Resources and Publications

Power is exercised everywhere in global health, although its presence may be more apparent in some instances than others. Studying power is thus a core concern of researchers and practitioners working in health policy and systems research (HPSR), an interdisciplinary, problem-driven field focused on understanding and strengthening multilevel systems and policies. This paper aims to conduct a power analysis as mobilized by the actors involved in implementation of the polio program. It will also reflect how different power categories are exerted by actors and embedded in strategies to combat program implementation challenges while planning and executing the Global Polio Eradication Initiative.

Frontline workers (FLWs) in the Global Polio Eradication Initiative go door-to-door delivering polio vaccine to children. They have played a pivotal role in eliminating wild polio from most countries on earth; at the same time, they face significant bodily risk. STRIPE, an international consortium, conducted a mixed-methods study exploring the knowledge and experiences of polio staff in seven countries (Afghanistan, Bangladesh, Democratic Republic of Congo, Ethiopia, India, Indonesia and Nigeria). We surveyed 826 polio FLWs and conducted semi-structured interviews with 22 of them. We used a body work framework to guide analysis…

Improving service delivery is a key strategy for achieving service coverage, one of the two components of universal health coverage (UHC). As one of the largest global public health initiatives, individuals involved with the Global Polio Eradication Initiative (GPEI) have learned many important lessons about service delivery. We identified contributors and challenges to delivering health services at national and subnational levels using experiences from the GPEI. We described strategies used to strengthen service delivery and draw lessons that could be applicable to achieving UHC.

Objectives: To document lessons from the Global Polio Eradication Initiative (GPEI) by determining factors associated with successful surveillance programme globally as well as at national and subnational levels. The process of conducting surveillance has been previously recognised in the literature as important for the success of polio surveillance activities.

Sustaining an effective evidence-based health intervention will maximize its impact on public health. Political and governmental reforms impacted on immunization program sustainability both positively and negatively. This study aims to explore the sustainability of polio immunization in a decentralized health system taking lessons learned from a polio eradication initiative in Indonesia.

Lessons learned from one global health program can inform responses to challenges faced by other programs. One way to disseminate these lessons is through courses. However, such courses are often delivered by and taught to people based in high-income countries and thus may not present a truly global perspective. The Synthesis and Translation of Research and Innovations from Polio Eradication (STRIPE) is a consortium of 8 institutions in Afghanistan, Bangladesh, the Democratic Republic of the Congo, Ethiopia, India, Indonesia, Nigeria, and the United States that seeks to carry out such a transfer of the lessons learned in polio eradication. This short report describes the collaborative process of developing content and curriculum for an international course, the learnings that emerged, the barriers we faced, and recommendations for future similar efforts…

Objective: This study employed the Consolidated Framework for Implementation Research (CFIR) to assess factors that enhanced or impeded the implementation of community engagement strategies using the Nigerian polio programme as a point of reference.

Introduction: The debate over the impact of vertical programmes, including mass vaccination, on health systems is long-standing and often polarised. Studies have assessed the effects of a given vertical health programme on a health system separately from the goals of the vertical programme itself. Further, these health system effects are often categorised as either positive or negative. Yet health systems are in fact complex, dynamic and tightly linked. Relationships between elements of the system determine programme and system-level outcomes over time.

Globally, gender as a barrier or facilitator in achieving health outcomes is increasingly being documented. However, the role of gender in health programming and organization is frequently ignored. The Global Polio Eradication Initiative, one of the largest globally coordinated public health programs in history, has faced and worked to address gender-based challenges as they emerge. This paper seeks to describe the role of gender power relations in the polio program across global, national, subnational, and front-line levels to offer lessons learned for global programs.

Vertical disease control programmes have enormous potential to benefit or weaken health systems, and it is critical to understand how programmes’ design and implementation impact the health systems and communities in which they operate. We use the Develop–Distort Dilemma (DDD) framework to understand how the Global Polio Eradication Initiative (GPEI) distorted or developed local health systems. We include document review and 176 interviews with respondents at the global level and across seven focus countries (Afghanistan, Bangladesh, Democratic Republic of Congo, Ethiopia, India, Indonesia and Nigeria). We use DDD domains, contextual factors and transition planning to analyse interactions between the broader context, local health systems and the GPEI to identify changes…

The scaling up of public health interventions has received greater attention in recent years; however, there remains paucity of systematic investigations of the scaling up processes. We aim to investigate the overall process, actors and contexts of polio immunization scaling up in Indonesia from 1988 until 2018.

Eradication of polio in the world is a historical and significant achievement in public health after eradication of smallpox. WHO’s Global Polio Eradication Initiative (GPEI) focused on effective implementation strategies to enhance access and availability of polio vaccine, production and distribution of vaccine, strong logistics and supply chain, massive communication campaign and health system strengthening.

