes, the structures became attractive to other public health interventions.

•The PEI structures were deployed to respond to other diseases interventions.

• This paper documents the structure for more systematic deployment for future public health interventions.

Abstract

Background

As part of the efforts to eradicate polioviruses in the African Region, structures were put in place to ensure coordinated mobilization and deployment of resources within the framework of the global polio eradication initiative (PEI). The successes of these structures made them not only attractive to other public health interventions, but also caused them to be deployed to the response efforts of other diseases interventions, without any systematic documentation. This article documents the contributions of PEI coordination units to other public health interventions in the African Region of World Health Organization

Methods

We reviewed the contributions of PEI coordination units to other public health interventions in five countries in the African Region.

Results

The analysis identified significant involvement of PEI coordination structures in the implementation of routine immunization programs in all the countries analyzed. Similarly, maternal and child health programs were planned, implemented, monitored and evaluation the Inter-Agency Coordination Committees of the PEI programs in the different countries. The hubs system used in PEI in Chad facilitated the efficient coordination of resources for immunization and other public health interventions in Chad. Similarly, in the Democratic Republic of Congo PEI led coordination activities benefited other public health programs like disease control and the national nutrition program, the national malaria control program, and the tuberculosis control program. In Nigeria, the polio Expert Review Committee effectively deployed the Emergency Operation Center for the implementation of prioritized strategies and activities of the National Polio Eradication Emergency Plan, and it was utilized in the response to Ebola Virus Disease outbreak in the country.

Conclusions

The PEI-led coordination systems are thus recognized as having made significant contribution to the coordination and delivery of other public health interventions in the African Region.

1. Introduction

The goal of the Global Polio Eradication Initiative (GPEI) is to complete the eradication and containment of all wild, vaccine-related and Sabin polioviruses, such that no child ever again suffers paralytic poliomyelitis. With the adoption of these goals, by the World Health Assembly, the World Health Organization (WHO) and its partners made good efforts to accelerate the interruption of polio viruses [1], [2] and [3]. Attainment of the goal of eradication rested on four pillars of the GPEI strategy, namely strengthening immunization systems to ensure high coverage with polio vaccines through routine childhood immunization, robust surveillance for AFP, supplementary immunization, and “mop-up” immunizations [4] and [5]. Enormous human, financial and material resources were mobilized and committed to efforts at interrupting transmission of polio viruses and eventual eradication of poliomyelitis in the world.

Coordination of the resources and efforts was undertaken centrally by the Global Polio Eradication Initiative (GPEI). Thus, a Secretariat, based in Geneva coordinates the GPEI activities including policy development and support to countries through the WHO Regional Offices. An independent polio monitoring board monitored the use of resources and implementation of programs to eradicate polioviruses in the countries. The WHO Regional Office coordinated the disbursement of resources and technical assistance to the countries as well as outbreak response.

At the country level, the coordination of polio eradication activities was taken up by different Inter-Agency Coordinating Committee (ICCs). The WHO Regional Committee for Africa endorsed the global eradication goal at its 39th session in 1989, while the national governments unanimously adopted a resolution urging them to initiate the implementation of specific eradication strategies in 1995 [6]. In addition to the standard ICCs, countries took initiatives to put together other coordinating bodies to address the peculiarity of the polio problem in the countries. In Nigeria, for instance, there was the Expert Review Committee (ERC) which provided guidance on the implementation of the polio eradication activities in the countries through a polio Emergency Operations Center (EOC).

However, anecdotal evidence point to the fact that these coordination units set up for the purpose of pursuing polio eradication also served for other public health interventions. The case of Ebola Disease outbreak is a case in point. The polio EOC in Nigeria coordinated response to the Ebola Virus Disease outbreak in Nigeria [7]. Unfortunately, the contribution of these polio coordination bodies and activities to other public health programs in the Region has not been articulated and documented. This paper reviews the coordination activities put together for polio eradication in the African Region with a view to highlighting their contribution to other public health programs in the Region. It also highlights best practices in coordination of public health interventions that could be borrowed by yet to be benefitted programs.