Abstract
BackgroundThe primary strategy to interrupt transmission of wild poliovirus in India is to improve supplemental immunization activities and routine immunization coverage in priority districts with a focus on 107 high-risk blocks of western Uttar Pradesh and central Bihar. Villages or urban areas with a history of wild poliovirus transmission, or hard-to-reach or resistant populations are categorized as high-risk areas within blocks. The Social Mobilization Network (SM Net) was formed in Uttar Pradesh in 2003 to support polio eradication efforts through improved planning, implementation and monitoring of social mobilization activities in those high-risk areas. In this paper, we examine the vaccination outcomes in districts of SM Net where the CORE Group works.MethodsWe carried out a secondary data analysis of routine monitoring information collected by the SM Net and the Government of India. These data include information about vaccination outcomes in SM Net areas and non-SM Net areas within the districts where the CORE Group operates. Statistical analysis was used to compare, between SM Net and non-SM Net areas, vaccination outcomes considered sensitive to social mobilization efforts of the SM Net. We employed Generalized Estimating Equations (GEE) statistical method to account for Intra-cluster Correlation (ICC), and used 'Quasi-likelihood under the independence model criterion (QIC)' as the model selection method.ResultsVaccination outcomes in SM Net areas were as high as or higher than in non-SM Net areas. There was considerable variation in vaccination outcomes between districts.ConclusionsWhile not conclusive, the results suggest that the social mobilization efforts of the SM Net and the CORE Group are helping to increase vaccination levels in high-risk areas of Uttar Pradesh. Vaccination outcomes in CORE Group areas were equal or higher than in non-CORE, non-SM Net areas. This occurred even though SM Net areas are those with more community resistance to polio vaccination and/or are have harder-to-reach populations than non-SM Net areas. Other likely explanations for the relatively good vaccination performance in SM Net areas are not apparent.
Highlights
The primary strategy to interrupt transmission of wild poliovirus in India is to improve supplemental immunization activities and routine immunization coverage in priority districts with a focus on 107 high-risk blocks of western Uttar Pradesh and central Bihar
Community Mobilization Coordinators (CMCs) areas are a group of villages within a block that have been purposively selected because they have the most difficulty achieving vaccination program targets
We would expect—in the absence of additional CORE Group Polio Project (CGPP) social mobilization efforts—that vaccination performance would be lower, on average, in CMC areas compared to non-CMC areas
Summary
The primary strategy to interrupt transmission of wild poliovirus in India is to improve supplemental immunization activities and routine immunization coverage in priority districts with a focus on 107 high-risk blocks of western Uttar Pradesh and central Bihar. Almost all wild polio cases in India are from high-risk districts in western Uttar Pradesh and central Bihar [3]. The most recent primary strategy to interrupt transmission of wild poliovirus in India is to improve supplemental immunization activities (SIAs or mass campaigns) and routine immunization coverage in 107 high-risk blocks of western Uttar Pradesh and central Bihar [4]. The CGPP harnesses and synchronizes the efforts of a coalition of US-based Private Voluntary Organizations (PVOs) and their in-country offices, as well as non-governmental organization (NGOs) partners to support the polio eradication effort by providing both social mobilization and detailed local planning for vaccination services. The project reaches these populations by systematic enumeration and tracking of children less than five years, and through highly targeted social mobilization strategies that rely on direct personal communication with families and with informal and formal community leaders
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