Abstract
Today, acceptance of oral polio vaccine is the highest ever. Reaching this level of acceptance has depended on decades of engaging with communities, building trust amid extraordinary social contexts, and responding to the complex variables that trigger behavioral and social change. Drawing on both the successes and setbacks in the 28 years of the Global Polio Eradication Initiative (GPEI), this article articulates what happened when the GPEI began to pay more attention to the dynamics of human and social behavior change. Three particular lessons for other health and immunization programs can be drawn from the experience of GPEI: change begins from within (ie, success needs institutional recognition of the importance of human behavior), good data are not enough for good decision-making, and health workers are important agents of behavior change. These lessons should be harnessed and put into practice to build demand and trust for the last stages of polio eradication, as well as for other life-saving health interventions.
Highlights
In 1988, the World Health Assembly (WHA) endorsed the ambitious goal of eradicating a vaccine-preventable disease—polio—for only the second time in history
The epidemiology and biology of the disease, the efficacy of oral polio vaccine (OPV) versus that of inactivated polio vaccine (IPV), the political commitment required, the cost-benefit analysis to the world, and the risks of a vertical eradication program undermining immunization programs were all at the forefront of deliberations [1, 2]
This article articulates what happened when the Global Polio Eradication Initiative (GPEI) began to pay more attention to the dynamics of human and social behavior change and to the lessons that can be drawn for other health and immunization programs
Summary
Placing Human Behavior at the Center of the Fight to Eradicate Polio: Lessons Learned and Their Application to Other Life-Saving Interventions. This article articulates what happened when the Global Polio Eradication Initiative (GPEI) began to pay more attention to the dynamics of human and social behavior change and to the lessons that can be drawn for other health and immunization programs. This analysis draws on key reports and documents of polio eradication efforts (eg, peer-reviewed literature and reports by the GPEI and the GPEI Independent Monitoring Board), with a particular focus on social, behavioral, and communication dynamics. The article focuses primarily on lessons learned, because social, behavioral, and operational dynamics of polio eradication have been widely documented in the peer-reviewed literature and by reports from the GPEI Independent Monitoring Board and others
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