Polio eradication - India: Reaching the Last Child

This was presented at the June 2004 UNICEF meeting dedicated to examining communication in the context of the final push to eradicate polio. The presentation provided an overview of the epidemiological history, current trends and risk factors in India, as well as the country-specific communication strategies.

As at May 15 2004, there have been 9 cases of wild polio virus in 2004, vs. a total of 225 in 2003. The profile of a typical polio case in 2003 was: 2 yrs old, Muslim, male, with a 50% chance of having 3 or fewer oral polio vaccine (OPV) doses. The communication strategy developed in 2004 was geared toward this high-risk population. An extensive analysis of supplementary immunisation activity (SIA) quality, including percentage of missed houses by region and routine immunisation rates, is included. Communication objectives are outlined, and quantifiable measures of success are identified. Extensive data regarding awareness and misconceptions about polio is provided. Advocacy and partnerships are identified, including the strategic use of celebrities. The mass media has been employed to influence family decisions, driven by extensive data regarding knowledge of polio sources.

Uttar Pradesh was the site of an extensive social mobilisation programme, which was a UNICEF initiative involving other partners such as Child Survival and Collaborations Resources Group (CORE) and Rotary. This programme included a 3-day community mobilisation coordinator (CMC) training course using child mapping, child participation, flip charts, local announcements at mosques, drumbeats, the formation of local social mobilisation groups and enrolling the support of local community leaders. Impact indicators assessed included booth coverage rates, child-house ratio and X to P conversion (acceptance) rates. Social mobilisation via CMC implementation is demonstrated to have a significant positive impact on immunisation rates.

Another communication innovation designed to reach families is a programme to "Brand India" - the application of social marketing practice to the development of IEC materials to develop a recognisable brand for polio communication in the country. Distinct challenges are identified in Bihar, where the acceptance of OPV is high but the population is harder to access, since it is more mobile and has a higher proportion of slum dwellers. The communication strategy in this region addresses local school committees. West Bengal is also specifically discussed.

Finally, the communication strategies are also integrating a routine immunisation emphasis, in anticipation of the successful eradication of polio.

Click here to download the full presentation as a PDF file.