Cross Border Initiative for Polio Eradication in Horn of Africa

The paper describes a systematic process to institutionalize a cross border initiative for polio eradication covering Kenya, South Sudan, Ethiopia and Uganda. Numerous previous coordination and implementation efforts at the national level have failed.  This paper examines an improved model at the operational level in the form of an ‘Initiative’ to address overall Polio Eradication Issues as opposed to adhoc meetings for supplementary polio immunization activities (SIA). It ensures an informed decision and commitment and ownership by border district health offices with active participation of non-health actors such as border security, immigration offices and other stakeholders.

The CORE Group Polio Project used data on routine immunization coverage, supplementary immunization quality, AFP surveillance, demographics, and health facility capacity to plan, implement and evaluate the initiative.  The CORE Group secured the commitment of district health officials to initiate joint meetings, conduct border health assessments, joint action plans, plan implementation, reporting and monitoring and evaluation.

The preliminary results demonstrate positive results. In 8 counties in South Sudan, 2 counties in Kenya and 2 Woredas in Ethiopia cross border committees mapped border points and increased the number of children immunized during SIAs. Each party is implementing its plan of action and sharing information with others.

The process is in the formative stage and is being strengthened with new lessons learnt.  Some of the challenges include documenting program effectiveness and advocacy to local government and the national MOH for increased ownership and resource allocation. Reporting, monitoring and evaluation system capacity for the initiative should be strengthened for proper documentation and dissemination of results.