Understanding barriers to stool adequacy: results from a programmatic assessment of Pakistan's acute flaccid paralysis active surveillance system in 12 priority districts

The assessment exposed gaps in AFP surveillance knowledge for some health facility staff, especially nurses and other paramedical or support professionals. Recommendations to improve the AFP surveillance system include monitoring and encouraging compliance with systematically scheduled health facility visits, increasing the frequency of AFP surveillance orientations, including paramedical professionals in AFP surveillance training, and developing a comprehensive messaging plan to increase knowledge about prompt reporting of AFP among healthcare providers and the public.