Since its inception in 1988, the Global Polio Eradication Initiative (GPEI) has partnered with 200 countries to vaccinate over 2.5 billion children against poliomyelitis. The polio eradication approach has adapted to emerging challenges and diverse contexts. Knowledge assets gained from these experiences can inform implementation of future health programs, but only if efforts are made to systematically map barriers, identify strategies to overcome them, identify unintended consequences, and compare experiences across country contexts.

Afghanistan and Nigeria are two of the three remaining polio endemic countries. While these two countries have unique sociocultural characteristics, they share major polio risk factors. This paper describes the countries’ shared contexts and highlights important lessons on implementing polio eradication activities among hard-to-reach populations relevant for future global health programs.

Previous initiatives have aimed to document the history and legacy of the Smallpox Eradication Program (SEP) and the Global Polio Eradication Initiative (GPEI). In this multi-pronged scoping review, we explored the evolution and learning from SEP and GPEI implementation over time at global and country levels to inform other global health programs.

Community engagement has been widely accepted as a tool to foster communities’ participation in health promotion activities, increase acceptance to health interventions and promote sustainability of the program. The implementing organization’s planning process and the convictions held by the communities are crucial factors to be considered for a successful community engagement activity. The funding process of the health intervention is a major constraint to be considered while implementing community engagement activities.
Consolidated Framework for Implementation Research is a valuable instrument for evaluating implementation of health intervention strategies. Ensuring that community engagement implementers address these highlighted issues early on will ultimately increase the chances of success of the strategy.

Since the Global Polio Eradication Initiative (GPEI) was initiated in 1988, it has invested more than one billion dollars annually; This is operated through thousands of staff and millions of volunteers in hundreds of communities in Nigeria. After over a decade of being the only endemic country in Africa, Nigeria was declared free of the polio virus in the last quarter of 2020. Post-polio, the crucial question is what should happen to the assets, capabilities, and lessons of the GPEI? What will become of the tools and functions that are currently funded by the GPEI? Most importantly, what will become of other programs and health priorities: which to varying degrees, have become reliant on GPEI-funded infrastructure for support? The aim of this brief is to identify key areas in which the polio program has supported other health programs and recommend concrete plans for leveraging these opportunities for other health programs.

Publication of this supplement was funded by the Bill & Melinda Gates Foundation (OPP1178578 , Teaching Global Health Leaders about the Lessons Learned from Polio Eradication). The articles have undergone the journal’s standard peer review process for supplements. The Supplement Editor declares that they have no competing interests.

The Global Polio Eradication Initiative (GPEI) – a global effort to eradicate polio (poliovirus and its debilitating diseases, e.g. severe forms of acute flaccid paralysis (AFP)) through vaccination and active surveillance – is the largest public health initiative in recent history. Since 1988, the program has delivered hundreds of billion doses of polio vaccines and vaccinated more than 2.5 billion children globally [1]. This effort has contributed to successfully wiping out cases of wild poliovirus (WPV) from almost every corner of the world, from 350,000 annual cases reported in 125 countries in 1988 to 143 cases in two countries in 2019 [2]. Endemic transmission of WPV now only occur in Afghanistan and Pakistan, and two of the three WPV strains (WPV2 and WPV3)Footnote1 have been declared eradicated as of 2019 [3, 4].

Lessons from polio eradication efforts and the Global Polio Eradication Initiative (GPEI) are useful for improving health service delivery and outcomes globally. The Synthesis and Translation of Research and Innovations from Polio Eradication (STRIPE) is a multi-phase project which aims to map, package and disseminate knowledge from polio eradication initiatives as academic and training programs. This paper discusses initial findings from the knowledge mapping around polio eradication activities across a multi-country context.

Complex global initiatives, like the Global Polio Eradication Initiative (GPEI), have prevented millions of paralyses and improved the health status of diverse populations. Despite the logistical challenges these initiatives must overcome at several levels, scant methods exist for systematically identifying and reaching a range of actors involved in their implementation. As a result, efforts to document the lessons learned from such initiatives are often incomplete. This paper describes the development and application of the Synthesis and Translation of Research and Innovations from Polio Eradication (STRIPE) systematic approach for identifying a comprehensive sample of actors involved in the GPEI.

Thoughtful and equitable engagement with international partners is key to successful research. STRIPE, a consortium of 8 academic and research institutions across the globe whose objective is to map, synthesize, and disseminate lessons learned from polio eradication, conducted a process evaluation of this partnership during the project’s first year which focused on knowledge mapping activities.