Dr. Filimona Bisrat, Secretariat Director and Senior Regional Technical Advisor
Secretariat Host Organization/ Consortium of Christian Relief and Development Associations (CCRDA)
CGPP Ethiopia reaches underserved rural, pastoralist and semi-pastoralist areas to facilitate opportunities to vaccinate and conduct case search and reporting to maintain acute flaccid paralysis (AFP) surveillance quality. The CGPP focuses on preventing polio through assistance to large-scale vaccination campaigns (SIAs), strengthening immunization systems and community-based surveillance. In 2019, CGPP Ethiopia began integrating community-based surveillance for three priority zoonotic diseases – Rabies, Anthrax, and Brucellosis – to strengthen Global Health Security.
Implementation Focal Sites
In 2020, CGPP Ethiopia operates in 85 border districts, or woredas, across the 5 regions of Gambella (13 woredas), SNNP (13 woredas), Oromia (11 woredas), Somali (28 woredas) and Benshangul-Gumuz (20 woredas). The project reaches 6.1 million people, or 10 percent of the country’s population.
Five international PVOs – Catholic Relief Services, Save the Children, World Vision, International Rescue Committee and Amref Health Africa – and four local NGOs – Pastoralist Concern, Ethiopian Orthodox Church, Ethiopian Evangelical Church Mekane Yesus and Organization for Welfare and Development in Action.
In November 2001, CGPP Ethiopia began activities to reach hard-to-reach communities with vaccination services and surveillance. Ethiopia is a country at high risk for importation from neighboring conflict-affected Somalia and South Sudan. The last case of wild polio virus was recorded in January 2014. Due to low routine immunization coverage and weak surveillance, parts of the country in 2020 are seeing climbing cases of circulating Type 2 vaccine-derived cases (cVDPV2).
Rugged terrain, scattered population settlements, weak health service systems, limited participation of key community members in planning of vaccination activities, and porous borders with polio-endemic areas pose the greatest challenges to control of polio transmission in Ethiopia. These barriers result in low community awareness about polio vaccination and AFP surveillance; resistance to the polio vaccine is very low.
Ongoing ethnic and tribal conflict in the areas of Somali, Benshangul-Gumuz, Gambella and Oromia regions resulted in the displacement of more than 1 million persons in 2018, impeded project staff movement and impacted project implementation. Another major concern has been the poor access to and the quality of health care, particularly for pastoralist populations and refugees crossing into the country to escape conflict. There are significant disparities found across project regions, but all share several features: difficult geographies, weak health infrastructures (with low technical and managerial capacities), bureaucratic systems with little accountability, low routine immunization coverage, poor surveillance systems, unrestricted population movement, and vulnerable populations scattered along the hard-to-reach borders.
The CGPP in Ethiopia has been a pioneer in the use of community volunteers for immunization promotion and community-based surveillance activities. In Ethiopia, more than 12,000 CGPP Community Volunteers (CVs) provide crucial support to increase the coverage of polio and other routine immunizations as well as surveillance of polio, measles and tetanus in hard-to-reach, high-risk, pastoralist and semi-pastoralist regions, which are sparsely populated. CVs, Health Development Army Leaders (HDALs) and Health Extension Workers (HEWs) actively search and report on cases of Acute Flaccid Paralysis, measles and neonatal tetanus and tracked newborns from early pregnancy. They regularly conduct house-to-house health education sessions and social mobilization activities during routine and supplementary immunization campaigns.
Increasing the involvement of traditional and religious leaders is among several strategies employed by CGPP Ethiopia to improve community acceptance of the polio vaccine rather than seeking traditional healers for the treatment of vaccine-preventable diseases. In 2019, the CGPP reached 5.4 million persons with routine and supplementary immunization campaigns, community-based disease surveillance and house-to-house health education activities to track and register pregnant mothers, newborns, and defaulter children.
Dr. Filimona Bisrat, Director
Legesse Kidanne, Deputy Director
Muluken Asres, GHS Advisor
Asrat Asress, Program Officer
Tenager Tadesse, M & E Officer
Bethelehem Asegedew, Communication Officer
Solomon H/Selassie, Senior Finance Officer
Bahiru Getachew, Finance Officer
Sophia Yoseph, Administrative & Liaison Officer
View past newsletters here
Asegedew, B.; Tessema, F.; Perry, H.B.; Bisrat, F. (2019) The CORE Group Polio Project’s community volunteers and polio eradication in Ethiopia: self-reports of their activities, knowledge, and contributions. Am. J. Trop. Med. Hyg., 101(Suppl 4), 2019, pp. 45–51.
Tessema, F.; Bisrat, F.; Kidane, L.; Assres, M.; Tadesse, T.; Asegedew, B. (2019). Improvements in Polio Vaccination Status and Knowledge about Polio Vaccination in the CORE Group Polio Project Implementation Areas in Pastoralist and Semi-Pastoralist Regions in Ethiopia, Am. J. Trop. Med. Hyg., 101(Suppl 4), 2019, pp. 52–58.
Stamidis, K.V.; Bologna, L.; Bisrat, F.; Tadesse T.; Tessema F.; Kang, E. (2019). Trust, communication, and community networks: How the CORE Group Polio Project community volunteers led the fight against Polio in Ethiopia’s most at-risk areas trust. Am. J. Trop. Med. Hyg., 101(Suppl 4), 2019, pp. 59–67.
Bisrat, F. Endeavors to improve immunization uptake in Ethiopia [Editorial]. The Ethiopian Journal of Health Development, 33(Special issue).
Tadesse, T., Gelaw, B., Haile, Y., Bisrat, F., Kidanne, L., Asres, M., Asress, A., Asegdew, B. & Tessema F. (2019) Immunization service availability and readiness in primary health care in pastoral and semi-pastoral CGPP Ethiopia implementation districts. The Ethiopian Journal of Health Development, 33(Special issue).
Asres, M., Tessema, F. (2019) Contribution of plastic bags to the retention of child immunization cards in Gambella Region and Assosa Zone, Benishangul-Gumuz Region, Ethiopia. The Ethiopian Journal of Health Development, 33(Special issue).
Bisrat, F., Abdissa, S., Asres, M., Tadesse, T., Kidanne, L., Asegdew, B., Zeleke, S., Asress, A., Tessema, F. (2019) Healthcare workers readiness immunization services at primary health care units in pastoral and semi-pastoral regions in Ethiopia: CORE Group Polio Project implementation areas. The Ethiopian Journal of Health Development, 33(Special issue).
Kidanne, L., Solomon, M., Bisrat, F., Asres, M., Tadesse, T., Asress, A., Asegdew, B., Zeleke, S., Tessema, F. (2019) Child vaccination timing intervals and missed opportunities in pastoral and semi-pastoral areas in Ethiopia . The Ethiopian Journal of Health Development, 33(Special issue).
Asres, M., Wachiso, A., Bisrat, F., Tadesse, T., Kidanne, L., Asegdew, B., Asress, A., Tessema, F. (2019) Immunization service providers’ knowledge, attitude and practice in primary health care units in pastoral and semi-pastoral areas of Ethiopia: CORE Group Polio Project. The Ethiopian Journal of Health Development, 33(Special issue).
REPORTS AND RESOURCES
Integrating Community Volunteers and Health Extension Workers to Increase Scalability and Sustainability, 13th World Congress on Public Health World Health Organization 2012