Abstract
.The last case of wild poliovirus in Ethiopia was reported in 2014. Until the disease is eradicated globally, the risk of reimportation remains high. In 1999, the CORE Group Polio Project (CGPP) began its community-centered polio eradication efforts in Ethiopia, using community volunteers (CVs) to ensure that no child has missed polio vaccine. This article documents the efforts of CVs and highlights innovative strategies, successes, and contributions. Qualitative data were collected from the CGPP implementation areas in 85 border woredas (districts) of Benishangul-Gumuz; Gambella; Oromia; Southern Nations, Nationalities, and Peoples’ Region; and Somali. A total of 151 in-depth interviews were conducted with CVs, parents, CGPP partners, and project stakeholders. Results of the study showed that CVs secured the buy-in of community members through open and fair eligibility and selection processes, thereby ensuring representation of community needs and perspectives. Community-driven participation consisted of identifying and choosing credible, trusted individuals who were willing to actively engage as caretakers of the community. Community volunteers then received specialized training and supportive supervision to build and expand their command of child health and vaccination information and interpersonal skills, fortifying the legitimacy of health messages and supporting the community’s sense of collective efficacy. The robust network of CVs built by the CGPP continues to effectively reach the most remote, rugged, and underserved areas of Ethiopia. Stakeholders credit the CGPP with playing a significant role in keeping Ethiopia polio-free and increasing the population coverage of polio and routine immunizations.
Highlights
Poliomyelitis is a highly infectious viral disease that can invade the central nervous system, causing irreversible paralysis
Oral polio vaccine 3 coverage in the CORE Group Polio Project (CGPP) implementation areas in Ethiopia rose from 61.1% to 73.5% between 2012 and 2017, and the percentage of fully immunized children increased from 24.7% to 43.6%
In Ethiopia, the CGPP community volunteers (CVs) have been instrumental in the fight for polio eradication by overcoming many of the challenges and pressures faced by paid frontline health workers
Summary
Poliomyelitis (polio) is a highly infectious viral disease that can invade the central nervous system, causing irreversible paralysis. There is no cure for polio, but it is preventable through immunization. In low- and middle-income countries, immunity is gained primarily through several rounds of repeated vaccination with routine oral polio vaccine (OPV) and at least one full dose of inactivated polio vaccine, which is administered by intramuscular injection, or with a fractional (one-fifth) dose given intradermally. In 1988, the World Health Assembly resolved to work toward the eradication of polio. Just 8 years earlier, the World Health Assembly had declared smallpox eradicated—the only infectious disease holding this distinction so far. To eradicate polio through surveillance and vaccination, the Global Polio Eradication Initiative (GPEI) began its work 30 years ago to tackle a disease that was paralyzing 1,000 children every day across the globe. Despite these promising results, there are remaining strongholds of at-risk populations in remote, insecure, and hard-to-reach areas in the three endemic countries of Afghanistan, Pakistan, and Nigeria
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