Key result
The Cross-Border Health Initiative (CBHI) was effective in bolstering immunization coverage, disease surveillance, and rapid outbreak response in border areas between Kenya and Somalia.
Why the study?
The persistent risk of wild poliovirus importation in the Horn of Africa demanded cross-border collaboration to address communication gaps and improve immunization coverage and surveillance.
The Cross-Border Health Initiative provides an effective operational model for improving immunization coverage and disease surveillance in vulnerable border regions.
Supports CBHI scaling in border regions; leaves open controlled trials before policy adoption.
In 2013, the outbreak of wild poliovirus (WPV) in the Horn of Africa (HOA) triggered an aggressive, coordinated national and regional response to interrupt continued transmission. Kenya, Somalia, Ethiopia, South Sudan, and other HOA countries share a range of complex factors that enabled the outbreak: porous and sparsely populated borders, insecurity due to armed conflicts, and weak health systems with persistently under-resourced health facilities resulting in low-quality care and low levels of immunization coverage in mobile populations. Consequently, the continued risk of WPV importation demanded cross-border and intersectoral collaboration. Assessing and addressing persistent communication gaps at the subnational levels were necessary to gain traction for improved immunization coverage and surveillance activities. This article describes a systematic approach to institutionalizing processes of dialogue and facilitation that can provide for a sustainable and effective joint cross-border health platform between Kenya and Somalia. It examines an operational model called the Cross-Border Health Initiative (CBHI) to support joint intercountry collaboration and coordination efforts. To evaluate progress of the CBHI, the authors used data from population coverage surveys for routine immunization and supplemental immunization activities (for polio), from acute flaccid paralysis (AFP) surveillance, and from plans developed by border districts and border health facilities. The project-trained community health volunteers have been a critical link between the hard-to-reach communities and the health facilities as well as an excellent resource to support understaffed health facilities. The authors conclude that the CBHI has been effective in bolstering immunization coverage, disease surveillance, and rapid outbreak response in border areas. The CBHI has the potential to address other public health threats that transcend borders.
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Arale et al. (2019) studied Wild poliovirus (WPV). Cross-Border Health Initiative (CBHI) was evaluated on Immunization coverage, disease surveillance, and rapid outbreak response. The Cross-Border Health Initiative (CBHI) was effective in bolstering immunization coverage, disease surveillance, and rapid outbreak response in border areas between Kenya and Somalia.
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