{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T10:14:37Z","timestamp":1783851277610,"version":"3.55.0"},"reference-count":15,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2021,4,27]],"date-time":"2021-04-27T00:00:00Z","timestamp":1619481600000},"content-version":"unspecified","delay-in-days":26,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Mastercard Center for Inclusive Growth"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Glob Health"],"accepted":{"date-parts":[[2021,4,6]]},"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:p>After more than 30 years of efforts to eliminate polio, India was certified polio free by WHO in 2014. The final years prior to polio elimination were characterised by concentrated efforts to vaccinate hard-to-reach groups in the state of Uttar Pradesh, including migrant workers, religious minority Muslims and impoverished communities with poor pre-existing social support systems. This article aims to describe the management strategies employed by India to improve the deployment and acceptance of vaccines among hard-to-reach groups in Uttar Pradesh in the final years prior to polio elimination.<\/jats:p>\n               <jats:p>Three main management principles contributed to polio elimination among the hardest to reach in Uttar Pradesh: bundling of health services, local stakeholder engagement and accountability mechanisms for public health initiatives. In an effort to market the polio campaign as an authentic health-oriented programme, vaccine acceptance was improved by packaging other basic healthcare services such as routine check-ups and essential medications. India also prioritised local stakeholder engagement by using influential community leaders to reach vaccine hesitant groups. Lastly, the accountability mechanisms developed between non-profit organisations and decision-makers in the field ensured accurate reporting and identified deficiencies in healthcare worker training. The lessons learnt from India\u2019s polio vaccination programme have important implications for the implementation of future mass vaccination initiatives, particularly when trying to reach vulnerable communities.<\/jats:p>","DOI":"10.1136\/bmjgh-2021-005125","type":"journal-article","created":{"date-parts":[[2021,4,27]],"date-time":"2021-04-27T12:05:19Z","timestamp":1619525119000},"page":"e005125","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Overcoming vaccine deployment challenges among the hardest to reach: lessons from polio elimination in India"],"prefix":"10.1136","volume":"6","author":[{"given":"Alejandra","family":"Bellatin","sequence":"first","affiliation":[{"name":"University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azana","family":"Hyder","sequence":"additional","affiliation":[{"name":"Munk School of Global Affairs and Public Policy, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sampreeth","family":"Rao","sequence":"additional","affiliation":[{"name":"Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7981-4303","authenticated-orcid":false,"given":"Peter Chengming","family":"Zhang","sequence":"additional","affiliation":[{"name":"Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada"},{"name":"Rotman School of Management, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita M","family":"McGahan","sequence":"additional","affiliation":[{"name":"University of Toronto, Toronto, Ontario, Canada"},{"name":"Munk School of Global Affairs and Public Policy, University of Toronto, Toronto, Ontario, Canada"},{"name":"Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada"},{"name":"Rotman School of Management, University of Toronto, Toronto, Ontario, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,4,27]]},"reference":[{"key":"2025073014071319000_6.4.e005125.1","first-page":"881","article-title":"Eradicating poliomyelitis: India\"s journey from hyperendemic to polio-free status","volume":"137","author":"John","year":"2013","journal-title":"Indian J Med Res"},{"key":"2025073014071319000_6.4.e005125.2","first-page":"545","article-title":"Progress toward interruption of wild poliovirus transmission - worldwide, 2009","volume":"59","year":"2010","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2025073014071319000_6.4.e005125.3","doi-asserted-by":"publisher","DOI":"10.9745\/GHSP-D-12-00018"},{"key":"2025073014071319000_6.4.e005125.4","doi-asserted-by":"publisher","DOI":"10.4103\/2229-3485.106389"},{"key":"2025073014071319000_6.4.e005125.5","unstructured":"Government of India . 107 block plan: completing polio eradication in the remaining 107 blocks, 2009. Available: https:\/\/iple.unicef.in\/document\/the-107-block-plan [Accessed 9 Feb 2019]."},{"key":"2025073014071319000_6.4.e005125.6","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0115628"},{"key":"2025073014071319000_6.4.e005125.7","first-page":"963","article-title":"Deconstructing social resistance to pulse polio campaign in two North Indian districts","volume":"46","author":"Chaturvedi","year":"2009","journal-title":"Indian Pediatr"},{"key":"2025073014071319000_6.4.e005125.8","unstructured":"United Nations International Children\u2019s Emergency Fund . Eradicating polio: reaching out to moving populations. Lucknow: United Nations International Children\u2019s Emergency Fund. Available: https:\/\/iple.unicef.in\/files\/ckuploads\/files\/Polio%20eradication%20in%20UP%20-%20Moving%20Populations.pdf"},{"key":"2025073014071319000_6.4.e005125.9","first-page":"50","article-title":"Role of social mobilization (network) in polio eradication in India","volume":"53 Suppl 1","author":"Siddique","year":"2016","journal-title":"Indian Pediatr"},{"key":"2025073014071319000_6.4.e005125.10","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jix068"},{"key":"2025073014071319000_6.4.e005125.11","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-11-1"},{"key":"2025073014071319000_6.4.e005125.12","first-page":"73","article-title":"Polio eradication: overview of social mobilization through behavior change communication mix and interpersonal communication in India","volume":"15","author":"Goyal","year":"2015","journal-title":"J Serv Res"},{"key":"2025073014071319000_6.4.e005125.13","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiw593"},{"key":"2025073014071319000_6.4.e005125.14","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.18-0283"},{"key":"2025073014071319000_6.4.e005125.15","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.18-0916"}],"container-title":["BMJ Global Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjgh-2021-005125","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T21:07:18Z","timestamp":1753909638000},"score":1,"resource":{"primary":{"URL":"https:\/\/gh.bmj.com\/lookup\/doi\/10.1136\/bmjgh-2021-005125"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4]]},"references-count":15,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,4,27]]},"published-print":{"date-parts":[[2021,4]]}},"alternative-id":["10.1136\/bmjgh-2021-005125"],"URL":"https:\/\/doi.org\/10.1136\/bmjgh-2021-005125","relation":{},"ISSN":["2059-7908"],"issn-type":[{"value":"2059-7908","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4]]}}}