• Users Online: 246
  • Print this page
  • Email this page

Table of Contents
Year : 2022  |  Volume : 27  |  Issue : 1  |  Page : 1-13

Evaluating nongovernmental organization–led community mobilizers in health promotion, immunization campaigns, and acute flaccid paralysis surveillance: a systematic review of the evidence

1 Department of Community Medicine, Bayero University/Aminu Kano Teaching Hospital, Kano State, Nigeria
2 Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
3 Federal Medical Center, Birnin Kudu, Jigawa State, Nigeria
4 Department of Community Medicine, University of Jos, Plateau State, Nigeria
5 Centre for Global Health, Usher Institute, University of Edinburgh, Scotland, United Kingdom
6 College of Public Health, University of South Florida, Tampa, FL, United States of America

Date of Submission02-Feb-2021
Date of Decision18-Apr-2021
Date of Acceptance18-May-2021
Date of Web Publication3-Dec-2021

Correspondence Address:
Muktar A Gadanya
Department of Community Medicine, Bayero University/Aminu Kano Teaching Hospital, Kano State.
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijmh.IJMH_5_21

Rights and Permissions

Community mobilization, partnership, and surveillance are regarded as key elements in various polio eradication activities. Several nongovernmental organizations have led community mobilizers (CMs) in different aspects of the polio eradication campaigns, and their effectiveness shows mixed findings. This study systematically reviewed the literature on the role of CMs in polio eradication activities. Literature searches were conducted using a combination of key words to find relevant published studies up to 30 November 2020. The 27-item Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist addressing the various components of systematic review was adhered to. A total of 1627 articles were identified by the search, with 65 articles passing the title/abstract and full text reviews, and with four additional articles obtained from references of articles included (making a total of 69 articles). Of these 69 articles involved in the review, 24 (five reviews and 19 original articles) focused largely and explicitly on CMs and were included in the full review. The rest (45) discussed CMs in a broader context, hence they were summarized based on part 1 of the data extraction form only.The findings of the review indicated that although CMs’ instrumental role in health promotion and supporting immunization is consistent for all the reviewed studies, their role in acute flaccid paralysis (AFP) case detection is limited. The role of CMs, other actors in community-based surveillance, and health education needs to be further strengthened, particularly in high-risk communities where routine immunization and AFP surveillance are much needed.

Keywords: Acute flaccid paralysis, community mobilization, community mobilizers, polio and systematic review

How to cite this article:
Gadanya MA, Alo C, Umar AA, Ahmad KA, Afolaranmi T, Adeloye D, Garba RM, Dabo B. Evaluating nongovernmental organization–led community mobilizers in health promotion, immunization campaigns, and acute flaccid paralysis surveillance: a systematic review of the evidence. Int J Med Health Dev 2022;27:1-13

How to cite this URL:
Gadanya MA, Alo C, Umar AA, Ahmad KA, Afolaranmi T, Adeloye D, Garba RM, Dabo B. Evaluating nongovernmental organization–led community mobilizers in health promotion, immunization campaigns, and acute flaccid paralysis surveillance: a systematic review of the evidence. Int J Med Health Dev [serial online] 2022 [cited 2023 Feb 8];27:1-13. Available from: https://www.ijmhdev.com/text.asp?2022/27/1/1/331727

  Introduction Top

The Global Polio Eradication Initiative (GPEI) has made substantial progress toward the attainment of a poliomyelitis-free world since its inauguration at the World Health Assembly (WHA) in 1988, but challenges still remain.[1] Since then, the WHA has urged polio endemic states to engage local leadership and members of the community in the remaining polio-affected populations to ensure acceptance of polio eradication interventions.[1] This initiative requires community mobilization, partnership, and effective surveillance systems to guide polio programmatic action.[2],[3],[4]

The community mobilizers (CMs) have been regarded as valuable tools in strengthening routine immunization for polio and other vaccine preventable diseases, conducting supplementary immunization and mop-up vaccination for successful polio eradication campaigns,[5],[6],[7] and in acute flaccid paralysis (AFP) surveillance.[8] A CM is an active community member who is well respected and conducts house-to-house surveillance. They are expected to be responsible for documentation, and they support pre-, during, and post-implementation activities.[9] Individual reports from different countries have been published on the role that CMs play in various activities related to polio eradication, including routine immunization, particularly in endemic, hard-to-reach, resistant, or security-challenged areas.[1],[4],[6],[8],[10] However, to our knowledge, no systematic review of these findings has been published.

