Core polio integration in practice lynch

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 InitiativeTHEN

NGOs & civil society

Communities

Some Realities

Global vaccinesupply and policy

Health systemmaterial infrastructure

Health systemhuman resources

Economics

Culture &

Politics

Other vaccinepreventable diseases

Conflict

Foodinsecurity

Vitamin Adeficiency Malaria

HIV/AIDS

Sanitation &hygiene

Global Polio Eradication InitiativeNOW

Global vaccinesupply and policy

Health systemmaterial infrastructure

Health systemhuman resources

Economics

Culture &

Politics

Other vaccinepreventable diseases

Conflict

Foodinsecurity

Vitamin Adeficiency

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 promtionother 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

Luena

Dala

Saurimo

Luacano

Cambulo

Soyo

Kalandula

Sede

Mbanza CongoCabinda

Puri

Sede

Cacongo

Chitato

Legend

Child ITN Use, Prev Night<= 55%

56-85%

85-100%

Below LQAS DR, Target = 85%

Angola Municipalities

± 0 250 500 750 1,000125Kilometers

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 dward@care.org