Effectiveness of a Census-Based Management Information System for Guiding Polio Eradication and Routine Immunization Activities: Evidence from the CORE Group Polio Project in Uttar Pradesh, India

Abstract

Census-based management information systems (CB-MISs) bring strength and power to public health programs by providing current information about everyone in the population covered by the program. Such a system has been developed by the CORE Group Polio Project (CGPP) in India. This article assesses the effectiveness of the CGPP CB-MIS in the management of social and behavioral change interventions. It also assesses the feasibility of the CB-MIS for vital events registration. We describe the procedures of the CB-MIS and measure the outcomes of the CGPP by observing the trends of vaccination coverage in CGPP catchment areas over time. We also compute vital statistics from births and deaths registered through the CGPP CB-MIS and compare them with the estimates from the Civil Registration System of India using statistics from India's Sample Registration System in Uttar Pradesh as the "gold standard." The CB-MIS has helped the CGPP to manage its social and behavior change communication interventions effectively, and it has contributed to the increase in polio vaccine coverage facilitated by the CGPP. We also estimate that the CGPP's CB-MIS has registered 86% of births and 98% of infant deaths, a much higher level of registration than has been achieved by the Civil Registration System for the entire state of Uttar Pradesh. The CB-MIS has helped to make it possible for community-based health workers to make behavioral diagnoses of barriers to immunization and to overcome them. The CB-MIS also provides a robust platform for community-based health workers to register vital events.

The Critical Role and Evaluation of Community Mobilizers in Polio Eradication in Remote Settings in Africa and Asia

“…2 CGPP India increased its full routine coverage in CGPP catchment areas of Uttar Pradesh from 48% (2008) to 78% (2017), well above Uttar Pradesh's state coverage (51% in 2016) by using local data from CGPP's census-based management information system. 3 India conducted barrier analysis to examine factors responsible for timely OPV 3, finding that respondents who perceived other benefits of child immunization were 3 times more likely to timely vaccinate their children than those who did not, allowing them to adapt their messaging. 22 Each country commissioned Knowledge, Attitude, and Practice surveys of the CMs and community residents that provided data for new messaging, refresher training, and increased supervision.…”

“…India also used Lot Quality Assurance Sampling surveys and Barrier Analysis to identify impediments to adopting healthy behaviors. 3 Linkages to the Health System CM Referrals. All countries had a referral system for polio, and most programs evolved over time to provide referrals for routine immunization, antenatal care, newborns, and childhood and adult illnesses.…”

“…India also used Lot Quality Assurance Sampling surveys and Barrier Analysis to identify impediments to adopting healthy behaviors. 3 …”

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.

“…If the vaccination team encounters refusal, CMCs engage the help of local in uencers to try to convince resistant families to allow their children to be vaccinated. After completion of an SIA, the SM Net functionaries visit all the houses with unvaccinated children and encourage them to go for polio vaccination in the upcoming/next SIA [8,17,18].…”

Lessons Learned from the CORE Group Polio Project and Their Relevance for Other Global Health Priorities

“…Previous articles in this series [1][2][3][4][5][6][7][8][9][10][11][12] have examined various aspects of the CGPP activities and their contribution to the overall GPEI. Despite numerous setbacks, the number of wild poliovirus cases has been significantly reduced.…”