In Uttar Pradesh, India, CMs were credited with achieving higher-than-expected community participation in polio immunization activities, a dropout rate of less than 7%, and increased booth coverage in the mobilized communities.[5],[11] Similar roles were also found in the Bombay slum of Malavani, India, where diphtheria-pertussis-tetanus (DPT) follow-up increased from 67% to 78% and the incidence of paralytic polio decreased between 1980 and 1987.[10] Similar findings were reported in Karachi, Pakistan.[12]

In Africa, after the major polio outbreak in Ethiopia in the year 2000, CORE Group Polio Project (CGPP)–led CMs were credited for successfully linking the mobile dispersed populations with the formal healthcare system. This resulted in the country’s increase in AFP case detection rate from 0.7% in 2000 to 2.8% in 2010.[13] In the same vein, while investigating the drivers of routine immunization in Africa, La Fond et al. found that community volunteer groups, among other factors, were responsible for a 15% average increase in the DPT3/Penta3 coverage between 2006 and 2010 in the selected countries of Ethiopia, Cameroon, and Ghana.[14] There were similar findings in Somalia[15] and Nigeria.[16],[17]

Some areas in Nigeria were known to be highly resistant against immunization activities and to occasionally harass or attack immunization teams. These areas were successfully tamed through the use of CMs in immunization campaigns.[18] For instance, in an immunization-resistant community in Nigeria, a World Health Organization (WHO)–led CM group involving mainly youth groups resulted in a significant decrease in the proportion of missing children from 7% in 2007 to 2% in 2015. Similarly, the number of noncompliant households in the community decreased after the intervention.[18],[19]

With billions of dollars expended on polio eradication, even a single case of Wild Polio Virus (WPV) can lead to a setback for the enormous success achieved at huge material and human costs. This study aims at systematically reviewing the literature on the effectiveness of nongovernmental organization (NGO)–led CMs to increase social mobilization to promote health messages, immunization campaign participation, routine immunization, and improve AFP case detection.

  Materials and Methods Top

Data sources and search strategy

A wide-ranging literature search was conducted on electronic databases by a public health information specialist with experience in conducting systematic literature search. A combination of keywords that reflect CMs and polio eradication and routine immunization was employed in the searches. The terms for the systematic search were adaptations from the validated filters for online version of Index Medicus produced by the United States’ Library of Medicine (PubMed) (Shojania and Bero)[20] and an Elsevier database of research articles and related works (EMBASE) (Wilczynski and Haynes)[21] and were parallel-reviewed again by another expert. Duplicates were identified and removed from the list of retrieved articles before conducting title and abstract screening on a spreadsheet. This study included studies published in the English language up to 30 November 2020. The complete search terms are provided in Appendix 1.

Study selection

Eligibility criteria and screening

The identified articles sourced from PubMed, Scopus, EMBASE, African Journals Online (Ajol), WHO, and United Nations Children Funds (UNICEF) websites were screened based on the agreed inclusion and exclusion criteria. The criteria for inclusion were: (i) studies with any of the quantitative, qualitative, and/or mixed methods; and (ii) studies with a focus on CMs in the context of the polio eradication initiative and routine immunization.

Articles that had no explicit mention of CMs or community mobilization were excluded.

Two reviewers screened all titles, findings were compared, and disagreements were resolved by a consensus-based discussion on the guidelines of Furlan, et al.,[22] with persisting disagreements resolved by a third, more experienced reviewer.

The full texts of articles involved in the review were sourced and subjected to another screening to ensure that they met the inclusion criteria. Totally, 1627 articles were identified by the search, with 65 articles passing the title/abstract and full text reviews, and with four additional articles added from the references of articles included (making a total of 69 articles). Of these 69 articles involved in the review, 24 (four review and 19 original articles) focused largely and explicitly on CMs and were included in the full review. The rest (45) discussed CMs in a broader context, hence they were summarized based on part 1 of the data extraction form only.

Data extraction

The following data sets from the agreed-upon full publications were extracted using a pretested extraction form: (i) general characteristics of the review, including country, subnational focus, funders, implementers, aim and nature of the intervention(s), study type, and presence and/or absence of controls; and (ii) review summary, comprising the specific intervention/research objectives of and the major findings and general characteristics of the article.

The extraction sheet also has two parts: (i) the article’s general characteristics and summary of findings, and (ii) specifics of funders, implementers, and outcomes for specific objectives.

Data analysis

Data were extracted using the described framework and recorded on a Microsoft Excel spreadsheet. The findings were combined on a component-by-component basis to aid theme identification and description.

Findings were reported based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (Liberati, et al.).[23] However, the findings could not be presented quantitatively and summary measures based on calculations were not possible due to the wide disparity of the reporting strategies and outcomes of the studies reviewed.

  Results Top

Search results

The database search yielded 1625 articles (from PubMed, Scopus, EMBASE, and WHO Global Health regional databases) that were potentially relevant to the systematic review. After the title/abstract review, 84 articles were selected for a full text review, after which 19 more were excluded.

