Data Sources in Polio Eradication

SVEA CLOSSER: Hi. My name is Svea Closser, and I’m a professor at the Johns Hopkins Bloomberg School of Public Health. Today, we’re going to be talking about how Polio decision makers use data. This is a really interesting topic because the Polio program has actually collected more health data about populations than probably any other public health project in history. And the ways that they use this data are actually really fascinating. So to start, we’re going to walk through the different kinds of data that people in polio eradication use. And there’s a huge number of different data sources that they draw from.

And bear with me a little bit as we get into the weeds on these because some of them are a little unconventional, and they’re potentially really useful for other health programs as well. Now other health programs have sometimes really use these data sources to their advantage, sometimes they haven’t. But understanding the ways that polio eradication has used data can be really useful in thinking about how to make decisions and health programs. So we’re going to start by watching a short video about eliminating polio in the Kosi River Basin. And quick heads up, this video is not about data, but I have some data questions I want you to think about as you watch the video.

So particularly, a few questions I want you to think about is if you were working in the Kosi River Basin trying to eliminate polio, what data would you need to collect in order to understand what kind of impacts you were having? How would you collect it and how would you use it? And as you’ll see from the video, these are actually pretty complex questions.

SPEAKER 2: It’s A long, hot walk to Tilkeshwar Village, but it’s easier than it used to be. [FOREIGN LANGUAGE]

Back in 2009, Martha was trying to help end polio transmission in the vast Kosi River Basin in Northeast India. At the time, it was a sanctuary for polio virus. There were huge challenges. With few roads, health staff spent hours walking in and out of the area each day. In the wet season, rain and snow melt from Nepal turned these planes into a dangerous inland ocean. And in the dry season, families spread far from the villages and roads to claim new plots of land to farm. For Martha, reaching them in a day was impossible. And when she did, families didn’t know her or the polio vaccine. [FOREIGN LANGUAGE]

Up to 20% of kids in the area were being missed. The polio partners knew they had to make changes fast. So they established places health staff could sleep and work in the villages, eliminating the hours long journey in and out. This meant Martha could stay in the community longer and get to know the families better. [FOREIGN LANGUAGE]

The changes resulted in thousands more children protected. Within two years, there was no more polio in the Kosi River Basin or in India. [FOREIGN LANGUAGE]

Today, Martha continues her work to ensure every child receives the polio and other routine vaccines. Women are also receiving antenatal care. The Kosi River Basin remains a remote, challenging area, but the innovative effort to end polio here has left a legacy of community trust in health workers like Martha.

SVEA CLOSSER: So as this example shows, collecting data on populations and the process of eliminating polio is actually quite complicated. In the Kosi River example, you’ve got populations that are not staying in one place, that kids may be moving around, they don’t have a stable address. And yet, you’re still trying to track vaccination coverage. You’re trying to know who got polio vaccine and who didn’t. You’re trying to know what coverage rates are in different populations that are constantly on the move. So these are some of the challenges that polio eradication have had to deal with. Hopefully you came up with some ideas about some of the data you might collect.

Let’s compare your answers to this question to what data is actually used in polio eradication. Today, we’re going to cover two fairly straightforward things. First, we’re going to talk about important data sources and polio eradication. Then the next, we’ll think about how this data is actually used to make decisions. So data used in polio eradication comes from a huge number of different sources. And these data sources are how polio eradication officials understand their process of implementation. In a way, these data sources are how those within polio eradication do implementation science. These data are used to track polio spread, to understand vaccination coverage, in other words, to understand how the polio program is working or not.

And although many of these data sources are to some degree standardized across the world, to collect them requires context specific strategies. Today, we’re going to look at several different kinds of data used in polio eradication. We’re going to look at data from the AFP surveillance system. We’re going to look at data collected on campaigns or supplementary immunization activities. We’re going to look at data around social mobilization, or what people think about polio vaccine and whether they’re children recovered. And we’ll look at other types of data as well.