Evaluating nongovernmental organization–led community mobilizers in health promotion, immunization campaigns, and acute flaccid paralysis surveillance: a systematic review of the evidence

Abstract

Community mobilization, partnership, and surveillance are regarded as key elements in various polio eradication activities. Several nongovernmental organizations have led community mobilizers (CMs) in different aspects of the polio eradication campaigns, and their effectiveness shows mixed findings. This study systematically reviewed the literature on the role of CMs in polio eradication activities. Literature searches were conducted using a combination of key words to find relevant published studies up to 30 November 2020. The 27-item Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist addressing the various components of systematic review was adhered to. A total of 1627 articles were identified by the search, with 65 articles passing the title/abstract and full text reviews, and with four additional articles obtained from references of articles included (making a total of 69 articles). Of these 69 articles involved in the review, 24 (five reviews and 19 original articles) focused largely and explicitly on CMs and were included in the full review. The rest (45) discussed CMs in a broader context, hence they were summarized based on part 1 of the data extraction form only.The findings of the review indicated that although CMs’ instrumental role in health promotion and supporting immunization is consistent for all the reviewed studies, their role in acute flaccid paralysis (AFP) case detection is limited. The role of CMs, other actors in community-based surveillance, and health education needs to be further strengthened, particularly in high-risk communities where routine immunization and AFP surveillance are much needed.