Performance and determinants of routine immunization coverage within the context of intensive polio eradication activities in Uttar Pradesh, India: Social Mobilization Network (SM Net) and Core Group Polio Project (CGPP)

Abstract Background A social mobilization (SM) initiative contributed to India’s success in polio elimination. This was the CORE Group Polio Project (CGPP) India, a partner of the Uttar Pradesh (UP) SM Network and which continued its SM activities, even during the polio-free period through a network of multi-level social mobilizers. This paper assesses the effects of this community-level SM (CLSM) intervention on the extent of community engagement and performance of polio Supplementary Immunization Activity campaigns (SIAs) during the post-polio-endemic period (i.e., from March 2012 to September 2017). Methods This study followed a quasi-experimental design. We used secondary, cluster-level data from CGPP India’s Management Information System, including 52 SIAs held from January 2008 to September 2017, covering 56 blocks from 12 districts of UP. We computed various indicators and performed Generalized Estimating Equations based analysis to assess the statistical significance of differences between the outcomes of intervention and non-intervention areas. We then estimated the effects of the SM intervention using Interrupted time-series, Difference-in-Differences and Synthetic Control Methods. Finally, we estimated the population influenced by the intervention. Results The performance of polio SIAs changed over time, with the intervention areas having better outcomes than non-intervention areas. The absence of CLSM intervention during the post-polio-endemic period would have negatively impacted the outcomes of polio SIAs. The percentage of children vaccinated at polio SIA booths, percentage of ‘X’ houses (i.e., households with unvaccinated children or households with out-of-home/out-of-village children or locked households) converted to ‘P’ (i.e., households with all vaccinated children or households without children eligible for vaccination), and percentage of resistant houses converted to polio acceptors would have gone down by 14.1 (Range: 12.7 to 15.5), 6.3 (Range: 5.2 to 7.3) and 7.4 percentage points, respectively. Community engagement would have reduced by 7.2 (Range: 6.6 to 7.7) percentage points. Conclusions The absence of CLSM intervention would have significantly decreased the level of community engagement and negatively impacted the performance of polio SIAs of the post-polio-endemic period. The study provides evidence of an added value of deploying additional human resource dedicated to social mobilization to achieve desired vaccination outcomes in hard-to-reach or programmatically challenging areas.

Download Full-text

Effectiveness of a Community-level Social Mobilization Intervention in Achieving the Outcomes of Polio Vaccination Campaigns During the Post-polio-endemic Period: Evidence from CORE Group Polio Project in Uttar Pradesh, India.

10.21203/rs.3.rs-103016/v1 ◽

2020 ◽

Author(s):

Manojkumar Choudhary ◽

Roma Solomon ◽

Jitendra Awale ◽

Rina Dey ◽

Jagajeet Prasad Singh ◽

...

Keyword(s):

Community Engagement ◽

Uttar Pradesh ◽

Social Mobilization ◽

Community Level ◽

Added Value ◽

Synthetic Control ◽

Core Group ◽

Percentage Points ◽

Polio Vaccination ◽

Vaccination Campaigns

Abstract Background:A social mobilization (SM) initiative contributed to India’s success in polio elimination. This was the CORE Group Polio Project (CGPP), a partner of Uttar Pradesh (U.P.) SM Network and which continued its SM activities, even during the polio-free period through a network of multi-level social mobilizers. This paper assesses the effects of this community-level SM (CLSM) intervention on the extent of community engagement and performance of polio vaccination campaigns during the post-polio-endemic period (i.e., from March 2012 to September 2017). Methods:This study followed a quasi-experimental design. We used secondary, cluster-level data from CGPP India’s Management Information System, including 52 SIAs held from January 2008 to September 2017 in 56 blocks, covering 12 districts of U.P. We computed various indicators and performed Generalized Estimating Equations (GEE) based analysis to assess the statistical difference. We then estimated the effects of the SM intervention, using Interrupted time-series, Difference-in-Differences and Synthetic Control Methods. Also, estimated the population influenced by the intervention. Results:The performance of polio vaccination campaigns changed over time, with the intervention areas having better outcomes than non-intervention areas. The absence of community-level SM Net intervention during the post-polio-endemic period would have negatively impacted booth coverage, X-to-P conversion rate, Refusal-to-Acceptor conversion of intervention areas to 14.1 (range: 12.7 to 15.5), 6.3 (range: 5.2 to 7.3) and 7.4 percentage points, respectively. Community engagement would have reduced by 7.2 (range: 6.6 to 7.7) percentage points. The study guesstimated that the intervention averted at least 43 (range: 40 to 47) paralytic polio cases annually from the intervention areas, during the post-polio-endemic period. Conclusions:The absence of CLSM intervention would have significantly decreased the level of community engagement and negatively impacted the performance of polio SIAs of the post-polio-endemic period. The study provides evidence of an added-value of additional human resources dedicated to social mobilization to achieve desired vaccination outcomes in hard-to-reach or programmatically challenging areas.

Download Full-text

Use of Call Centers in Polio Eradication Efforts in Island Settlement in Chad

Journal of Immunological Sciences ◽

10.29245/2578-3009/2021/s2.1113 ◽

2021 ◽

Vol Special Issue (2) ◽

pp. 87-93

Author(s):

Adele Daleke Lisi Aluma ◽

Sam Koulmini ◽

Souley Kalilou ◽

Obianuju Igweonu ◽

Felix Amadou Kouassi ◽

...

Keyword(s):

Call Centers ◽

Immunization Coverage ◽

Oral Polio Vaccine ◽

Polio Eradication ◽

Routine Immunization ◽

Community Leaders ◽

African Region ◽

Global Polio Eradication Initiative ◽

Telephone Calls ◽

Immunization Campaign

Background: One of the four key strategies of the Global Polio Eradication Initiative (GPEI) is high immunization coverage, with oral polio vaccine as part of routine immunization schedules. However, given the weak routine immunization structures in the African Region, coverage is enhanced with supplemental immunization activities (SIAs), and mop-up immunizations. Unfortunately, anecdotal information show that vaccination teams sometimes omit some catchments areas without immunization. This paper thus describes the use of “Call Centers” in detecting missed populations and taking prompt corrective action. Method: The study was based on review of call records during polio supplemental immunization campaigns in Bol Districts in Chad from February to May 2018. The immunization coverage resulting from these campaigns was compared with that of February 2018. A compilation of data – details on communities, community leaders, and their phone numbers was performed. On the eve of the campaign, community leaders were alerted on the vaccinators’ visitThe community leaders were called on the eve of the campaign to alert them on the visit of the vaccinators. At the end of each day, activities (visits as well) were reviewed at the coordination centres Vaccinators were asked to return to any community where community leaders did not confirm visits). Result: Telephone calls allowed the verification and confirmation of the vaccinators visits in 92% of cases. Villages where vaccination was planned but which were not reached were revisited. More than 1,011 children were caught up through this approach in 10 villages in the Bol district. Conclusion: In conclusion, call centers played significantly higher role in generating covering more children with immunization during immunization campaign.

Download Full-text