In response to the continued circulation of vaccine-derived poliovirus (cVDPV) in neighboring countries, Botswana implemented two rounds of Polio Supplementary Immunization Activities (SIAs) to strengthen population immunity and protect its polio-free status. The campaign was prompted by identified immunity gaps among children, sub-optimal surveillance indicators, declining routine immunization coverage in some districts, and the presence of zero-dose children who had not received any vaccinations.
Extensive preparations were undertaken to ensure a successful campaign. Districts updated microplans to identify target populations and hard-to-reach settlements, while resources were mobilized through collaboration between the Ministry of Health MoH), Ministry of Local Government and Traditional Affairs (MLGTA) and partners, including WHO and UNICEF. Health workers, supervisors, and data managers received comprehensive training, and cold chain systems were strengthened to guarantee vaccine potency. Logistics arrangements ensured timely distribution of vaccines and supplies, supported by strong coordination mechanisms and dedicated subcommittees overseeing operations, logistics, surveillance, communication, monitoring, and finance.
During implementation, vaccination teams worked across the country to reach eligible children in the health facilities, homes, pre-schools and preschools and other transit sites. Real time monitoring using the Open Data Kit (ODK) platforms was done and rapid corrective actions where gaps were identified. Effective vaccine management procedures ensured accountability and minimized wastage, while transport support enabled teams to access remote communities. Independent monitoring provided valuable feedback on coverage and helped identify missed children for immediate follow-up vaccination.
Post-campaign evaluations demonstrated the impact of the intervention. Analysis of administrative and monitoring data showed improved performance between the first and second rounds, reflecting the success of targeted corrective measures. Administrative coverage increased across most districts, Independent Monitoring (IM) results showed a reduction in missed children and improved awareness of the campaign. Lot Quality Assurance Sampling (LQAS) findings further confirmed enhanced campaign quality, with more districts achieving the accepted performance threshold in Round 2 compared with Round 1.
Importantly, the campaign also strengthened routine immunization and vaccine-preventable disease surveillance systems by identifying zero-dose and under-vaccinated children, Acute Flaccid Paralysis cases and linking them to routine services.
The Botswana Polio SIAs showcased the power of collaboration, careful planning, and real-time monitoring in protecting children from preventable diseases. Beyond increasing immunity against polio, the campaign strengthened health systems, surveillance, and community engagement, leaving a lasting legacy for future public health interventions.
