UNICEF - Lessons Learned: Communication for Polio Eradication

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The Polio Eradication Initiative

Goals:

• by the end of 2002
  
  Global interruption of polio virus transmission
• by the end of 2005
  
  Certification of global polio eradication

The Mid-Year Meeting on communication for PE, June 2001

Objectives

• Sustain & reinforce collaboration among partners
• Share lessons learned
• Review & update the 2001 joint workplans

Focus of the Mid-Year Meeting: “Reaching the unreached child”

Epidemiological update on PEI implementation:

• Substantial progress, but virus persists in some areas because part of population is unreached of under-serviced by PEI
• Minority groups are at risk

Lessons learned from a communication perspective

Accessing hard-to-reach

Identify & understand reasons

~ Conduct rapid assessments to answer questions such as WHO is not coming, WHY are they not coming, WHERE are they located

Involve community leaders from unreached communities & build ongoing relationships with religious leaders, medical staff, media & other social groups

~ Involve them in research process

~ Involve them in decision making process

~ Motivate them to motivate others in community

Focus on service-providers

~ Bear in mind gender, religion and ethnicity of those approaching caretakers

~ Train service providers in basic IPC skills

Remind them to:

• Be nice to the caretakers (CT)
• Ask CT is they know what vaccine is for
• Tell CT vaccine does not replace routine imm.
• Encourage CT to talk to neighbours about importance to take their children for vaccination

Reach hard-to-reach through their own communication channels

~ Identify com. channels:mass, group, one/one

~ Involve community to determine tone & appeal (what can motivate others)

~ Timely disseminate consistent information to targeted audiences

~ Let community conduct monitoring & assessment of effectiveness of messages

Dealing efficiently with rumours

~ Identify source & understand reasons

~ Give immediate & ongoing response using all possible channels:media, church, mosque, youth association, community assembly…

~ Advocate & build alliances with opinion leaders & those responsible for rumours and misconceptions (personal visits, invitations to official NIDs launching, lobby by influential persons of community…)

~Educate media people on polio issues, in order to demystify the sensationalism that misinformation can create

Communication strategies in conflict countries

Days of tranquillity are not always reliable, therefore it is recommended:

~ To work with permanent staff who live in targeted areas

~ To build up relationships with NGOs having access

~ To establish working relationship with all warring factions leaders

~ To give credit to those who helped in facilitating access

Cross-border / synchronised NIDs

Improve communication & co-operation between partners across borders by:

~Avoiding large number of overlapping meetings

~ Conducting local assessment for a better knowledge of targeted cross-border areas / population / their communication channels

~ Assessing opportunities/weaknesses in common communication activities

~ Stimulating EPI & communication teams to work closely together during all phases of synchronised NIDs

Micro planning

Community-based approach will stimulate community participation and ownership

Provide training in how to do micro planning at all levels

Training in map reading and interpretation should be provided to identified staff and service providers

Social mobilisation & comm. interventions need to be integrated within microplans

Specific social mobilisation activities have to be put in place for the hard-to-reach

Social mobilisation cannot overcome shortfall in effective micro planning, supervision and monitoring

Dealing with polio outbreaks

Avoid rumours

Information sent to media and public should be continuos, straigthforward and regularly updated

Build alliances

~ With community and religious leaders (personal visits, invitations to official NIDs launching, lobby by influential persons of community)

~ Organise workhops with media, medical staff, community leaders to strengthen commitment and ownership

Monitor communication activities and integrate findings in workplan

Maintain high routine immunisation coverage

Maintain high AFP surveillance levels and OPV coverage

Vaccine Derived Polio Virus (VDPV) is of concern

~ Avoid misinformation through educating selected & influential journalists to cover polio issues

~ Alliance building through continued and straigthforward information

~ Openness recommended concerning weather stopping immunisation after polio eradication or not / Unified standpoint of polio partners is needed

Community based surveillance

Surveillance needs to be done at household and community level

~ Obtain commitment of the government health team

~ Obtain commitment of volunteers linked to community participation

~ Build a positive relationship between health team and volunteers

~Focus on quality and quantity of the training of volunteers

~A code of conduct for surveillance officers is needed to be fully implemented in all countries, using data and holding them accountable for working with communities

~ Involve traditional healers

~ Integrate within surveillance system other occurrences/diseases relevant to communities

~ Regular supervision necessary

~ System of rewards is recommended

~ Particular attention is needed not to miss AFP cases in pre-walking children

Monitoring communication interventions: indicators & meth.

Develop more effective communication materials and social mobilisation methods on the basis of solid and participatory research

Develop client-friendly approach

Outline the importance of service providers in building fruitful interpersonal relationship with caretakers to promote vaccination

Integrate at least three of the following indicators within NIDs planning and review, in order to measure process & impact of communication interventions:

• Percentage of caretakers of infants under 1 year who know correctly when next immunisation is due;
• Percentage of caretakers of infants under 1 year who know the number of visits needed to complete childhood immunisation;
• Percentage of caretakers of infants under 1 year who know where to take their baby for routine immunisation;
• Percentage of caretakers at NIDs knowing that NIDs do not replace routine immunisation;
• Percentage of caretakers at NIDs that are advised about routine immunisation during NIDs;
• Percentage of district/sub-district plans that map resistant or difficult groups, including “zero dose” children, and propose strategies for reaching them;
• Percentage of vaccinators who know how to recognise AFP and where such a case should re reported;
• Percentage of vaccinators who can correctly explain how to interpret and use VVMs on polio vaccine vials.

Polio, Immunisation plus/ GAVI linkage and integration communication implications at regional and country level

Avoid fragmentation through closer integration between GAVI. EPI and polio eradication

Integrate a strategic and participatory communication approach within GAVI

Share lessons learned, tools and outcomes with partners

For more information contact: Thilly De Bodt - tdebodt@unicef.org