Social Mobilisation/Communication Polio Eradication Partnership - Nigeria

The involvement of religious and traditional leaders is a key strategy in the advocacy component of this communication initiative. At the state level, Emirs (Islamic rulers, chiefs, or commanders) have been contacted to seek support for vaccination messages and programme goals. From the state level down through the Local Government Authority (LGA, or traditional 'District') to Ward and Village Heads, advocacy activities include "sensitisation meetings" with local religious and traditional leaders.

Mass media is another programme approach. 'Flag-offs' (campaign inauguration ceremonies) are held at the start of each new campaign round and occasionally covered by local print and/or TV channels. Throughout a round of NIDs/SNIDs, radio and television are the central media used; communication largely takes the form of 'jingles' (or 'spots'). While there is TV work, ownership outside major urban centres is extremely limited. Thus, in light of the facts that 1) radio ownership is estimated at between 25% and 80% of households, 2) radio is an effective medium among rural Nigerians, and 3) radio is a trusted and cost-effective source of information, radio is considered to be the major avenue for mass local programme communication. Radio jingles are produced (and occasionally modified or reproduced at the LGA level) in four local languages (Hausa, Igbo, Yoruba and Fulani). These spots consist, in most cases, in a short drama trialogue.

The production of printed IEC materials is also used to disseminate information about vaccination and to advocate for participation. Large numbers of several different poster designs are delivered at or shortly before the start of each round of NIDs/SNIDs, at which time they are posted on the vehicles engaged in transporting teams during the campaign and on a variety of public sites. However, posters are more or less non-existent in rural areas, due to issues such as the difficulty of posting on adobe surfaces. Printed flyers have also been produced.

Interpersonal communication is also used as a communication tool here. For Nigerian NIDs/SNIDs, a vaccinator team (VT) comprises two people - ideally, one male and one female. The male, locally recruited through Village Heads in the planned area being addressed, acts as 'guide'; the female (with more reliable cultural access to households), is recruited through the Primary Health Coordinator to act as vaccinator. To varying degrees, VTs receive technical and social mobilisation training, as per the "cascade approach" developed by USAID's Basic Support for Institutionalizing Child Survival (BASICS). In some areas, town criers have also been engaged and trained.

Immunisation & Vaccines, Health, Children.

National activities for polio eradication started in Nigeria in 1996. NIDs/SNIDs were initiated in this country in 1998; between 1998 and late 2002 there were 19 NIDs/SNIDs in Nigeria. The number of wild polio virus (WPV) cases in 31 states in 1999 (981 cases) dropped to 174 cases in 15 states in 2002.

An evaluation of the Nigerian SM/C activities summarised here, which was conducted in 2003 (please see contact information below to request a copy), found that "Through analysis of 'resistance', and random household sampling during the November 2002 round, it is possible to suggest that perhaps the major constraint on PEI performance is the skills and behaviour of the VTs rather than the disposition of the recipients. In spite of repeated reports...of mass, organised resistance (in some cases up to 80% of entire communities, or whole schools reported resistant), very little in the way of such mass organised protest could be discovered. More frequently, the VT had simply failed to explain its purpose, or to visit all houses, or to investigate all children in a house, or to secure permission prior to entering a school, or to answer the perfectly legitimate and often rational questions of potential OPV end-users...If one of the key remaining obstacles in PEI is a communications failure on the part of vaccinators at the household level, then vaccinators need to be better trained in communication."