How Can Measles Eradication Strengthen Health Care Systems?

Wednesday, 18th of December 2013

[source]Journal of Infectious Diseases[|source]

 It is well established that many disease-control programs, including elimination and eradication initiatives, are delivered through a vertical approach, which can potentially hamper health systems strengthening. To avoid such a negative feedback loop, it is essential that disease control programs are integrated with multifunctional health care delivery. For example, polio SIAs frequently include vitamin A supplementation, BUT they do not generally include other interventions, such as deworming or other vaccines. Studies from India and Nigeria have documented that when repeated rounds of polio SIAs take place in areas with very few other public health services, they create resentment among the population and may reduce compliance.

In this article, the authors propose that measles eradication strengthens routine vaccination through a) operational research to determine the optimal ways of strengthening the system priority areas, b) focussing on improving the process by which activities are delivered, rather than exclusively on providing inputs, c) explore introduction of a routine second dose of measles, irrespective of vaccine coverage rates for the first dose and d) increased integration. More details on this simple but yet informative paper are available at:  http://jid.oxfordjournals.org/content/204/suppl_1/S78.long

 

Abstract

Elimination and eradication initiatives are generally delivered through a vertical approach, which can potentially hamper health systems. We propose 3 approaches by which a measles eradication initiative can ensure that health systems are left strengthened when the eradication goal has been accomplished. First, focus should be placed on strengthening routine vaccination, which could generate positive trickle-up effects on other primary health care services. Second, increased integration with multifunctional health services should be emphasized. Third, efforts should be made to change traditional donor behavior that prioritizes vaccination campaigns and uses uncoordinated staff incentives.