Of the remaining 65 reports [Figure 1], 24 articles (five review and 19 original articles) satisfied the secondary inclusion criteria, that is focused largely and explicitly on CMs or community mobilization and were included in the full review. The rest (41) did not meet the criteria, hence they were summarized based on part 1 of the data extraction form only, together with four additional articles added from the references of articles included.
Figure 1: Flowchart of the article selection process. CM = community mobilize

Click here to view

Most of the reviewed articles on the contributions of CMs to polio eradication were conducted in India, Nigeria, and Pakistan. Some studies were exclusive to certain countries, whereas others were a part of multicountry investigation, as shown in [Table 1].
Table 1: Setting of the 24 articles with exclusive/primary focus on community mobilizers

Click here to view

Details of the studies’ contexts and findings are provided in Tables 2–4.

  Discussion Top

This systematic review used the available literature to point the various mechanisms through which CMs participated, with an implication for ways to enhance their roles and integration into health systems [Tables 2]. It also shows their dynamic roles in various polio eradication and routine immunization strategies at different geographical settings [Table 3][Table 4][Table 5][Table 6].
Table 2: Summary of the CMs’ roles in polio eradication activities and routine immunization

Click here to view
Table 3: Community mobilizers and promotion of health messages

Click here to view
Table 4: Community mobilizers and immunization campaign participation

Click here to view
Table 5: Community mobilizers and support of routine immunization

Click here to view
Table 6: Community mobilizers and AFP case detection

Click here to view

The promotion of health messages by CMs decreased resistance to polio vaccine uptake in the high-risk districts of India and Chile and increased community awareness about poliomyelitis.[8],[41]

Other studies describing the relationship between CMs and immunization promotion for both immunization campaigns and routine immunization have found similar results.[17],[42],[43],[44],[45],[46]

In Afghanistan, studies wherein community-based healthcare professionals worked with community volunteers increased childhood vaccination coverage rates for the basic vaccines.[47] Cutts found that urban immunization programs require intersectoral collaboration to mobilize community members and community structures to vaccinate eligible children and their mothers.[44] They also showed the benefits of community mobilization to identify and refer eligible people for vaccination.

The polio birth dose is an important entry step for routine immunization and it can help to strengthen trust in safety of the vaccine; other services that the healthcare system can provide and community mobilization are shown to be essential for ensuring polio birth dose vaccination.[45] Proactive engagement with the community by CMs, such as door-to-door immunization services, has improved DPT and polio primary vaccination.[17] In addition, the selection of well-integrated CMs and proper training is a vital component in improving vaccination rates.[46]

Although CMs have consistently been shown to have beneficial effects on supporting routine immunization services,[42],[43],[44],[48],[49] their roles in AFP case detection reported mixed findings. Lack of proper training and supervision were the most cited reasons for the poor performance of AFP surveillance systems. In another study, it was found that the limitations of community volunteers and health extension workers in detecting cases of AFP were due to lack of knowledge of the formal case definition.[39] Low literacy and lack of adequate supervision of the community volunteers led to less effective surveillance systems. Training CMs on case definition and the elements of community-based surveillance (CBS) will improve the ability of community volunteers and health extension workers to detect and report cases of AFP.[40],[50],[51],[52]

Another barrier in establishing successful CBS systems is security. Research examined a broad range of strategies in the unstable states of Adamawa, Borno, and Yobe in Nigeria where the security challenges have led to the killing of health workers, destruction of health facilities, and displacement of large populations.[34] They conducted a retrospective review of AFP surveillance between 2009 and 2014, using the AFP database at the WHO, Nigeria country office. They also reviewed the reports of surveillance activities conducted in these states to identify strategies that were implemented to improve polio surveillance. They identified the annual training of surveillance officers, an increase in the number of community informants, and media-based messaging (via radio and television) to sensitize the public to the importance of surveillance as the key strategies to strengthen case detection.

