Health Interventions to Promote the Polio Vaccine within the Global Polio Eradication Initiative: A Systematic Review From 2000-2014.

INTRODUCTION: Launched in 1988 by the World Health Organization (WHO), the primary goal of the Global Polio Eradication Initiative (GPEI) was to eradicate polio by the year 2000. The mobilization of communities was critical in achieving this goal. Although the disease has persisted beyond the year 2000, the number of cases dropped compared to their level in 1988, witnessing significant progress. AIM: As polio is near being eradicated, this study is an attempt to review health communication and behavior change interventions used to promote the polio vaccine within the GPEI in order to highlight best practices and lessons learned to be used eventually to combat other vaccine-preventable diseases. METHODS: A systematic analysis of peer-reviewed articles describing interventions to promote polio vaccine, increase community awareness and parents’ adherence to immunization activities from 2000 to 2014 within the GPEI across the world was conducted. RESULTS: Of the 15 publications included in the review, five reported on health promotion interventions analysis and planning frameworks, eight reported on public health communication interventions, and one article reported on ecological approaches. Interventions grounded on analysis and planning frameworks resulted in increased awareness, real-time rumors tracking, and addressing controversy and mistrust about the vaccine. Interventions based on public health communication theories resulted in increased support from policy makers, community, and religious leaders as well as increased community involvement in activities. These interventions also increased knowledge and attitude changes toward immunization. Lastly, ecological approaches demonstrated their usefulness in conducting multi-level analysis to identify social etiologies of a persistent low polio vaccine rate. RECOMMENDATIONS: Since polio campaigns are required as long as there will be a single case, evidence-based and theory-driven behavior change and communication interventions may still be of help. They can help ensure people’s adherence to subsequent rounds and avoid campaigns fatigue, both at the global and country levels. Furthermore, to take extensive advantage of all health promotion strategies used in the GPEI, further research, that includes peer-reviewed and other types of documentation, is needed to better inform future programs to increase the overall immunization coverage.