The President of the Republic of Madagascar, Andry Rajoelina, and the First Lady, Mialy Rajoelina, received a high-level delegation from the Global Polio Eradication Initiative (GPEI) on April 25, 2024 in Ambohitsorohitra palace in the capital, Antananarivo.
The delegation included the Regional Director of the World Health Organization (WHO) for Africa, Dr Matshidiso Moeti, the President of the Polio Oversight Board, Dr Chris Elias, the Regional Director of UNICEF for Eastern and Southern Africa, Etleva Kadilli, and the Director of Health Systems Strengthening and Immunization from Gavi, the Vaccine Alliance, Alex de Jonquieres.
To read more about the meeting, a press release is available here in French.
Antananarivo – Quality assurance surveyor Anja Mandimbisoa arrives at a random lot numerically selected, throws her pen in the air, and whichever house it is pointing at when it lands is the next on her evaluation list. With their consent, she then sits down with the family to verify whether the children in the household have the mark on their little fingers confirming they have been vaccinated against polio.
“The fact that it is a random selection provides a true picture of immunization coverage at the district level,” explains Mandimbisoa, one of 16 external Lot Quality Assurance Sampling (LQAS) surveyors trained by World Health Organization (WHO) in Analamanga region, Madagascar, to identify any missed children.
As the country concludes its third round of polio vaccinations this year, the response reflects that the job to end polio does not end with the conclusion of a vaccination round. Instead, it is the actions between rounds that make all the difference.
The polio eradication programme is using technology in innovative ways to map the activities of polio workers on the ground, and ensure that expertise and support is getting to the areas where it is most needed.
More than 300 international consultants are deployed by the partners of the GPEI in some of the countries most vulnerable to polio. By strengthening surveillance, tracking the virus, identifying immunity gaps and supporting vaccination campaigns to fill them, these consultants provide an important boost to capacity in polio-affected or vulnerable countries. By using new technologies, the programme is mapping the activities of all consultants to capture the range of locations they travel to and the activities they carry out. These innovations ensure that countries receive the best support from these consultants, and that they are working where the need is greatest.
Survey 123
The introduction of this new technology means that each week, no matter where they are in the world, international consultants report on their activities using a smartphone application called Survey123. The report only takes a minute to complete, works offline and captures their location at the time of reporting. By answering questions on what activities and diseases they have been working on that week, this tool enables the GPEI to capture data in real-time and ensure international consultants are being efficiently deployed in high risk polio areas and being used to their greatest advantage.
In the below snapshot from the first week of October, reports from the consultants can be seen in Guinea, the Lake Chad region, Madagascar, Somalia, Afghanistan and Pakistan – the areas that are most vulnerable to the virus.
From the 3 – 9 October, 242 out of 300 users completed an activity report using Survey 123, giving the programme essential information about their location and activities. Over 5000 reports were captured between February and September.
Getting people where they are most needed
Survey123 is also enabling the GPEI to identify changes in deployment over time. The recent notification of wild poliovirus in the Lake Chad region demonstrated the use of this clarity, by showing the movement of consultants into and around the Lake Chad region, despite insecurity and inaccessibility.
In depth analysis such as this provides greater clarity on what additional human resources are needed to respond to outbreaks or newly recognised risk areas, and indicates how rapidly GPEI resources can be used to fill important needs.
Following cases of polio being found in Nigeria in July 2016, Survey 123 was able to show the movement of international consultants into the affected areas to strengthen the response effort.
The broader benefits of polio eradication
Due to the scale of polio eradication activities even in the most remote and vulnerable areas to reach every last child, international consultants are sometimes present where other health infrastructure is weak. The capacity of the polio programme in these vulnerable areas is sometimes used to support other health initiatives, including improving routine immunisation, measles activities, communication for development and emergency response.
Analysing the collected reports from Survey 123 is giving us greater insight into the extent to which consultants are supporting other health programmes. The support provided to other health programmes shown in the map below highlights the continued benefits of the polio eradication infrastructure to other public health initiatives, giving the donors to the GPEI more bang for their buck when investing in polio eradication. The information gathered from this new technology is helping to inform transition planning efforts, providing information needed to country governments and GPEI partners as they look ahead to what should happen to the polio eradication infrastructure once the goal of a polio-free world has been achieved.
International consultants working on polio are also helping to support other health programmes. This map shows the amount of time in the different WHO Regions being spent on both polio and non-polio activities.
The Global Polio Eradication Initiative (GPEI) is highlighting the innovations that are helping to bring us closer to a polio-free world. Find out about other new approaches driving the polio eradication efforts by reading more in the Innovation Series.
