Impact, Innovation, and Inclusion of Civil Society Organizations in Polio Eradication: The CORE Group Polio Project Story

"Getting to the final eradication of polio will require further application of the lessons learned from the CORE Group Polio Project regarding community engagement in order for communities where transmission is still occurring to take ownership of the issue and to recognize the benefits for their own populations..." - Dr. Henry B. Perry, co-editor

This supplement to the American Journal of Tropical Medicine and Hygiene (AJTMH) features a series of 14 articles chronicling the CORE Group Polio Project (CGPP)'s efforts to improve community health in extremely difficult contexts by working to eradicate polio, improve immunisation uptake, promote healthy household behaviours for mothers and children, and strengthen community-based surveillance in order to certify that polio eradication has in fact been achieved.

The supplement features the work of approximately 40 authors from India, Ethiopia, Nigeria, Kenya, South Sudan, Malawi, and the United States - most of them field programme managers. Their contributions explore the CGPP's work, which is funded by the United States Agency for International Development (USAID), over 2 decades, with a focus on high-risk areas with marginalised or hard-to-reach populations where health systems and immunisation programmes are also weak, where transmission of poliovirus has not been stopped or where the risk of recurrent transmission is high, and where resistance to the polio campaign has been encountered.

Specifically, the articles examine CGPP's model of community engagement and the concrete, often creative strategies that have been designed to inspire the participation of local civic leaders and communities in ways to complement top-down vertical efforts of ministries of health and other partners in the Global Polio Eradication Initiative (GPEI). It has done so by: strategically reaching and engaging with communities in challenging contexts to promote positive participation and acceptance of polio eradication efforts, involving marginalised communities through behaviour change strategies coordinated by national and local non-governmental organisations (NGOs), and motivating underserved communities to take ownership of their health.

Examples of specific activities discussed in the articles include: pioneering the use of community-based surveillance, promoting independent campaign monitoring, establishing a cross-border initiative, developing a cadre of community mobilisers and volunteers to track missed children, involving families in discussions about the importance of immunisation, providing behaviour change education on key health issues, dispeling rumours and misperceptions, and linking families to vaccination sites and other health services.

Contents:

• "Community Engagement, Ownership, and Civil Society Organizations in Polio Eradication" - by Jon K. Andrus and Henry B. Perry
• "The CORE Group Polio Project: An Overview of Its History and Its Contributions to the Global Polio Eradication Initiative" - by Lee Losey, Ellyn Ogden, Filimona Bisrat, Roma Solomon, David Newberry, Ellen Coates, Dora Ward, Lisa Hilmi, Karen LeBan, Vanessa Burrowes, and Henry B. Perry
• "Involvement of Civil Society in India's Polio Eradication Program: Lessons Learned" - by Roma Solomon
• "Effective Partnership Mechanisms: A Legacy of the Polio Eradication Initiative in India and Their Potential for Addressing Other Public Health Priorities" - by Jitendra Awale, Manojkumar Choudhary, Roma Solomon, and Adesh Chaturvedi
• "Effectiveness of a Census-Based Management Information System for Guiding Polio Eradication and Routine Immunization Activities: Evidence from the CORE Group Polio Project in Uttar Pradesh, India" - by Manojkumar Choudhary, Henry B. Perry, and Roma Solomon
• "The CORE Group Polio Project's Community Volunteers and Polio Eradication in Ethiopia: Self-Reports of Their Activities, Knowledge, and Contributions" - by Bethelehem Asegedew, Fasil Tessema, Henry B. Perry, and Filimona Bisrat
• "Improvements in Polio Vaccination Status and Knowledge about Polio Vaccination in the CORE Group Polio Project Implementation Areas in Pastoralist and Semi-Pastoralist Regions in Ethiopia" - by Fasil Tessema, Filimona Bisrat, Legesse Kidane, Muluken Assres, Tenager Tadesse, and Bethelehem Asegedew
• "Trust, Communication, and Community Networks: How the CORE Group Polio Project Community Volunteers Led the Fight against Polio in Ethiopia's Most At-Risk Areas" - by Katherine V. Stamidis, Lydia Bologna, Filimona Bisrat, Tenager Tadesse, Fasil Tessema, and Elizabeth Kang
• "The CORE Group Partners Project in North East Nigeria: Community Engagement Strategies to Combat Skepticism and Build Trust for Vaccine Acceptance" - by Samuel Usman, Lydia Bologna, and Katherine V. Stamidis
• "Contributions of Volunteer Community Mobilizers to Polio Eradication in Nigeria: The Experiences of Non-governmental and Civil Society Organizations" - by Janefrancis Ijeoma Duru, Samuel Usman, Opeyemi Adeosun, Katherine V. Stamidis, and Lydia Bologna
• "Use of Social Mobilization and Community Mobilizers by Non-governmental Health Organizations in Malawi to Support the Eradication of Polio, Improve Routine Immunization Coverage, and Control Measles and Neonatal Tetanus" - by Andrew Chimpololo and Vanessa Burrowes
• "Evaluation of the Functionality and Effectiveness of the CORE Group Polio Project's Community-Based Acute Flaccid Paralysis Surveillance System in South Sudan" - by Anthony Kisanga, Bausumo Abiuda, Peter Walyaula, Lee Losey, and Omongot Samson
• "Preventing Importation of Poliovirus in the Horn of Africa: The Success of the Cross-Border Health Initiative in Kenya and Somalia" - by Ahmed Arale, Mercy Lutukai, Somane Mohamed, Lydia Bologna, and Katherine V. Stamidis
• "Lessons Learned from the CORE Group Polio Project and Their Relevance for Other Global Health Priorities" - by Henry B. Perry, Roma Solomon, Filimona Bisrat, Lisa Hilmi, Katherine V. Stamidis, Robert Steinglass, William Weiss, Lee Losey, and Ellyn Ogden

Dr. Perry explains: "The CORE Group Polio Project demonstrates the powerful synergism of international NGOs working at scale with national NGOs with adequate international donor funding and technical support to reach down to the household level to the most vulnerable and underserved communities with priority public health interventions. The lessons learned have powerful applications for addressing other public health priorities and for extending basic primary health care services to the billions of people not being reached at present."