Another recommendation from the literature to improve AFP surveillance is mass media messaging to entire communities, not only to CMs.[39],[51] It was found that only about one-fifth of the studied sample in Nigeria were aware of the AFP surveillance system/activities and only 6.6% could give a correct definition of the meaning of AFP surveillance.[53]

There has been some success with building effective community-based AFP surveillance. This study examined the introduction of CBS of AFP by the CGPP in Ethiopia. The system was created from a partnership between Ethiopian and U.S.-based NGOs. The CGPP supported volunteers in capacity building regarding AFP and in facilitating case reporting. Volunteers additionally conducted active AFP searches, visiting community leaders who were likely to know of AFP cases. The researchers found a near doubling of AFP reporting in project areas since the implementation of CBS, according to key informant interviews with stakeholders.[13]

The literature on community mobilization for polio eradication indicates that CMs can be used to successfully improve vaccination rates, educate, and engage communities about polio and AFP. However, the literature is still fairly limited. For examining the success of CMs in health messaging for polio eradication, only two papers fit the inclusion criteria. Although other papers explored the impact of CMs on promoting health messages, they did not meet the rigorous scientific requirements to apply their findings to program strategies. There needs to be more rigorous examination of the impact of CMs on polio eradication. Understandably, these studies are not easy to conduct as polio eradication campaigns are now mostly concerned with marginalized and isolated subpopulations. However, their findings can have an impact outside of polio eradication campaigns, indicating how to best engage with these communities to improve health outcomes.

  Conclusions Top

This review shows that CMs positively support social mobilization activities for the promotion of health messages, immunization campaign participation, and routine immunization; they have also remained a valuable tool for effective AFP case detection, reporting, and overall surveillance strategies in their respective communities for successful polio eradication program and routine immunization. Although there seem to be consistent findings in all the reviewed studies regarding their role in promotion of health messages, immunization campaign participation, and routine immunization, their effectiveness in AFP case detection is relatively limited because of the need for more training and low literacy level among significant proportion of CMs. It is evident that increasing the CMs’ ability to identify AFP is necessary and should extend beyond just CMs to the general community through mass media.

Based on the findings of this review, it is recommended that CMs require adequate supervision and support to improve theirs and the community’s ability to contribute to routine immunization and polio eradication initiatives and activities, notably through community participation and CBS. The CMs need sufficient and continual training on all aspects of their work, related to routine immunization and ongoing activities with the GPEI with special emphasis on AFP case detection. Studies in this review showed that their low formal education on case definitions of AFP contributed to underperformance in AFP case detection relative to other tasks in polio eradication and routine immunization. The CMs’ role should be expanded to work with other formally engaged actors in the GPEI, with increasing engagement in routine immunization and other aspects of health care as the GPEI enters its final stages. Identification and capacity building by hiring additional CMs should be cognizant of the limitations and experiences of the currently trained CMs. In addition, CMs and other actors in CBS need to be further motivated through capacity building and special recognition, especially in all high-risk communities.

With the burden of AFP and WPV on regional and global decline, it should be remembered that humongous material and human resources were expended on polio eradication and even a single case of WPV can lead to a setback for the enormous success achieved at huge costs and with extraordinarily large opportunity costs to other health and human development activities. Every effort needed to globally eradicate polio needs to be sustained.[84]


