Polio Eradication as a Platform for Integration

Filimona Bisrat (MD, MPH), CORE Group Polio Project

June 15, 2011Global Health Council

38th Annual International ConferenceOmni Shoreham Hotel, Washington, DC

CORE Group Ethiopia• CORE began polio work in Ethiopia in Nov. 2001• 3 programs (malaria., EPI, polio eradication) – Partnering with 9 International & 11 local NGOs – Covering 132 Woredas in 8 Regions & one City

Administration– Reaching a total population of 11,458,933• CORE Ethiopia Secretariat housed in CCRDA

•Hard to reach and rural areas

•Pastoralist populations

•Porous borders with Sudan, Kenya Somalia & Djibouti

CORE Group Ethiopia Projects

• Funded by: USAID• 7 regions, 19 Zones &

55 Woredas• Beneficiaries

•Total population of 4,576,557 •< 1 yr 101,648 •< 5 yr 618,360 •< 15 yr 1,905,903

• 11 NGOs (7 intl. & 4 local)• 5 yr. grant up to 2012

• Funded by : GAVI through FMOH

• 4 regions & 40 Districts • Beneficiaries

•Total population of 2,404,285 •< 1 yr 60,947 •< 5 yr 115,405

• 7 NGOs (4 intl. & 3 local)• 1.8 M USD for 2 yrs.

• Funded by Global Fund through FMOH

• 6 regions, 1 CA & 100 Districts

• Beneficiaries•Total population of 6,748,026Pregnant Women 264,929 •< 5 yr - 874,353

• 14 NGOs (4 intl. & 10 local)• 3.9 M USD for 3 yrs

CORE GROUP POLIO PROJECT

GAVI CSO Support Project

Malaria FMOH/GF Project

“Secretariat Model” as a platform

• Integration among PVOs/NGOs between CSO and other national and global stakeholders

• Opportunity to address other issues through same community level structures– Routine immunization– Integrated disease surveillance– Malaria

The CGE Secretariat Members

International• CARE• CCF• CRS• Plan • SC-US• WVE• IRC• AMREF• PCI• KHI

Key Partners• FMoH• USAID• WHO• UNICEF• CCRDA• Rotary

International

Local Partners• PC• ATCC• HCS • EECMY• AdCS• BCS• JeCCDO• M4M• TYA• TRTA• APDA

Secretariat Model Approach• Democratic decision process• Coordination, technical backstopping and quality

assurance of the activities through Representation at national and international forums

• Documentation of impact/outcomes• Integrated implementation at community level

focused on awareness and demand creation and support to service delivery

• Capacity building for government staff as well as NGO/PVOs at central, regional and woreda levels

CORE Ethiopia Organogram Director

Communication Officer

Monitoring & Evaluation

Officer

Program Director

CGPP

Focal Person

GAVI

Focal Person

Malaria

Focal Person

Senior Finance Officer

Finance Officer

Admin. & Liaison Officer

AdminAssistant

Driver

Focal Persons/Program Officers/ are assigned based on

geographical location in order to make supervision & follow up

activities for all the three projects

Achievements

Representation of Community-level Expertise

National Level• Inter-agency Coordination

Committee (ICC)• New vaccine initiative• National Malaria Task

Force• Coordination Against

Malaria in Ethiopia – Steering committee member

International level• WHO’s AFRO Task Force

for Immunization• GAVI Civil Society Task

Force & steering committee member

Major Outcomes of State-Level Advocacy

• Participation of Presidents and senior officials Regional states on Immunization increased

• Regional interagency Coordination Committee (ICC) established

• Woreda EPI taskforce established at Woreda level

• Penta 3 coverage has become one the evaluation criteria for Woreda administration councils

Gambella Regional President participates in polio campaign

In CORE Group Polio Project Areas

Routine Immunization Baseline & Midterm in CGPP Areas

CARD RETENTION

* Represents statistically significant difference (at alpha = 5%) between baseline and midterm figures.

Routine ImmunizationBaseline & Midterm in CGPP Areas

* Represents statistically significant difference (at alpha = 5%) between baseline and midterm figures.

OPV0 OPV0 OPV0OPV3 OPV3 OPV3Penta1 Penta1 Penta1Penta3Penta3Penta3

* * ** ** ** *

Baseline n=883Midterm n=286

Baseline n=602Midterm n=281

Baseline n=593Midterm n=263

Lessons Learnt• Manage larger coverage geographically and in beneficiaries

including previously silent areas• Able to create joint action against polio as well as other killer

diseases that are rampant in the country .• Enhancing the capacity of partners’ staff and front line health

workers as well as volunteer community health workers• Obtained recognition of its joint effort and awarded

additional funds from GAVI Alliance CSO support and Global fund Malaria Project to extend its coverage and capacity.

• Accorded seat on ICC as well as other policy bodies and representation to international bodies by FMOH

Challenges• Establishing trust

– Among IPVOs– Gaining confidence of external stakeholders in

CSO capacity

• Administrative policies vary widely across partner organization

• Variation in technical capacity of partners

The Way Forward

• Expansion in relation to geography and type of interventions to other unreached areas– Best mix of technical areas?

• Role beyond 2012/eradication of polio• Incorporation of secretariat as bona fide in-

country NGO to continue collaborative efforts to improve women’s and children’s health

Social Mobilization Activities

Thank You!