Contribution of polio eradication initiative to strengthening routine immunization: Lessons learnt in the WHO African region

Abstract

PEI has been associated with increased spending on immunization and the related improvements, especially in the areas of micro planning, service delivery, program management and capacity building. Continued efforts are needed to mobilize international and domestic support to strengthen and sustain high-quality immunization services in African countries. Strengthening RI will in turn sustain the gains made to eradicate poliovirus in the region.

Introduction of Inactivated Poliovirus Vaccine and Trivalent Oral Polio Vaccine/Bivalent Oral Polio Vaccine Switch in the African Region

“…Routine immunization is a major pillar of the GPEI endgame strategic plan, delivering 4 doses of tOPV at birth, 6, 10, and 14 weeks of age. To sustain the gains of polio eradication and maintain a polio-free African Region, resources of the polio eradication initiative were deployed to improve RI performance and to increase immunization coverage in several countries [ 2 , 17 ]. Financial, physical, human, and other resources were used to support immunization programs.…”

“…Microplanning was used to identify settlements or villages with a high number of unvaccinated children and a global positioning systems (GPS) was used to create accurate, coordinate-based maps for polio-endemic states that were consequently utilized to provide routine vaccines [ 17 ]. For instance, health facility microplans were updated in what is named in Nigeria “reach every ward” to capture previously unreached settlements, improving access and utilization of the immunization services by reestablishing immunization service delivery points (fixed sites) in wards with existing facilities and outreach or mobile sites [ 2 ]. Strategies used for unreached children during polio campaigns were leveraged to ensure that RI services are provided in identified areas.…”

“…Data were analyzed and used for actions to improve performance at all levels. Similarly, GPEI contributions to supportive supervision was strengthened and text messaging was used to transmit data and drive corrective actions, in what is known as Nigeria’s real-time tracking of routine immunization supervision [ 2 ]. Regular meetings were also held between the village committees and health facility staff to improve linkages and enable good turnout during outreach and mobile services.…”

“…GPEI led to monthly monitoring and decision-making meetings that took into account immunization and existing problems in the health sector. In Tanzania, health workers with experience in polio management provided RI and other services in an integrated manner in remote villages that lacked adequate health services [ 2 ]. GPEI funds facilitated the logistics and management of vaccines ensuring uninterrupted supply of vaccines at the endpoints.…”

“…An additional objective of the endgame strategy is to strengthen routine immunization (RI) as the primary pillar to sustain high population immunity. Routine immunization performance will be strengthened through implementation of activities and strategies to raise immunization coverage and to ensure high population immunity against polioviruses, especially type 2, after withdrawal of OPV2 [ 2 ]. Outbreaks of wild poliovirus (WPV) and cVDPV are closely correlated with low vaccine coverage and hence routine immunization performance [ 3 ].…”