Dataset Information

The CORE Group Polio Project: An Overview of Its History and Its Contributions to the Global Polio Eradication Initiative.

ABSTRACT: The CORE Group Polio Project (CGPP) has contributed to polio eradication by successfully engaging civil society, particularly the non-governmental organization (NGO) community. This engagement, which began with a grant from the U.S. Agency for International Development in 1999, has contributed to improvements in routine immunization programs, polio campaign quality, and surveillance for acute flaccid paralysis in many challenging geographic areas. The CGPP has worked closely with polio eradication partners in a collaborative and supportive role. The CGPP has focused largely on high-risk areas with marginalized or hard-to-reach populations where health systems and immunization programs have also been weak and where transmission of poliovirus had not been stopped. The CGPP has engaged local civic leaders and communities in ways to complement top-down vertical efforts of ministries of health and other partners in the Global Polio Eradication Initiative. The CGPP has developed innovative strategies to detect cases using community-based surveillance, promoted independent campaign monitoring, established cross-border initiatives, and developed a strong and creative cadre of community mobilizers to track missed children and deliver behavior change education. Many of the innovations and approaches that the CGPP helped to develop are now being replicated by governments and international agencies to tackle other public health priorities in underserved and marginalized communities around the world. This article is the first in a series of articles describing the work of the CGPP. Because the article describes the work of more than 40 NGOs in 11 countries over 20 years, it provides only an overview, leaving many important details and variations of the CGPP's work to be described elsewhere, including in other articles included in this series.

SUBMITTER: Losey L

PROVIDER: S-EPMC6776098 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:There are currently huge efforts by the World Health Organization and partners to complete global polio eradication. With the significant decline in poliomyelitis cases due to wild poliovirus in recent years, rare cases related to the use of live-attenuated oral polio vaccine assume greater importance. Poliovirus strains in the oral vaccine are known to quickly revert to neurovirulent phenotype following replication in humans after immunisation. These strains can transmit from person to person leading to poliomyelitis outbreaks and can replicate for long periods of time in immunodeficient individuals leading to paralysis or chronic infection, with currently no effective treatment to stop excretion from these patients. Here, we describe an individual who has been excreting type 2 vaccine-derived poliovirus for twenty eight years as estimated by the molecular clock established with VP1 capsid gene nucleotide sequences of serial isolates. This represents by far the longest period of excretion described from such a patient who is the only identified individual known to be excreting highly evolved vaccine-derived poliovirus at present. Using a range of in vivo and in vitro assays we show that the viruses are very virulent, antigenically drifted and excreted at high titre suggesting that such chronic excreters pose an obvious risk to the eradication programme. Our results in virus neutralization assays with human sera and immunisation-challenge experiments using transgenic mice expressing the human poliovirus receptor indicate that while maintaining high immunisation coverage will likely confer protection against paralytic disease caused by these viruses, significant changes in immunisation strategies might be required to effectively stop their occurrence and potential widespread transmission. Eventually, new stable live-attenuated polio vaccines with no risk of reversion might be required to respond to any poliovirus isolation in the post-eradication era.

Project description:ObjectivesTo document lessons from the Global Polio Eradication Initiative (GPEI) by determining factors associated with successful surveillance programme globally as well as at national and subnational levels. The process of conducting surveillance has been previously recognised in the literature as important for the success of polio surveillance activities.DesignA cross-sectional survey with closed and open-ended questions.SettingsSurvey of persons involved in the implementation of surveillance activities under the GPEI at the global level and in seven low-income and middle-income countries.ParticipantsIndividuals (n=802) with ≥12 months of experience implementing surveillance objective of the GPEI between 1988 and 2019.Main outcome measures and methodsQuantitative and qualitative analyses were conducted. Logistic regression analyses were used to assess factors associated with implementation process as a factor for successful surveillance programme. Horizontal analysis was used to analyse qualitative free-text responses on facilitators and barriers identified for conducting surveillance activities successfully.ResultsOverall, participants who reported challenges relating to GPEI programme characteristics had 50% lower odds of reporting implementation process as a factor for successful surveillance (adjusted OR (AOR): 0.50, 95% CI: 0.29 to 0.85). Challenges were mainly perceptions of external intervention source (ie, surveillance perceived as 'foreign' to local communities) and the complexity of surveillance processes (ie, surveillance required several intricate steps). Those who reported organisational challenges were almost two times more likely to report implementation process as a factor for successful surveillance (AOR: 1.89, 95% CI: 1.07 to 3.31) overall, and over threefolds (AOR: 3.32, 95% CI: 1.14 to 9.66) at the national level.ConclusionsProgramme characteristics may have impeded the process of conducting surveillance under the GPEI, while organisational characteristics may have facilitated the process. Future surveillance programmes should be designed with inputs from local communities and frontline implementers.

