TY - JOUR
T1 - The impact of polio eradication on routine immunization and primary health care
T2 - A mixed-methods study
AU - Closser, Svea
AU - Cox, Kelly
AU - Parris, Thomas M.
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 D.
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
AU - Nuttall, Elizabeth
N1 - Publisher Copyright:
© 2014 Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.
PY - 2014/11/1
Y1 - 2014/11/1
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.
AB - 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.
KW - eradication
KW - health systems
KW - poliomyelitis
KW - routine immunization
UR - http://www.scopus.com/inward/record.url?scp=84910682831&partnerID=8YFLogxK
U2 - 10.1093/infdis/jit232
DO - 10.1093/infdis/jit232
M3 - Article
C2 - 24690667
AN - SCOPUS:84910682831
SN - 0022-1899
VL - 210
SP - S504-S513
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
ER -