The authors acknowledge Drs. R. Ibrahim, A. Sari, U. M. Ibrahim, and F. S. Dankishiya for their help during the process of writing this article.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Chaturvedi S, Dasgupta R, Adhish V, Ganguly KK, Rai S, Sushant L, et al. Deconstructing social resistance to pulse polio campaign in two North Indian districts. Indian Pediatr 2009;46:963-74.  Back to cited text no. 1
Government of Canada/Public Health Agency of Canada. International Note - Acute Flaccid Paralysis Surveillance: A Global Platform for Detecting and Responding to Priority Infectious Diseases - CCDR Volume 30-24 - Public Health Agency of Canada; 2004. Available from: http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/04vol30/dr3024a-eng.php (accessed June 9, 2020).  Back to cited text no. 2
Arora NK, Chaturvedi S, Dasgupta R. Global lessons from India’s poliomyelitis elimination campaign. Bull World Health Organ 2010;88:232-4.  Back to cited text no. 3
Isibor I, Gasasira A, Mkanda P, Weldegriebriel G, Bassey BE, Toritseju MS, et al. Rapid assessments of acute flaccid paralysis surveillance in seven key polio high risk states in Northern Nigeria. Peak J Med Sci 2014;2:33.  Back to cited text no. 4
Weiss WM, Rahman MD, Solomon R, Ward D. Determinants of performance of supplemental immunization activities for polio eradication in Uttar Pradesh, India: Social mobilization activities of the social mobilization network (SM net) and CORE Group Polio Project (CGPP). BMC Infect Dis 2013;13:17.  Back to cited text no. 5
Bisrat F, Kidanel L, Abraha K, Asres M, Dinku B, Conlon F, et al. Cross-border wild polio virus transmission in CORE Group Polio Project areas in Ethiopia. Ethiop Med J 2013;51(Suppl 1):31-9.  Back to cited text no. 6
Nasiru SG, Aliyu GG, Gasasira A, Aliyu MH, Zubair M, Mandawari SU, et al. Breaking community barriers to polio vaccination in Northern Nigeria: The impact of a grass roots mobilization campaign (Majigi). Pathog Glob Health 2012;106:166-71.  Back to cited text no. 7
Dasgupta R, Chaturvedi S, Adhish SV, Ganguly KK, Rai S, Sushant L, et al. Social determinants and polio ‘endgame’: A qualitative study in high risk districts of India. Indian Pediatr 2008;45:357-65.  Back to cited text no. 8
UNICEF Nigeria, 2015. Support to Polio Eradication Initiative in Nigeria. Available from: https://www.unicef.org/nigeria/NG_Japan_Natcom_Final_Report_Polio_SC120766_Nigeria_2015.pdf (accessed June 9, 2020).  Back to cited text no. 9
Kowli SS, Bhalerao VR, Jagtap AS, Shrivastav R. Community participation boosts immunization coverage. World Health Forum 1990;11:169-72.  Back to cited text no. 10
Coates EA, Waisbord S, Awale J, Solomon R, Dey R. Successful polio eradication in Uttar Pradesh, India: The pivotal contribution of the Social Mobilization Network, an NGO/UNICEF collaboration: The setting for polio eradication in India. Available from: http://www.researchgate.net/publication/... (accessed June 12, 2020).  Back to cited text no. 11
Carbonu DM, Hashwani S, Badruddin G, Marshall P, Fazal S. All hands against polio. World Health Forum 1998;19:188-91.  Back to cited text no. 12
Curry D, Bisrat F, Coates E, Altman P. Reaching beyond the health post: Community-based surveillance for polio eradication. Dev Pract 2013;23:69-78. doi: 10.1080/09614524.2013.753410.  Back to cited text no. 13
La Fond A, Kanagat N, Steinglass R, Fields R, Sequeira J, Mookherji S. Drivers of routine immunization coverage improvement in africa: Findings from district-level case studies. Health Policy Plan 2015;30:298-308.  Back to cited text no. 14
Kamadjeu R, Mulugeta A, Gupta D, Abshir Hirsi A, Belayneh A, Clark-Hattingh M, et al. Immunizing nomadic children and livestock–experience in north east zone of Somalia. Hum Vaccin Immunother 2015;11:2637-9.  Back to cited text no. 15
Bassey BE, Rui VG, Gasasira AN, Mkanda P, Weldegbriel G, Mulum TJ,et al. Characteristics of acute flaccid paralysis reported by the surveillance system and verified by WHO officer in Akwa Ibom State-Nigeria, 2006–2012. Health (Irvine Calif)1988;6:2602-10. doi:10.4236/health.2014.619299.  Back to cited text no. 16
Emergency Response Committee. Report of the 33 Rd Meeting of the Expert Review Committee (ERC) On Polio Eradication & Routine Immunization in Nigeria. Abuja; 2017. Available from: http://polioeradication.org/wp-content/uploads/2017/04/NIG_ERC_Report_JAN2017.pdf (accessed June 16, 2020).  Back to cited text no. 17
Grassly NC. The final stages of the global eradication of poliomyelitis. Trans R Soc Lond B Biol Sci 2013;368:20120140.  Back to cited text no. 18
Mohammed AJ, Datta KK, Jamjoon G, Magoba-Nyanzi J, Hall R, Mohammed I. Independent evaluation team’s report on barriers to polio eradication in Nigeria. 2009. The Polio Network; 2019. Available from: http://www.comminit.com/polio/content/report-barriers-polio-eradication-nigeria-independent-evaluation-team-nigeria (accessed April 13, 2019).  Back to cited text no. 19
Shojania KG, Bero LA. Taking advantage of the explosion of systematic reviews: An efficient MEDLINE search strategy. Eff Clin Pract 2001;4:157-62.  Back to cited text no. 20
Wilczynski NL, Haynes RB; Hedges Team. EMBASE search strategies achieved high sensitivity and specificity for retrieving methodologically sound systematic reviews. J Clin Epidemiol 2007;60:29-33.  Back to cited text no. 21
Furlan JC, Singh J, Hsieh J, Fehlings MG. Methodology of systematic reviews and recommendations. J Neurotrauma 2011;28:1335-9. doi:10.1089/neu.2009.1146.  Back to cited text no. 22
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration. PLoS Med 2009;6:e1000100.  Back to cited text no. 23
Hsu CA, Safdar RM, Ahmed J, Jorba J, Sharif S, Farag N, et al. Progress toward poliomyelitis eradication - Pakistan, January 2015-September 2016. CDC MMWR 2017;66:1276-80.  Back to cited text no. 24
Anjum Q, Omair A, Inam SN, Ahmed Y, Usman Y, Shaikh S. Improving vaccination status of children under five through health education. J Pak Med Assoc 2004;54:610-3.  Back to cited text no. 25
Ghafoor S, Nadeem S. Eradication and current status of poliomyelitis in Pakistan: Ground realities. J Immunol Res 2016;6:2016. doi: 10.1155/2016/6837824.  Back to cited text no. 26
Lahariya C, Khandekar J, Ray TK, Meenakshi , Pradhan SK. Role of an area specific approach to increase community participation in pulse polio program in a locality of South Delhi. J Commun Dis2007;39:245-8.  Back to cited text no. 27
Deutsch NS, Singh V, Curtis R, Siddique AR. Legacy of polio-use of India’s social mobilization network for strengthening of the universal immunization program in India. J Infect Dis 2017;216:S260-6. doi: 10.1093/infdis/jix068.  Back to cited text no. 28
Ndiaye SM, Quick L, Sanda O, Niandou S. The value of community participation in disease surveillance: A case study from Niger. Health Promot Int 2003;18:89-98. doi:10.1093/heapro/18.2.89.  Back to cited text no. 29
Kowli SS, Bhalerao VR, Jagtap AS, Shrivastav R. Community participation boosts immunization coverage. World Health Forum1990;11:169-72. Available from http://www.who.int/iris/handle/10665/52237.  Back to cited text no. 30
Warigon C, Mkanda P, Banda R, Zakari F, Damisa E, Idowu A, et al. The journalists initiatives on immunisation against polio and improved acceptance of the polio vaccine in Northern Nigeria 2007-2015. J Infect Dis 2016;213(Suppl 3):S86-90.  Back to cited text no. 31
Dalhatu S, AbdulGhani N, Bozkurt V. A systematic review on factors affecting community participation towards polio immunization in Nigeria. Mediterr J Soc Sci2015;6:407-16.  Back to cited text no. 32
Musa A, Mkanda P, Manneh F, Korir C, Warigon C, Gali E, et al. Youth group engagement in noncompliant communities during supplemental immunization activities in Kaduna, Nigeria, in 2014. J Infect Dis 2016;213:S91-5. doi: 10.1093/infdis/jiv510. Epub 2015 Nov 25.  Back to cited text no. 33
Hamisu AW, Johnson TM, Craig K, Mkanda , Banda R, Tegegne SG, et al. Strategies for improving polio surveillance performance in the security-challenged Nigerian states of Adamawa, Borno, and Yobe during 2009–2014. J Infect Dis 2016;213:137-8.  Back to cited text no. 34
Aylward RB, Linkins J. Polio eradication: Mobilizing and managing the human resources. Bull World Health Organ 2005;83:268-73.  Back to cited text no. 35
Curry DW, Perry HB, Tirmizi SN, Goldstein AL, Lynch MC. Assessing the effectiveness of house-to-house visits on routine oral polio immunization completion and tracking of defaulters. J Health Popul Nutr 2014;32:356-66.  Back to cited text no. 36
Shaikh I, Omair A, Inam SN, Safdar S, Kazmi T, Anjum Q. National polio day campaign in a squatter settlement through medical students. J Pak Med Assoc 2003;53:98-101.  Back to cited text no. 37
Ahmed Z, Fenta H, Mekonnen A. Factors affecting community participation in an immunization campaign in Gondar, Ethiopia. Ethiop Med J 1979;17:33-6.  Back to cited text no. 38
Asres M, Bisrat F, Kebede Y, Asegedew B, Getachew B, Fantahun M. Knowledge and practice of frontline health workers (health extension workers and community volunteer surveillance focal persons) towards acute flaccid paralysis (AFP) case detection and reporting in pastoralist and semi-pastoralist areas of Ethiopia. Ethiop Med J 2013;51(Suppl 1):51-7.  Back to cited text no. 39