Project description:BackgroundGlobally, community engagement is an integral part of most public health programs and the social mobilization (SM) intervention of India's polio eradication program is one such example that contributed to eliminating polio from the country. CORE Group Polio Project (CGPP), a partner of Uttar Pradesh (U.P.) SM Network executed its activities through a network of social mobilizers called Community Mobilization Coordinators (CMCs). These were deployed in polio high risk areas to perform awareness generation and trust-building activities with communities and achieved high coverage of polio vaccination during Supplementary Immunization Activity campaigns (SIAs). This paper measures the extent and outcomes of CMC community engagement in SM interventions and polio SIAs.MethodsThis study used secondary, cluster-level data from Management Information System of CGPP India, including 52 SIAs held between January 2008 to September 2017 in 56 blocks/polio planning units, covering 12 districts of U.P. We used five indicators that reflected community engagement in polio SIAs and constructed a Community Engagement Index (CEI). Further, we estimated the difference in the CEI between CMC and non-CMC areas, using Generalized Estimating Equations (GEE) and also estimated treatment effects through Difference-in-Differences (DID) method using STATA.ResultsOverall, 78.6% (95% confidence interval (CI) = 78.3, 78.8) of families from the study area were engaged in the polio SIAs and the extent of community engagement increased over time. The mean CEI of entire study period in CMC areas (85.8%; 95% CI = 85.6, 86.0) was significantly higher (P < 0.001) than that of non-CMC areas (71.3%; 95% CI = 71.1, 71.5). Over time, the SM intervention led to at least 11 percentage points increase in the CEI of CMC areas with about 17% of this achievement attributable to CGPP India's SM efforts.ConclusionsThe study findings suggest that intensive social mobilization efforts can significantly increase the extent of community engagement. The community engagement learnings of polio SM Network may be useful to achieve the desired outcomes of public health programs such as the National Health Mission (NHM) of India, that serves communities for multiple health issues.

Project description:BACKGROUND:Children who receive all doses of scheduled vaccines reduce their susceptibility to vaccine-preventable diseases. In India, full immunization coverage has increased significantly. However, only a small proportion of children are immunized on time. Globally, studies on factors affecting coverage of childhood immunization have found a significant impact by demand and supply-side determinants. This paper explores the demand-side determinants of timely immunization of the third dose of oral polio vaccine (OPV3) among children aged 6-11 months in the catchment areas of CORE Group Polio Project India. METHODS:We analyzed secondary de-identified data from a household level 'Doers and Non-doers survey' conducted in 2015. Determinants of timely OPV3 immunization were identified by modeling the characteristics of index children and survey respondents, surveyed households, respondents' media habits, their exposure to immunization services and perceptions towards child immunization, through a multinomial regression analysis. RESULTS:The eight demand-side predictors based on the background characteristics and perceptions of caregivers determined timely vaccination of OPV3. The strongest predictor of timely OPV3 immunization was found to be the fathers' educational level. Children of uneducated or lesser educated fathers had increased odds of not receiving the OPV1 vaccination, as compared to children of more educated fathers (OR > 10). Respondents who strongly perceived other (non-health) benefits of child immunization were three times more likely to timely vaccinate their children than those who do not. Furthermore, mothers who disagreed with the positive attributes of child immunization were 25 times more likely to delay or not to take their children for OPV immunization on time. CONCLUSIONS:This study found eight essential factors that are responsible for timely OPV3. Despite limitations in data collection and analysis, immunization programs in India could use the eight identified demand-side determinants of timeliness and tailor communication strategies accordingly. We suggest that program communication efforts be directed at male community members; such messaging should address parents' perceptions of non-health benefits and stress the positive attributes of child immunization. Further investigation would be helpful to assess the various risk factors of under-vaccination as well as vaccinators' understating about timely immunization.

Dataset Information

The CORE Group Polio Project: An Overview of Its History and Its Contributions to the Global Polio Eradication Initiative.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets