Public Health Campaign Integration: Lessons Learned from 30 Years of Polio Campaigns in Ethiopia, India, and Nigeria

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The Health Campaign Effectiveness Coalition published this technical brief in November 2020 to summaries the key takeaways from three decades of campaigns in three countries.

Key messages:

• Co-delivery and collaboration of campaigns are powerful tools for increasing coverage of health services and improving community acceptance of campaigns. The impact of integrated campaigns on broader health system and population health outcomes is less clear.

• A range of health interventions were successfully integrated with mass polio campaigns in Ethiopia, India, and Nigeria, including provision of vitamin A for child malnutrition, provision of de-worming tablets for helminthiasis, and distribution of insecticide-treated nets (ITNs) for malaria

• Surveillance of diseases targeted by campaigns can be successfully integrated with broader disease surveillance

• Campaign implementation is shaped by the local context, especially by the influence of frontline health workers. Campaigns interact on the ground regardless of planned collaboration and co-delivery. Planning for integration, with consideration of workflows of frontline health workers, could maximize positive impacts of campaigns.

• Suggestions from policymakers in Ethiopia, India, and Nigeria on ways to improve planning and implementation of co-delivery and collaboration of campaigns include: Investing in long-term contracts and coordinated training for campaign workers; using co-delivery and collaboration to reach hard-to-reach populations; Engaging in coordinated social mobilization across health programs

• Co-delivery and collaboration plans should avoid creating parallel structures

• The following questions should be considered when planning for and implementing coordinated and/or codelivered health campaigns: How can co-delivery or collaboration help to improve the efficiency (cost and quality of delivery) and effectiveness of these programs? What are the critical needs of target communities? Can co-delivery or collaboration help address any of these needs? Is the workflow across all campaigns well integrated and streamlined for frontline staff? Are campaigns pulling human or other resources from the health system, and if so how might co-delivery and collaboration serve to minimize negative health system impacts? Does integration exacerbate long-term health-system dependence on campaign funding and resources? What is the plan for transition, if needed?