The role of the Stop Transmission of Polio (STOP) program in developing countries: the experience of Kenya

Abstract

Background: In 1988, the 41 st World Health Assembly (WHA) marked the launch of the Global Polio Eradication Initiative (GPEI) for the eradication of polio. A key component of the GPEI has been the development and deployment of a skilled workforce to implement eradication activities. In 1989, the Stop Transmission of Polio (STOP) was initiated to address skilled human resource gaps and strengthen poliovirus surveillance. This paper describes the role of the STOP 52 team in technical capacity building and health system strengthening in the implementation of polio eradication strategies in Kenya following the outbreak of Circulating Vaccine-derived Poliovirus type 2 (cVDPV2). Methods: Overview of the STOP program, deployment, and the modality of support are described. Descriptive analysis was conducted using data collected by the STOP 52 team during integrated supportive supervisory visits conducted from July 2018 to September 2019. Analyses were carried out using Epi-Info statistical software (Version 7.0) and maps were developed using Quantum Geographic Information System (Q-GIS) (version 3.12.0). Results: The STOP 52 team supportively supervised 870 health facilities on Expanded Program on Immunization (EPI), and Acute Flaccid Paralysis (AFP) and other Vaccine-Preventable Diseases (VPDs) surveillance in 16 (34.1%) of the 47 counties during the study period. AFP surveillance was conducted in all health facilities supervised leading to the detection and investigation of 11 unreported AFP cases. The STOP 52 team, as part of the outbreak response, provided technical support to five successive rounds of polio Supplementary Immunization Activities (SIAs) conducted during the study period. Moreover, in addressing programmatic data needs, the STOP 52 Data Manager played a valuable role in enhancing the quality and use of data for evidence-based planning and decision-making. The STOP 52 team contributed to the development of operational plans, guidelines and training manuals, and participated in the delivery of various Training of Trainers (TOT) and On-the-Job Training (OJT) on EPI, AFP and other VPDs surveillance including data management. Conclusion: The STOP 52 team has contributed to polio eradication efforts in Kenya by enhancing AFP and other VPDs surveillance, supporting polio SIAs, strengthening EPI, use of quality EPI, AFP and other VPDs data, and capacity building of Frontline Health Workers (FLWs). The use of Open Data Kit (ODK) technology during supportive supervision, and AFP and other VPDs surveillance was found to be advantageous. A national STOP program should be modeled to produce a homegrown workforce to ensure the availability of more sustainable technical support for polio eradication efforts in Kenya and possibly other polio-affected countries.

Active search for COVID-19 cases during integrated supportive supervision using an electronic platform to improve healthcare workers performance in Niger: the legacy of the polio eradication program

“…Solutions to these issues may contribute to the overall improvement of the health system, as well as disease surveillance. In Kenya, the STOP program, a network of trained public health practitioners who supported with training and skill transfer, ensured the ISS's sustainability and helped in the reporting of missing AFP cases at health facilities and in the community [ 3 ]. Similarly, by combining polio eradication program (PEP) supervision with COVID-19 monitoring, we were able to identify and effectively trace 10 missing cases of suspected COVID-19 at the community level.…”

“…The electronic collection of data from ISS visits using the ODK Collect application provides evidence-based to track operational level activities but, above all, to contribute to the continuous improvement of the performance of vaccination-preventable disease surveillance [ 3 ]. The integration of COVID-19 surveillance into this activity is an opportunity to increase its surveillance sensitivity.…”