Dinku B, Kumie A, Bisrat F. Linking community volunteer surveillance focal persons with health extension workers on polio surveillance. Ethiop Med J 2013;51(Suppl 1):71-6.  Back to cited text no. 40
Borgoño JM, Corey G. The Chilean experience with antipoliomyelitis vaccination. Dev Biol Stand 1978;41:141-8.  Back to cited text no. 41
Lunsford SS, Fatta K, Stover KE, Shrestha R. Supporting close-to-community providers through a community health system approach: Case examples from Ethiopia and Tanzania. Hum Resour Health 2015;13:12.  Back to cited text no. 42
Tonglet R, Soron’gane M, Lembo M, Wa Mukalay M, Dramaix M, Hennart P. Evaluation of immunization coverage at local level. World Health Forum 1993;14:275-81.  Back to cited text no. 43
Cutts FT. Strategies to improve immunization services in urban Africa. Bull World Health Organ 1991;69:407-14.  Back to cited text no. 44
Kidanne L, Bisrat F, Dinku B, Lynch M, Fantahun M. Newborn tracking for polio birth dose vaccination in pastoralist and semi-pastoralist CORE Group Polio Project implementation districts (woredas) in Ethiopia. Ethiop Med J 2013;51(Suppl 1):1-12.  Back to cited text no. 45
Husain S, Omer SB. Routine immunization services in Pakistan: Seeing beyond the numbers. East Mediterr Health J 2016;22:201-11.  Back to cited text no. 46
Akseer NS, Hossain SM, Mashal MT, Rasooly MH, Bhatti Z, Rizvi A, et al. Achieving maternal and child health gains in Afghanistan: A countdown to 2015 country case study. Global Health 2016;4:395-413. doi:10.1016/S2214-109X(16)30002-X.  Back to cited text no. 47
Main B, James , Lower T, James R, Rouse I. Changes in expanded program for immunization coverage for mother and child in Krakor, Cambodia 1996–1998. Trop Med Int Health 2001;6:526-8. doi: 10.1046/j.1365-3156.2001.00743.x.  Back to cited text no. 48
Pomerai KW, Tshimanga RF, Muchekeza M. Evaluation of the acute flacid paralysis (AFP) surveillance system in Bikita district Masvingo province 2010. BMC Research Notes 2014;7:252. doi: 10.1186/1756-0500-7-252.  Back to cited text no. 49
Banerjee K, Bandyopadhyay S, Hlady WG, Sarkar S, Andrus JK. Surveillance for polio eradication: Current status and lessons learnt–India, 1999. J Indian Med Assoc 2000; 98:6-9.  Back to cited text no. 50
Kuroiwa C, Chosa T, Murakami H, Duangmala S, Vongphrachanh P, Saito T, et al. Polio surveillance in Lao PDR: A two-year experience of active case search, 1994–96. J Trop Pediatr 1999;45:185-90.  Back to cited text no. 51
Abraham K, Bisrat F, Fantahun M, Asres M, Kidane L, Rogie B. Acute flaccid paralysis surveillance status and community awareness in pastoralist and semi-pastoralist communities of Ethiopia. Ethiop Med J 2013;51(Suppl 1):13-20.  Back to cited text no. 52
Musa OI, Akande TM, Salaudeen GA, Aderibigbe AS, Bolarinwa A, Jimoh OR. Community awareness and sensitization on acute flaccid paralysis case reporting in a Northern state of Nigeria. Int J Trop Med 2009;4:4-8.  Back to cited text no. 53
Steering group report, part II: Maternal and child health in the seventh five year plan. Special Article. Indian J Pediatr1985;52:113-4.  Back to cited text no. 54
Owais A, Hanif B, Siddiqui AR, Agha A, Zaidi AK. Does improving maternal knowledge of vaccines impact infant immunization rates? A community-based randomized-controlled trial in Karachi, Pakistan. BMC Public Health 2011;11:239. doi: 10.1186/1471-2458-11-239.  Back to cited text no. 55
Ponnuraj S. Community protection for the health of mothers and children. World Health Forum 1994;15:272-4.  Back to cited text no. 56
Waisbord S, Shimp L, Ogden EW, Morry C. Communication for polio eradication: Improving the quality of communication programming through real-time monitoring and evaluation. J Health Comm 2010;15(Suppl 1):9-24. doi: 10.1080/10810731003695375.  Back to cited text no. 57
Botha HP. Primary health care according to African requirements. Isr J Med Sci 1983;19:698-702.  Back to cited text no. 58
Closser S. Pakistan’s lady health worker labor movement and the moral economy of heroism. Ann Anthropol Pract 2015;39:16-28. doi: 10.1111/napa.12061.  Back to cited text no. 59
Henderson RH, Keja J, Hayden G, Galazka A, Clements J, Chan C. Immunizing the children of the world: Progress and prospects. Bull World Health Organ 1988;66:535-43.  Back to cited text no. 60
Jawdekar AM. A proposed model for infant and child oral health promotion in India. Int J Den2013:1-6. doi: 10.1155/2013/685049.  Back to cited text no. 61
Iatridis DS. Cuba’s health care policy: Prevention and active community participation. Soc Work 1990;35:29-35.  Back to cited text no. 62
