Polio Eradication as a Platform for Integration_6.15.11_Bisrat


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  • Let me start by mentioning that in Ethiopia we were able to sample enough caretakers so that we could look at estimates for 3 different general regions in Ethiopia. Our Ethiopia Secretariat team thought it most beneficial to break up the project area by predominant lifestyle because this influences how our volunteers work with their communities and health posts. So, if there were large and interesting differences between the three areas, I’ve broken them out. If not, then I used a weighted aggregate estimate. You can see here card retention rates for the three areas.
  • You can see here again the three regions (agrarian, semi-pastoralist, and pastoralist). To keep it simple, we’re showing you four vaccinations for each (OPV0 in blue, OPV3 in green, Penta1 in orange, and Penta3 in yellow). Other OPVs and Pentas follow the same pattern and that is, project areas saw a statistically significant increase in OPV0 rates in all three areas, which is great news in Ethiopia where, as you can see, OPV0 rates are much, much less than other doses because of cultural and logistical factors. Beyond, OPV0, agrarian areas saw small decreases or small increases in vaccination rates, but nothing significant. Whereas the two other areas, saw statistically significant increases in vaccination rates for all doses of OPV and Penta. Catching up to agrarian areas, which remained steady. All OPV0 significant; OPV3 S and P significant; Penta1 S and P significant; Penta3 S and P significant. BCG and measles – data quality a question for baseline. Same pattern OPV1 – Penta3 – S and P significant while A is not.
  • Polio Eradication as a Platform for Integration_6.15.11_Bisrat

    1. 1. Polio Eradication as a Platform for Integration Filimona Bisrat (MD, MPH), CORE Group Polio Project June 15, 2011 Global Health Council 38 th Annual International Conference Omni Shoreham Hotel, Washington, DC
    2. 2. CORE Group Ethiopia <ul><li>CORE began polio work in Ethiopia in Nov. 2001 </li></ul><ul><ul><li>3 programs (malaria., EPI, polio eradication) </li></ul></ul><ul><ul><li>Partnering with 9 International & 11 local NGOs </li></ul></ul><ul><ul><li>Covering 132 Woredas in 8 Regions & one City Administration </li></ul></ul><ul><ul><li>Reaching a total population of 11,458,933 </li></ul></ul><ul><ul><li>CORE Ethiopia Secretariat housed in CCRDA </li></ul></ul>
    3. 3. <ul><li>Hard to reach </li></ul><ul><li>and rural areas </li></ul><ul><li>Pastoralist populations </li></ul><ul><li>Porous borders with Sudan, Kenya Somalia & Djibouti </li></ul>
    4. 4. CORE Group Ethiopia Projects <ul><li>Funded by: USAID </li></ul><ul><li>7 regions, 19 Zones & 55 Woredas </li></ul><ul><li>Beneficiaries </li></ul><ul><ul><li>Total population of 4,576,557 </li></ul></ul><ul><ul><li>< 1 yr 101,648 </li></ul></ul><ul><ul><li>< 5 yr 618,360 </li></ul></ul><ul><ul><li>< 15 yr 1,905,903 </li></ul></ul><ul><li>11 NGOs </li></ul><ul><li>(7 intl. & 4 local) </li></ul><ul><li>5 yr. grant up to 2012 </li></ul><ul><li>Funded by : GAVI through FMOH </li></ul><ul><li>4 regions & 40 Districts </li></ul><ul><li>Beneficiaries </li></ul><ul><ul><li>Total population of 2,404,285 </li></ul></ul><ul><ul><li>< 1 yr 60,947 </li></ul></ul><ul><ul><li>< 5 yr 115,405 </li></ul></ul><ul><li>7 NGOs </li></ul><ul><li>(4 intl. & 3 local) </li></ul><ul><li>1.8 M USD for 2 yrs. </li></ul><ul><li>Funded by Global Fund through FMOH </li></ul><ul><li>6 regions, 1 CA & 100 Districts </li></ul><ul><li>Beneficiaries </li></ul><ul><ul><li>Total population of 6,748,026 </li></ul></ul><ul><ul><li>Pregnant Women 264,929 </li></ul></ul><ul><ul><li>< 5 yr - 874,353 </li></ul></ul><ul><li>14 NGOs </li></ul><ul><li>(4 intl. & 10 local) </li></ul><ul><li>3.9 M USD for 3 yrs </li></ul>CORE GROUP POLIO PROJECT GAVI CSO Support Project Malaria FMOH/GF Project
    5. 5. “ Secretariat Model” as a platform <ul><li>Integration among PVOs/NGOs between CSO and other national and global stakeholders </li></ul><ul><li>Opportunity to address other issues through same community level structures </li></ul><ul><ul><li>Routine immunization </li></ul></ul><ul><ul><li>Integrated disease surveillance </li></ul></ul><ul><ul><li>Malaria </li></ul></ul>
