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Core polio integration in practice lynch
 

Core polio integration in practice lynch

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  • Social mobilization for campaigns and community based surveillance for accute flaccid paralysis was to add on to community volunteers activities in other programs (C-IMCI, handwashing, nutrition, etc.)
  • Communities demanded additional services, wanted to know why the gov’t only cared about polio Inadequate population immunity despite high vaccination rates suggested that WASH measure to impede transmission might be necessary/helpful. So in keeping with global PEI (WHO/CDC) strategy the SMNet adopted WASH promotion as part of its activities. Also added health camps, with additional healtht services i.e., onther vaccines, prenatal, etc.
  • Some of the CGPPs successful integrated activities are indicated because of the logistical simplicity. (Give out VitA and neds while you’re goging house to house with polio drops.) Others work because the content is related. (People know polio transmission is caused by fecal oral transmission due to poor hygiene and sanitation, and they are more strongly motivated by clean-up days, etc. than by endless campaigns alone.)
  • Incidentally, an advantage to our collaborative approach is that the entire “secretariat” of PVOs/NGOs have access to any staff with experience in the different areas in any of the other NGOs Serious attention to systems strengthening is hard enough when it’s the same cast of characters. Integration across sharply different areas (malaria and immunization) requires interaction with two or more different sets of individuals
  • Within CGPP integration beyond nimmunization involving health system has largely occurred through integrated campaigns, in which MOH was responsible for training, support, supervision of MOH workers. In fact w/I CGPP effort greatest challenge to implementing community based RI such as defaulter tracing has been local gaps in immunization services (encompassing material infrastructure, human skills building, particularly around microplanning and local commitment) In community-level activities expectations of volunteers may already be unreasonable, on the other hand training itself, greater visibility and ability to offer broader range of services all serve as motivating factors

Core polio integration in practice lynch Core polio integration in practice lynch Presentation Transcript

  • CORE Polio: Integration in practice CORE Group Spring Meeting May 2011
  • A Starting Point
    • Integration – service delivery
      • Clinical
      • Community-based
    • Not…
      • Organizational (WHO + UNICEF + MOH + Rotary + CDC + USAID…)
      • Financial (funding streams by activity, donor)
      • Systems (integrated family health unit vs. EPI + infectious disease + maternal…)
  • Global Polio Eradication Initiative THEN NGOs & civil society Communities
  • Some Realities Global vaccine supply and policy Health system material infrastructure Health system human resources Economics Culture & Politics Other vaccine preventable diseases Conflict Food insecurity Vitamin A deficiency Malaria HIV/AIDS Sanitation & hygiene
  • Global Polio Eradication Initiative NOW Global vaccine supply and policy Health system material infrastructure Health system human resources Economics Culture & Politics Other vaccine preventable diseases Conflict Food insecurity Vitamin A deficiency Malaria HIV/AIDS Sanitation & hygiene
  • The Birth of CORE Polio
    • Initial idea was actual to integrate polio into Child Health and Survival Grant Program
      • NGO/PVOs reach hard-to-reach and resistant
      • And represent reality on the ground to GPEI
  •  
  • Growth of CORE Polio as a platform Polio campaigns and Surveillance Measles (health promotion) Integrated campaigns (measles, VitA, nets) Routine Immunization (defaulter tracing, health worker skills) Handwashing promtion other sanitation
  • How it works in Africa
    • Malaria IEC in Ethiopia and Angola
      • Malaria BCC messages included with polio-related ones by same volunteers
      • Monitoring as integrated as possible
        • A single monitoring report to central in-country which they can parse as needed
        • Integrated population based surveys
      • Dedicated malaria field supervision staff
  • How it works in India - 1
    • India hygiene and sanitation
      • Community resistance to sole focus on polio
      • Highly efficient transmission
      • Promotion of handwashing and other hygiene behaviors
  • How it works in India - 2
    • Same staff at all levels
    • Developed new messages and carefully designed SM activities and integrated them into polio/immunization social mobilization
    • Completely integrated M&E
  •  
  • ITN use in integrated campaign
  • Reasons to integrate
    • Logistical
      • Measles, VitA, nets during polio campaign
    • Content
      • Hygiene and sanitation
    • A mixture
      • Routine immunization
  • Some thoughts…
    • Range of technical assistance needs
    • Potentially multiple relationships, especially with health system counterparts
  • Issues to consider going forward
    • Local capacity building
      • with multiple health system counterparts
      • On skills required for integrated service delivery
    • Volunteer fatigue vs. “thirst for knowledge”
  • Thank You!
    • Dora Ward, CORE Group Polio Project [email_address]