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.This is the publisher’s final pdf. The published article is copyrighted by the author(s) and published by Oxford University Press on behalf of the Infectious Diseases Society of America. The published article can be found at: http://jid.oxfordjournals.org/.Keywords: health systems, eradication, poliomyelitis, routine immunizatio
