New research conducted by Addis Ababa University and Johns Hopkins University sheds light on internal and external factors impacting Ethiopia’s polio eradication program.
Recently, in May 2019 and April 2022, Ethiopia was reclassified as an out breaking country given the outbreak in the horn of Africa and the presence of cVDPV3 in the Somali region.
According to the research, environmental barriers, geographic inaccessibility, conflict, mobile population, health system barriers and community barriers emerged as central challenges.
Nevertheless, according to the research, implementations were successful when it came to being flexible and responsive to emerging issues including; adapting service delivery to meet beneficiaries the country was able to develop sound management strategies for planning monitoring and evaluation.
“Polio eradication initiatives are relevant for the implementation of other lifesaving health programs” emphasized Dr. Meseret Zelalem, Director of Maternal Child Health and Nutrition Directorate at Ministry of Health.
The last imported case of wild poliovirus (WPV) in Ethiopia was reported in Somali region in 2014. Ethiopia was removed from the list of polio-endemic countries by the WHO in 2015 and in June 2017, was recognized by the African Regional Certification Commission for maintaining polio-free status for nearly four consecutive years. However, it maintained a “key at-risk” classification from the Global Polio Eradication Initiative (GPEI) in part because the country was located in the WPV importation belt, where any pockets of low coverage as well as suboptimal surveillance system performance made Ethiopia susceptible to outbreaks due to importation of poliovirus.
Ethiopia started polio eradication efforts in 1996, eight years after the World Health Assembly committed to the global eradication of polio in 1988.
The GPEI is led at the global level by the World Health Organization, UNICEF, the U.S. Centers for Disease Control and Prevention, Rotary International, the Bill & Melinda Gates Foundation, and the Global Alliance for Vaccines and Immunization (GAVI).
Currently, polio eradication activities are conducted independently while advised by GPEI. The polio eradication initiative strategy in Ethiopia includes four main pillars: strengthening routine immunization; ongoing polio surveillance; conducting polio- specific supplemental immunization activities (SIAs), or campaigns; and “mop up” activities where vaccinators actively seek out and vaccinate children who had been missed during regular immunizations.
From the study it was noted that delivery of routine immunization in Ethiopia was provided via the Expanded Program on Immunization (EPI) and the Ministry of Health staff at each level of the healthcare system. However, supplementary immunization activities and mop-ups were coordinated and managed by specialized committees at the national, sub-national and local levels.
As indicated, the coordination of the polio eradication program in Ethiopia including resource mobilization, logistics management, social mobilization and vaccination are centrally managed via the strategic interagency coordination committees and their technical subcommittees.
Similarly, as stated on paper, the Civil Society Organizations/Non-Governmental Organizations (CSOs/NGOs) have also played a vital role in implementing eradication activities among hard-to-reach populations, deploying more than 4,000 Community Volunteer Surveillance Focal Persons at the village level to conduct house-to-house case detection and reporting of acute flaccid paralysis.