Federal Communication Plan for Polio and EPI in Pakistan

This document was released by the United Nations Children's Fund (UNICEF) Pakistan country office and details the federal communication plan for polio eradication and the expanded programme on immunisation (EPI) for 2007. It underlines the need for intensive communication efforts in promoting routine immunisation (RI) and measles control, which in turn are used to support the efforts for polio eradication. Additionally, polio-specific communication interventions in high-risk areas are described in detail.

Background

According to this document, Pakistan launched the EPI programme in 1976 in an effort to strengthen overall immunisation coverage in all parts of the country, which in some areas remained as low as 2%. The programme struggled to maintain significant gains over the next two decades, leading to high numbers of emerging polio cases on a global scale. In 1994 the first National Immunisation Day (NID) for polio was held and a house-to-house service delivery strategy was implemented. This led to a drastic decrease in the number of polio cases, from 1,803 in 1993 to 53 in 2004. In 2005, the government of Pakistan committed to achieving global immunisation targets and launched the National EPI Policy and Strategy Guidelines for Pakistan, which addressed specific objectives including: interruption of poliovirus; reduction of measles mortality by 95%; and reduction of diphtheria, pertussis, hepatitis B, and childhood tuberculosis to a minimum level.

Assessment reports conducted on a national level indicated a high level of willingness in the general public to accept vaccination, but a low level of awareness about immunisation and how to access these services. This point highlighted the need for an improved communication strategy in order to strengthen immunisation efforts. Prior to 2004, communication activities were broad-based and did not take into account epidemiological, campaign, and social data. Over the past few years, activities such as NIDs have attained a high level of visibility and awareness as a result of an integrated communication campaign that has included mass media, advocacy, interpersonal communications (IPC), education materials, and social mobilisation. The use of these tools has been informed by data gathered from sources such as:

• Report on Assessment of Barriers to Immunisation Services in Pakistan
• Household Polio Knowledge Baseline Sample Survey (SoSec 2005)
• Impact Evaluation of Teeku Advertisements (Gallup 2005)

According to this plan, in 2007 the communication objectives for achieving polio eradication, attaining 95% measles campaign coverage, and strengthening routine immunisation included:

• Identifying remaining underserved populations or communities and intensifying eradication efforts to reach them.
• Increasing awareness of the importance of RI through mass and interpersonal communication.
• Involving religious, social, and civic partners in immunisation activities at all levels.

Key Strategic Components

According to this plan...

Campaign Support Materials:

Polio immunisation activities, in particular NIDs, require print materials - such as posters, banners, fliers, and other support materials - all carrying the Pakistan PEI logo and tag line in a uniform colour scheme. A 2005 survey gauging household knowledge indicated that 86% of respondents recognised this polio logo.

Routine immunisation and measles campaigns require similar print materials, all branded with the associated 'Teeku' branding scheme.

Mass Media Support:

It is estimated that mass media in Pakistan reaches over 80% of the population. Mass media is used extensively to promote polio campaigns and maintain RI awareness through newspapers, radio, and television. The campaigns often enlist the support of national celebrities and political and religious leaders to appeal to audience segments in local languages. The main source of immunisation messaging exposure is reported to be television.

Social Mobilisation:

The primary activities for district initiatives in addressing community involvement/partnerships include:

• Grassroots efforts for polio, measles, and routine immunisation campaigns through regular (monthly and pre-campaign) engagement of district-level political leadership and partnerships with civic, social, and religious persons, groups, and institutions.
• Engagement of key private sector partners, non-governmental organisations (NGOs), media, Nazims (local elected officials), councilors, religious leaders, relevant line ministries/ departments, private practitioners/ traditional healers/ medical students, and students of secondary schools.
• Recruitment of community members to participate as supervisors, vaccinators, and guides.
• Partnerships with schools – ‘Immunisation Friendly Schools’ to ensure immunisation of every eligible child.

The primary activities for increasing household knowledge and participation include:

• Engaging communities in dialogue about polio, measles, and routine immunisation through community/prayer meetings.
• Mobilisers and supervisors with strong IPC skills will inform families about the immunisation activities ahead of the campaign.

High-Risk District Approach:

Intensified social mobilisation support in the high-risk districts will be lead by a District Health Communications Support Officer (DHCSO), who will be responsible for social mobilisation support on a long-term basis for both polio and routine immunisation. In order to tailor communication services to ensure that all activities are appropriate and cover all areas, social mapping of target areas and resources, such as medical practitioners, mosques, and schools, will be conducted within each district.

This plan details additional strategic components, as well as a number of related communications activities set to take place in 2007. Planned monitoring and evaluation processes for these activities are also discussed. In conclusion, the plan recommends that a knowledge, attitudes, and practices (KAP) survey be conducted in two phases during 2007 in order to track the impact of the federal PEI and EPI communications plans on immunisation coverage in Pakistan.

For a copy of this plan, please contact UNICEF Pakistan as noted below.