Volume 101 Number 4_Suppl
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



This article describes the functionality and effectiveness of a community-based acute flaccid paralysis (AFP) surveillance system designed and implemented by the CORE Group Polio Project (CGPP) in conflict-affected and inaccessible areas of South Sudan between October 2015 and September 2017. The findings are based on interviews with key informants and focus group discussions as well as data from the CGPP and the management information system of the WHO. Through the implementing partners, the CGPP identified and built the capacity of the community-based surveillance (CBS) system, a system consisting of county supervisors, payam (sub-county) assistants, and community key informants. This structure played a critical role in the identification and reporting of AFP cases. The CGPP also established partnerships with other key players–local and international–to reach greater numbers of people, particularly displaced populations. Evaluation findings show an increase from 0.0% to 56.4% of cases reported through the CBS system between January 2016 and June 2017, and 80.0% of the cases reported within WHO standards of 24–48 hours were through the CBS system, whereas 20.0% were through the facility-based system. The CBS system also recorded an increase from 36.0% in 2014 to 92.0% in December 2016 for the number of counties that were reporting AFP. A CBS system is, therefore, a valuable complement to facility-based surveillance in insecure environments or where the population has limited access to facilities. Community-based surveillance systems also have the potential to identify cases of other infectious diseases of public health importance.

[open-access] This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


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  1. UNOCHA, 2018. South Sudan. Available at: https://www.unocha.org/south-sudan/. Accessed February 7, 2019. [Google Scholar]
  2. World Health Organization, 2014. South Sudan Polio Updates (Weekly Surveillance Update No. 12). Juba, South Sudan: WHO, 2224. [Google Scholar]
  3. World Health Organization, 2015. South Sudan Polio Updates (Weekly Surveillance Update No. 15). Juba, South Sudan: WHO, 2022. [Google Scholar]
  4. World Health Organization, 2016. South Sudan–GPEI. Available at: http://polioeradication.org/where-we-work/south-sudan/. Accessed February 7, 2019. [Google Scholar]
  5. WHO EMRO, 2018. WHO EMRO Polio Eradication Initiative South Sudan. Available at: http://www.emro.who.inthb/polio/countries/south-sudan.html. Accessed February 6, 2019. [Google Scholar]
  6. Wassilak S, Orenstein W, , 2010. Challenges faced by the global polio eradication initiative. Expert Rev Vaccines 9: 447449. [Google Scholar]
  7. Losey L, 2019. The CORE Group Polio Project: an overview of its history and its contributions to the global polio eradication initiative. Am J Trop Med Hyg 101 (Suppl 4): 414. [Google Scholar]
  8. Ratnayake R, 2016. Assessment of community event–based surveillance for Ebola virus disease, Sierra Leone, 2015. Emerg Infect Dis 22: 14311437. [Google Scholar]
  9. Stamidis K, Bologna L, Losey L, , 2018. CORE Group Polio Project (CGPP) Final Evaluation Report 2017. Available at: https://coregroup.org/wp-content/uploads/2018/06/CGPP-Evaluation-Report-FINAL-5-10-2018.pdf. Accessed February 7, 2019. [Google Scholar]
  10. Nsubuga P, 2006. Public Health Surveillance: A Tool for Targeting and Monitoring Interventions. Washington, DC: The World Bank and Oxford University Press. [Google Scholar]
  11. Oum S, Chandramohan D, Cairncross S, , 2005. Community-based surveillance: a pilot study from rural Cambodia. Trop Med Int Health 10: 689697. [Google Scholar]
  12. Baatiema L, Sumah AM, Tang PN, Ganle JK, , 2016. Community health workers in Ghana: the need for greater policy attention. BMJ Glob Health 1: e000141. [Google Scholar]
  13. Pallares G, , 2018. How South Sudan Stopped Guinea Worm Disease in its Tracks. Available at: https://www.devex.com/news/q-a-how-south-sudan-stopped-guinea-worm-disease-in-its-tracks-92414. Accessed February 4, 2019. [Google Scholar]
  14. Mbabazi W, Lako AK, Ngemera D, Laku R, Yehia M, Nshakira N, , 2013. Maiden immunization coverage survey in the republic of South Sudan: a cross-sectional study providing baselines for future performance measurement. Pan Afr Med J 16: 110. [Google Scholar]

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  • Received : 08 Feb 2019
  • Accepted : 06 Mar 2019
  • Published online : 03 Oct 2019

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