The Impact of Polio Eradication on Routine Immunization and Primary Health Care: A Mixed-Methods Study

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.

Pakistan's lady health worker labor movement and the moral economy of heroism

“…Other research projects I have been involved in included interviews with over 50 LHWs as well as with international polio eradication policymakers (Closser ; Closser et al ). These other research projects were more ethnographic, including not just interviews but extensive participant observation.…”

Routine immunization services in Pakistan: seeing beyond numbers

“…Intense utilization of the public health machinery and a concentration of resources on polio-focused activities is widely cited for shifting the focus away from routine immunization and causing "polio fatigue" among staff, managers and the community (19,26,27). There is, however, little empirical evidence that this has negatively impacted routine immunization activities (28).…”

Polio Immunization Social Norms in Kano State, Nigeria: Implications for Designing Polio Immunization Information and Communication Programs for Routine Immunization Services

“…. (some) take the vaccines because of the meager incentives given to them" (Closser, 2015;Closser, Cox, & Parris, 2014). Others take the vaccine out of intimidation, fear of arrest, and prosecution (Daily Trust, 2014; Integrated Regional Information Networks [IRIN], 2011; Mohammed, 2015;News Agency of Nigeria, 2015;Otieno, 2013).…”