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J Infect Dis. 2014 Nov 1;210 Suppl 1:S504-13. doi: 10.1093/infdis/jit232. Epub 2014 Apr 1.

The impact of polio eradication on routine immunization and primary health care: a mixed-methods study.

Author information

1
Department of Sociology and Anthropology, Middlebury College, Middlebury.
2
ISciences, Burlington, Vermont.
3
Philip R. Lee Institute for Health Policy Studies, University of California at San Francisco.
4
Freelance Consultant, Secunderabad.
5
Department of Anthropology, Oregon State University.
6
Addis Ababa University, Ethiopia.
7
Department of Sociology, Bayero University, Kano, Nigeria.
8
Independent Consultant, Corvallis, Oregon.
9
MNCH-RH Department, Health Services Academy, Islamabad.
10
Global Health and Development, London School of Hygiene and Tropical Medicine, United Kingdom.
11
National University of Rwanda School of Public Health, Kigali, Rwanda.
12
Department of Biomedical Ethics, McGill University, Montreal, Canada.
13
Global Public Health Solutions, Decatur, Georgia.
14
Deep Children Hospital and Research Centre, Gandhidham, India.
15
Department of Surgery, Aga Khan University, Karachi, Pakistan.

Abstract

BACKGROUND:

After 2 decades of focused efforts to eradicate polio, the impact of eradication activities on health systems continues to be controversial. This study evaluated the impact of polio eradication activities on routine immunization (RI) and primary healthcare (PHC).

METHODS:

Quantitative analysis assessed the effects of polio eradication campaigns on RI and maternal healthcare coverage. A systematic qualitative analysis in 7 countries in South Asia and sub-Saharan Africa assessed impacts of polio eradication activities on key health system functions, using data from interviews, participant observation, and document review.

RESULTS:

Our quantitative analysis did not find compelling evidence of widespread and significant effects of polio eradication campaigns, either positive or negative, on measures of RI and maternal healthcare. Our qualitative analysis revealed context-specific positive impacts of polio eradication activities in many of our case studies, particularly disease surveillance and cold chain strengthening. These impacts were dependent on the initiative of policy makers. Negative impacts, including service interruption and public dissatisfaction, were observed primarily in districts with many campaigns per year.

CONCLUSIONS:

Polio eradication activities can provide support for RI and PHC, but many opportunities to do so remain missed. Increased commitment to scaling up best practices could lead to significant positive impacts.

KEYWORDS:

eradication; health systems; poliomyelitis; routine immunization

PMID:
24690667
PMCID:
PMC4197907
DOI:
10.1093/infdis/jit232
[Indexed for MEDLINE]
Free PMC Article

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