Ghana - Communication Consultant Report

Preparatory Phase Activities

Strengths

• A dedicated national Expanded Programme for Immunisation (EPI) manager and regional public health officials
• Presentation and discussions on communication management during a national micro planning training
• Regional/district communication planning meetings
• A national media/religious communication officers consultation meeting
• Creation of a Health Promotion Network with Ghana Health Communication Initiative and communication officers from religious institutions
• Development/adaptation/distribution of polio kits
• Joint planning with:
  
  • Ghana Association of Private Schools
  • Ministry of Women and Children
  • Commission for children
  • Ghana Private Road Transport Union
  • National Islamic Association for Peace, Democracy and Development
  • Allaharum Sunna Islamic Association
  • Executives of Ghana Education/Immigration Services and the Police
  • The traditional/religious leaders
• Joint advocacy activities with the Health Promotion Network members
• Orientation of the national supervisors prior to National Immunisation Days (NIDs)

Weaknesses

• Non-involvement of the Regional Health Promotion Officers in the national micro planning training
• An inadequately managed national ICC sub - committee on communication
• Failure to organise a feed back forum to update all allies of NIDs issues
• Inadequate involvement of all the religious leaders
• Inadequate polio kits produced and supplied
• Failure to implement all the media advocacy visits the health promotion network members recommended
• Failure to supervise vaccination teams/volunteers training to emphasise IPC skills for the teams/volunteers

Action Points

• Lobbied for their inclusion and have participated in the training for the 2nd round
• Efforts are under way to strengthen this sub-committee on communication
• Plans are under way to organise a similar consultation meeting in the North
• Some Polio kits have been distributed to the regions for reproduction and redistribution to the districts
• Plans are underway to meet the Health Promotion Team members prior to the 2nd Round of NIDs
• A UNICEF consultant is working on the distribution of polio kits to all the religious institutions

Microplanning Activities

Strengths

• Enumerating all known pockets of rejections and deciding communication strategy for each
• Advocacy plan and distribution of IEC materials in known pockets of rejections
• Resource allocation for district communication activities
• Review and adaptation of the national communication work plan and some regional ones
• Distribution of letters and consent forms to the parents of children in the known rejection schools
• Distribution of burners to all districts and sub district headquarters
• Identification of regional radios for intensive campaigns
• Development of public announcements in six languages
• Identification of "experienced" district supervisors for hard-to-convince communities
• One-to-one discussions and sensitisation with known anti polio activists

Weaknesses

• All children not immunised in rejection areas
• Inadequate advocacy with the executives of the local radio station to lobby for more free or subsidised airtime for EPI programmes
• A commitment by a religious leader (for example in Joskan community in Volta Region) cannot be pinned to commitment from followers

Action points

• Meetings have been planned with family doctors to lobby for their support for EPI programmes
• Approaches to the principals of the schools are under way to be addressed by the regional public health authorities
• The regional minister of Volta Region and the Regional Public Health Officer are exploring strategies to immunise all children in Joskan community

Organisational Aspects

Strengths

• Timely release of social mobilisation funds to all districts
• A pre NIDs assessment of the state of communication preparedness by the national supervisors/regional supervisors and district coordinators
• Development of distribution lists for all NIDs burners
• Involvement of district assembly members in the communication plans
• A well structured and followed advocacy plan
• Daily media monitoring of EPI activities by the Health Promotion Network members
• Some joint cross boarder communication activities

Weaknesses

• Full membership of the ICC sub committee on communication is yet to be achieved
• Some districts had inadequate communication work plans
• The pre NIDs and Intra NIDs assessment of the most effective communication interventions are not used to plan future communication plans. The 2nd Round communication intervention is based on "have done it before" knowledge
• A uniform allocation of communication funds to all districts could be unrealistic favoring some small ones while the big ones and densely populated ones remain under-served
• Inconsistent dates for the cascaded training

Action Points

• Some communication activities such as radio spots have already begun
• Intensified supervision of vaccination team/volunteers training has been planned to increase their IPC skills
• Intensified supervision of implementation of the 2nd Round of NIDs is also planned to intensify teams dissemination of EPI messages during NIDs
• Synchronise regional, district and vaccination team training

Implementation

Strengths

• Greater Accra Regional NIDs launching by the Hon. Minister of Women and Children
• Regional launching of NIDs in some regions
• Intensified radio announcements relating to the NIDs in local languages
• Interviews with BBC World Service Radio, the Canadian Post and the local media
• Use of PA systems and loud speakers prior to arrival of teams in some communities
• Intensified public announcements in the religious institutions
• Static immunisation centers at religious institutions
• Use of a "Super Check" system to monitor the quality of NIDs
• Intensified reminders to the teams to disseminate messages relating to immunisation during the house-to-house activities
• Intensified supervision of vaccination teams/volunteers activities
• Prompt response to communities with missed children (rapid assessment) and rejection areas
• Participation by some district assembly members especially in Greater Accra Region
• Field orientation of vaccination teams/volunteers on the dissemination of key images during NIDs
• Supervisors' participation in the dissemination of key information to caregivers during NIDs

Weaknesses

• Some inaccessible communities due to heavy rains in Volta (off bank communities) and Eastern regions (Afram Plains)
• Inadequate knowledge about the quality and effectiveness of the communication interventions in the flooded areas
• Inadequate dissemination of the EPI messages by the teams during NIDs
• Inadequate supervision of the implementation exercise
• Inadequate involvement of the political leaders in many areas due to the current competing priorities
• Inadequate PA systems in the districts
• Only one region used the "Super Check" system
• Inconsistent messages given in Central Region relating to ITNs

Action Points

• Regional teams have plans to try and immunise prior to the second round and plan to conduct the 2nd Round in December for those missed communities
• District Health teams have been encouraged to lobby for more support to communication activities from their respective district assemblies and district coordinating councils
• Timely commencement of communication activities
• Sustain EPI communication activities outside the NIDs

Follow Up

Strengths

• Sustain the involvement of religious and traditional leaders in EPI programmes by holding a biannual meetings with them
• Institutionalising health talks in religious programmes
• Intensify IPC training for community health nurses
• Regularise training for community volunteers on AFP detection and prompt reporting processes
• Expansion and regular supervision of outreach programmes to strengthen routine immunisation
• Sustain the involvement of the Health Promotion Network in the EPI activities by holding a biannual meeting with them for regular health programmes and prior to and after each round of NIDs
• Strengthen the ICC sub committee on communication through continuous lobbying for support at each level
• Support and participate in GAVI Polio primary school competitions organised by Greater Accra Region and the "Right to Play"
• Produce generic polio kits for advocacy activities
• Monitor plans of immunising the missed off bank communities in Volta Region and Afram Plains
• Intensify vaccination teams/volunteers supervision and training activities
• Continuous monitoring of the media and rumors
• Awaiting dates to meet the family doctors of expatriate communities, Apostolic church leadership in Accra
• Intensive advocacy activities are underway

Action Points

• Discussions under way with partners for reinstitution of the ICC sub committee on communication
• Facilitation to hold the Health Promotion Network feed back meeting and the religious/traditional leaders meeting

Budget

• $10,000 (production of NIDs fliers)
• Regional/district contributions

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