    6. 6. The CGE Secretariat Members <ul><li>International </li></ul><ul><li>CARE </li></ul><ul><li>CCF </li></ul><ul><li>CRS </li></ul><ul><li>Plan </li></ul><ul><li>SC-US </li></ul><ul><li>WVE </li></ul><ul><li>IRC </li></ul><ul><li>AMREF </li></ul><ul><li>PCI </li></ul><ul><li>KHI </li></ul><ul><li>Key Partners </li></ul><ul><li>FMoH </li></ul><ul><li>USAID </li></ul><ul><li>WHO </li></ul><ul><li>UNICEF </li></ul><ul><li>CCRDA </li></ul><ul><li>Rotary International </li></ul><ul><li>Local Partners </li></ul><ul><ul><li>PC </li></ul></ul><ul><ul><li>ATCC </li></ul></ul><ul><ul><li>HCS </li></ul></ul><ul><ul><li>EECMY </li></ul></ul><ul><ul><li>AdCS </li></ul></ul><ul><ul><li>BCS </li></ul></ul><ul><ul><li>JeCCDO </li></ul></ul><ul><ul><li>M4M </li></ul></ul><ul><ul><li>TYA </li></ul></ul><ul><ul><li>TRTA </li></ul></ul><ul><ul><li>APDA </li></ul></ul>
    7. 7. Secretariat Model Approach <ul><li>Democratic decision process </li></ul><ul><li>Coordination, technical backstopping and quality assurance of the activities through Representation at national and international forums </li></ul><ul><li>Documentation of impact/outcomes </li></ul><ul><li>Integrated implementation at community level focused on awareness and demand creation and support to service delivery </li></ul><ul><li>Capacity building for government staff as well as NGO/PVOs at central, regional and woreda levels </li></ul>
    8. 8. CORE Ethiopia Organogram Director Communication Officer Monitoring & Evaluation Officer Program Director CGPP Focal Person GAVI Focal Person Malaria Focal Person Senior Finance Officer Finance Officer Admin. & Liaison Officer Admin Assistant Driver Focal Persons/Program Officers/ are assigned based on geographical location in order to make supervision & follow up activities for all the three projects
    9. 9. Achievements
    10. 10. Representation of Community-level Expertise <ul><li>National Level </li></ul><ul><li>Inter-agency Coordination Committee (ICC) </li></ul><ul><li>New vaccine initiative </li></ul><ul><li>National Malaria Task Force </li></ul><ul><li>Coordination Against Malaria in Ethiopia – Steering committee member </li></ul><ul><li>International level </li></ul><ul><li>WHO’s AFRO Task Force for Immunization </li></ul><ul><li>GAVI Civil Society Task Force & steering committee member </li></ul>
    11. 11. Major Outcomes of State-Level Advocacy <ul><li>Participation of Presidents and senior officials Regional states on Immunization increased </li></ul><ul><li>Regional interagency Coordination Committee (ICC) established </li></ul><ul><li>Woreda EPI taskforce established at Woreda level </li></ul><ul><li>Penta 3 coverage has become one the evaluation criteria for Woreda administration councils </li></ul>Gambella Regional President participates in polio campaign
    12. 12. In CORE Group Polio Project Areas
    13. 13. Routine Immunization Baseline & Midterm in CGPP Areas CARD RETENTION * Represents statistically significant difference (at alpha = 5%) between baseline and midterm figures.
    14. 14. Routine Immunization Baseline & Midterm in CGPP Areas * Represents statistically significant difference (at alpha = 5%) between baseline and midterm figures. OPV0 OPV0 OPV0 OPV3 OPV3 OPV3 Penta1 Penta1 Penta1 Penta3 Penta3 Penta3 * * * * * * * * * Baseline n=883 Midterm n=286 Baseline n=602 Midterm n=281 Baseline n=593 Midterm n=263
    15. 15. Lessons Learnt <ul><li>Manage larger coverage geographically and in beneficiaries including previously silent areas </li></ul><ul><li>Able to create joint action against polio as well as other killer diseases that are rampant in the country . </li></ul><ul><li>Enhancing the capacity of partners’ staff and front line health workers as well as volunteer community health workers </li></ul><ul><li>Obtained recognition of its joint effort and awarded additional funds from GAVI Alliance CSO support and Global fund Malaria Project to extend its coverage and capacity. </li></ul><ul><li>Accorded seat on ICC as well as other policy bodies and representation to international bodies by FMOH </li></ul>
    16. 16. Challenges <ul><li>Establishing trust </li></ul><ul><ul><li>Among IPVOs </li></ul></ul><ul><ul><li>Gaining confidence of external stakeholders in CSO capacity </li></ul></ul><ul><li>Administrative policies vary widely across partner organization </li></ul><ul><li>Variation in technical capacity of partners </li></ul>
    17. 17. The Way Forward <ul><li>Expansion in relation to geography and type of interventions to other unreached areas </li></ul><ul><ul><li>Best mix of technical areas? </li></ul></ul><ul><li>Role beyond 2012/eradication of polio </li></ul><ul><li>Incorporation of secretariat as bona fide in-country NGO to continue collaborative efforts to improve women’s and children’s health </li></ul>
    18. 18. Social Mobilization Activities
    19. 19. Thank You!