The impact of polio eradication on routine immunization and primary health care: A mixed-methods study

Svea Closser, Kelly Cox, Thomas M. Parris, R. Matthew Landis, Judith Justice, Ranjani Gopinath, Kenneth Maes, Hailom Banteyerga Amaha, Ismaila Zango Mohammed, Aminu Mohammed Dukku, Patricia A. Omidian, Emma Varley, Pauley Tedoff, Adam D. Koon, Laetitia Nyirazinyoye, Matthew A. Luck, W. Frank Pont, Vanessa Neergheen, Anat Rosenthal, Peter NsubugaNaveen Thacker, Rashid Jooma, Elizabeth Nuttall

Research output: Contribution to journalArticlepeer-review

49 Scopus citations


Background. After 2 decades of focused efforts to eradicate polio, the impact of eradication activities on health systems continues to be controversial. This study evaluated the impact of polio eradication activities on routine immunization (RI) and primary healthcare (PHC).

Methods: Quantitative analysis assessed the effects of polio eradication campaigns on RI and maternal healthcare coverage. A systematic qualitative analysis in 7 countries in South Asia and sub-Saharan Africa assessed impacts of polio eradication activities on key health system functions, using data from interviews, participant observation, and document review.

Results: Our quantitative analysis did not find compelling evidence of widespread and significant effects of polio eradication campaigns, either positive or negative, on measures of RI and maternal healthcare. Our qualitative analysis revealed context-specific positive impacts of polio eradication activities in many of our case studies, particularly disease surveillance and cold chain strengthening. These impacts were dependent on the initiative of policy makers. Negative impacts, including service interruption and public dissatisfaction, were observed primarily in districts with many campaigns per year.

Conclusions: Polio eradication activities can provide support for RI and PHC, but many opportunities to do so remain missed. Increased commitment to scaling up best practices could lead to significant positive impacts.

Original languageEnglish
Pages (from-to)S504-S513
JournalJournal of Infectious Diseases
StatePublished - 1 Nov 2014
Externally publishedYes


  • eradication
  • health systems
  • poliomyelitis
  • routine immunization

ASJC Scopus subject areas

  • General Medicine


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