Scientists call for better community engagement to fight polio

The international health community should move away from a leader-centric approach to polio eradication campaigns in Nigeria, Pakistan and Afghanistan, according to two articles recently published in PLOS Medicine.

In one article, Seye Abimbola from the National Primary Health Care Development Agency in Nigeria and other authors from the three countries argued that the global health community and governments need to build trust and prioritize polio eradication in routine health services to battle the deadly disease. The authors said that current strategies being used to fight polio may not be best suited to the situation in the three countries.

"(In) our view, the ambition of the global health community to eradicate polio appears to be blinding it to lessons learned about health systems over the past 30 years," the authors said. "Polio eradication will only be achieved with stronger health systems and bottom-up community engagement, which is likely to require more time and more investment than is currently available in Pakistan, Nigeria, and Afghanistan because of their political fragility."

In a separate essay, Svea Closser and Rashid Jooma from the U.S.-based Middlebury College and the Pakistan-based Aga Khan University highlighted the importance of women from the Lady Health Workers Program in Pakistan's polio eradication effort. The approximately 106,000 lady health workers engage in polio campaigns and other health-related matters throughout Pakistan. The authors said the workers are typically in desperate financial straits and risk their lives as frontline health workers.

"Pakistan's (lady health workers) have the potential to achieve universal immunization and polio eradication in the country," Closser and Jooma said. "In fact, both of these goals are probably impossible without their full support. Achieving them depends on a shift from treating frontline female health staff as disposable labor to truly engaging them as well-supported, active partners in achieving a healthier Pakistan."