Core polio integration in practice lynch
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Transcript of Core polio integration in practice lynch
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CORE Polio: Integration in practice
CORE Group Spring Meeting
May 2011
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A Starting Point
• Integration – service delivery– Clinical – Community-based
• Not…– Organizational (WHO + UNICEF + MOH + Rotary
+ CDC + USAID…)– Financial (funding streams by activity, donor)– Systems (integrated family health unit vs. EPI +
infectious disease + maternal…)
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Global Polio Eradication InitiativeTHEN
NGOs & civil society
Communities
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Some Realities
Global vaccinesupply and policy
Health systemmaterial infrastructure
Health systemhuman resources
Economics
Culture &
Politics
Other vaccinepreventable diseases
Conflict
Foodinsecurity
Vitamin Adeficiency Malaria
HIV/AIDS
Sanitation &hygiene
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Global Polio Eradication InitiativeNOW
Global vaccinesupply and policy
Health systemmaterial infrastructure
Health systemhuman resources
Economics
Culture &
Politics
Other vaccinepreventable diseases
Conflict
Foodinsecurity
Vitamin Adeficiency
Malaria
HIV/AIDS
Sanitation&
hygiene
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The Birth of CORE Polio
• Initial idea was actual to integrate polio into Child Health and Survival Grant Program– NGO/PVOs reach hard-to-reach and resistant– And represent reality on the ground to GPEI
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Growth of CORE Polio as a platform
Polio campaigns and Surveillance
Measles (health promotion)
Integrated campaigns(measles, VitA, nets)
Routine Immunization(defaulter tracing,
health worker skills) Handwashing promtionother sanitation
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How it works in Africa
• Malaria IEC in Ethiopia and Angola– Malaria BCC messages included with polio-
related ones by same volunteers– Monitoring as integrated as possible
• A single monitoring report to central in-country which they can parse as needed
• Integrated population based surveys
– Dedicated malaria field supervision staff
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How it works in India - 1
• India hygiene and sanitation– Community resistance to sole focus on polio
– Highly efficient transmission
– Promotion of handwashing and other hygiene behaviors
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How it works in India - 2
• Same staff at all levels
• Developed new messages and carefully
designed SM activities and integrated them
into polio/immunization social mobilization
• Completely integrated M&E
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ITN use in integrated campaign
Luena
Dala
Saurimo
Luacano
Cambulo
Soyo
Kalandula
Sede
Mbanza CongoCabinda
Puri
Sede
Cacongo
Chitato
Legend
Child ITN Use, Prev Night<= 55%
56-85%
85-100%
Below LQAS DR, Target = 85%
Angola Municipalities
± 0 250 500 750 1,000125Kilometers
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Reasons to integrate
• Logistical
– Measles, VitA, nets during polio campaign
• Content
– Hygiene and sanitation
• A mixture
– Routine immunization
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Some thoughts…
• Range of technical assistance needs
• Potentially multiple relationships, especially with health system counterparts
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Issues to consider going forward
• Local capacity building – with multiple health system counterparts– On skills required for integrated service
delivery
• Volunteer fatigue vs. “thirst for knowledge”