CORE Group's Polio Eradication Efforts
Over the last 10 years, the CORE Group, in partnership with UNICEF, Rotary International, and the governments of India, Nepal, Ethiopia, and Angola, has worked to reduce the burden of polio by mobilizing communities to participate in routine immunization campaigns and vaccination services.
Understanding the Barriers to Immunization
CORE Group and its partners work with communities to reduce the barriers to immunization. Common barriers include a lack of awareness regarding vaccination, poor surveillance capacity, and a belief that vaccinations can be harmful to children. In July 2008, the Core Group Polio Project team conducted an assessment to better understand the specific barriers in each of the four CGPP countries.
FY09 Reports
CORE Group Polio Project: FY09 Program Annual Report
Technical Progress of the Expanded CORE Group Polio Project - August 2009
CORE Group Polio Project: Goal, Objectives, Activities, and Milestones
Angola
The CORE Group Polio Project has been active in Angola since 2001.
CORE Group members in Angola:
* Africare
* Catholic Relief Services
* Save the Children
* Salvation Army World Service Office
* World Vision
Angola CGPP Baseline Survey report
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Background
When the original CORE Group project began in 2001, Angola was experiencing a major outbreak- over 1,000 cases. The outbreak was concentrated in the capital city of Luanda. In the subsequent four years no additional cases were identified, but surveillance was poor.
The CORE Group Polio Project (CGPP) focused on community-based surveillance to enhance detection of acute flaccid paralysis (AFP)-a symptom of polio. The CGPP in Angola encompasses volunteer tracking of defaulters, use of community maps in detailed sub-district level micro-planning, and active case searching among local leaders and healers. The CGPP-Angola coordinates the work of 5 US-based PVO partners and many local partners to reach 3,781,072 children under fifteen each year.
2008 Survey Results - Survey results in Angola found that there is still a high resistance to immunizing children among mothers. Although mass media campaigns about vaccination and acute flaccid paralysis (AFP) have been conducted in the project area, knowledge about AFP, a symptom of polio, was low among mothers the surveyed. (Only 45 % of respondents had heard of AFP.) The project is exploring social behavior change methodologies to better understand why mothers do not want their children vaccinated and ways that awareness about AFP can be raised.
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Ethiopia
The CORE Group Polio Project has been active in Ethiopia since 2000.
CORE Group members in Ethiopia:
* AMREF
* International Rescue Committee
* Catholic Relief Services
* Save the Children
* CARE International
* Christian Children's Fund
* Plan
* World Vision
Ethiopia CGPP Baseline Survey report
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Background
In Ethiopia, the CORE Group Polio Project (CGPP) began in 2000 and has addressed a variety of challenges to reaching extraordinarily inaccessible communities with vaccination services and surveillance. As a country at high risk for importation from conflict-ridden Somalia and South Sudan on its borders, Ethiopia must maintain high immunization rates and excellent surveillance.
CGPP has focused on reaching underserved rural and migrant populations, certainly to facilitate opportunities to vaccinate, but with at least as much focus on case search and reporting to maintain acute flaccid paralysis (AFP) surveillance quality.
Currently, the 12 CGPP-Ethiopia partners including eight PVOs and four local NGOs. These partners are implementing activities in 52 woredas (districts) of seven regions in the country reaching a total of 2,039,905 children under 15 annually.
2008 Survey Results - Survey results in Ethiopia revealed that polio campaigns were very successful at immunizing target children and that knowledge about AFP is high (at 70%). Some barriers do remain, including: a belief among respondents (90%) that children can receive polio vaccinations too often, and that some children should not be vaccinated or might be hurt by the polio vaccination.
The most prevalent reasons for not getting a child vaccinated included lack of healthcare workers coming to give the vaccine at the village, lack of awareness about the vaccine, and an absence of a health facility in the locality.
The CGPP team recognizes that sustained efforts and attention to a range of barriers to immunization seeking are needed to strengthen surveillance and routine immunization for polio.
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India
The CORE Group Polio Project has been active in India since 2001.
CORE Group members in India:
* Adventist Development and Relief Agency
* Catholic Relief Services
* Concern Worldwide
India CGPP India Baseline Survey report
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Background
India remains an epicenter of wild poliovirus transmission and is responsible for a number of cases imported in recent years into previously polio-free countries not only in Asia but also in Africa. India's total number of cases was 874 in 2007 and 674 in 2006, compared to only 66 cases nationwide in 2005.
Because of the high quality of surveillance in India and the high level of resistance to polio vaccination in concentrated sub-populations, the CGPP program in India focuses on social mobilization and detailed, sub-district level micro-planning to overcome resistance in order to improve supplemental polio immunization and routine immunization coverage. The CGPP-India operates in 11 high risk districts in the state of Uttar Pradesh, reaching 21,428,498 children under 15 each year.
2008 Survey Results - In India, there is a high acceptance among mothers for repeated polio doses, but routine immunization coverage and retention of immunization records is low. The polio campaigns have a significant reach of the population, but knowledge of the age at which the first dose of polio should be given.
The project team recognizes the need to address the following barriers: low literacy level of mothers for planning any communications activities, the need for ongoing capacity building of Community Mobilization Coordinators, since that was the most commonly cited source of information, and building greater awareness about when the first dose of vaccination can be given.
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Nepal
The CORE Group Polio Project has been active in Nepal since 2001.
CORE Group members in Nepal:
* Care Nepal
* Save the Children
* Plan
* World Vision
* Adventist Development and Relief Agency
Nepal CGPP Baseline Survey report
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Background
Nepal's excellent public health system with a government-sanctioned network of community health volunteers (Female Community Health Volunteers - FCHVs) has maintained high vaccination coverage rates.
Despite the work of the CORE Group Polio Project (CGPP) and other local, national and international partners, in 2008 Nepal experienced 5 polio cases linked to importation from India.
Exceptionally high coverage and sensitive surveillance are critical for Nepal due to its proximity to and porous border with India, an epicenter of polio transmission. Working through the health systems already in place, particularly the District Public Health Offices and the FCHVs, the CGPP annually reaches 2,489,715 children under 15 with vaccination promotion and AFP surveillance awareness.
2008 Survey Results - In Nepal, the survey revealed that mothers received information about polio vaccinations primarily through female community health volunteers. Other effective ways that worked to get messages to mothers include: radio, neighbors, and health workers, respectively.
Knowledge of AFP could be improved, as well as the age at which to give the first dose of polio.
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