Sobti D, Cueto M, He Y. A public health achievement under adversity: The eradication of poliomyelitis from Peru, 1991. Am J Public Health 2014;104:2298-305. doi: 10.2105/AJPH.2014.301995. Epub 2014 Oct 16.  Back to cited text no. 63
Yehualashet YG, Mkanda P, Gasasira A, Erbeto T, Onimisi A, Herton J, et al. Strategic engagement of technical surge capacity for intensified polio eradication initiative in Nigeria, 2012–2015. J Infect Dis 2016;213(Suppl 3):S116-23. doi: 10.1093/infdis/jiv494. Epub 2016 Feb 23.  Back to cited text no. 64
Roberts L. Disease eradication. Killings force rethinking of Pakistan’s anti-polio drive. Science 2013;339:259-60. doi: 10.1126/science.339.6117.259.  Back to cited text no. 65
Sabin AB. Perspectives on rapid elimination and ultimate global eradication of paralytic poliomyelitis caused by polioviruses. Eur J Epid 1991;7:95-120.  Back to cited text no. 66
Closser S, Jooma R. Why we must provide better support for Pakistan’s female frontline health workers. PLoS Med 2013;10:e1001528.  Back to cited text no. 67
Mandke VB, Pawar RM, Naik DD. Epidemiology of poliomyelitis in a slum of bombay. Indian Pediatr 1991;28:615-8.  Back to cited text no. 68
Golladay FL. Community health care in developing countries. Finance Dev 1980;17:35-9.  Back to cited text no. 69
Gupta M, Angeli F, Bosma H, Rana M, Prinja S, Kumar R, et al. Effectiveness of multiple-strategy community intervention in reducing geographical, socioeconomic and gender based inequalities in maternal and child health outcomes in Haryana, India. PLoS One 2016;11:e0150537. doi:10.1371/journal.pone.0150537.  Back to cited text no. 70
He Y, Zarychta A, Ranz JB, Carroll M, Singleton LM, Wilson PM, et al. Childhood immunization rates in rural intibucá, honduras: An analysis of a local database tool and community health center records for assessing and improving vaccine coverage. BMC Public Health 2012;12:1056.  Back to cited text no. 71
Maher CP, Hall JJ, Yakam W, Naupa M, Leonard D. Improving vaccination coverage: The experience of the expanded programme on immunization in vanuatu. P N G Med J 1993;36:228-33.  Back to cited text no. 72
Latin American Countries Set 1985 EPI Targets at Lima Meeting. Expanded program on immunization in the Americas. EPI News Letter 1984;2:1-8.  Back to cited text no. 73
Obregon R, Waisbord S. The complexity of social mobilization in health communication: Top-down and bottom-up experiences in polio eradication. J. Health Comm 2010;15:25-47. doi: 10.1080/10810731003695367.  Back to cited text no. 74
Schoeps A, Ouédraogo N, Kagoné M, Sié A, Müller O, Becher H. Socio-demographic determinants of timely adherence to BCG, penta3, measles, and complete vaccination schedule in Burkina Faso. Vaccine 2013;32:96-102.  Back to cited text no. 75
Nkowane AM, Boualam L, Haithami S, El Sayed el TA, Mutambo H. The role of nurses and midwives in polio eradication and measles control activities: A survey in Sudan and Zambia. Hum Resour Health 2009;7:78.  Back to cited text no. 76
Datar A, Mukherji A, Sood N. Health infrastructure & immunization coverage in rural India. Indian J Med Res 2007;125:31-42.  Back to cited text no. 77
[PUBMED]  [Full text]  
Ezezika OC. Building trust: A critical component of global health. Ann Glob Health 2015;81:589-92.  Back to cited text no. 78
Ghosh S. A feasible strategy for a health care package. Indian Pediatr 1990;27:327-32.  Back to cited text no. 79
Kowli SS, Kumar RR, Trivedi MJ, Bhalerao VR. Experience with under five’s clinic in Malavani- a slum near Bombay. J Postgrd Med 1984;30:9-13.  Back to cited text no. 80
Sabin AB. Strategy for rapid elimination and continuing control of poliomyelitis and other vaccine preventable diseases of children in developing countries. Br Med J (Clin Res Ed) 1986;292:531-3.  Back to cited text no. 81
Johnson G. We can do the job ourselves: Marshall Islanders push intensive immunization program. Integration1989;21:46-7.  Back to cited text no. 82
Nasseri K, Sadrizadeh B, Malek-Afzali H, Mohammad K, Chamsa M, Cheraghchi-Bashi MT, et al. Primary health care and immunisation in Iran. Public Health 1991;105:229-38.  Back to cited text no. 83
Soudarssanane MB, Rotti SB, Srinivasa DK, Ramalingam G. Paralytic poliomyelitis in children under 6 years in Pondicherry: A community survey. J Epidemiol Community Health 1993;47:210-4.  Back to cited text no. 84


  [Figure 1]

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]


    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

  In this article
Materials and Me...
Materials and Me...
Article Figures
Article Tables

 Article Access Statistics
    PDF Downloaded171    
    Comments [Add]    

Recommend this journal